Tuesday September 27th 2016

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Treating addiction in mothers with young children: INTERVIEW with NCADD Phoenix

Addiction treatment for moms

Mothers are some of the strongest people on Earth. They can carry the world on their shoulders. But they are also human.

Turning to drugs or alcohol can turn your world upside-down. Addiction will affect you, your children, and your family. So, what steps do women need to take to get sober (especially mothers), when they are struggling with substance abuse? How can mothers get help? And what does that help look like?

Help for pregnant or new mothers

Today, we talk with Holly Williamson, Clinical Director of NCADD Phoenix She tells us about treatment options (and barriers) for mothers and pregnant women. We also hope to raise awareness about the challenges that women with children face in their fight with addiction.

More details about¬†treating addiction in mothers with young children in the following interview. Then, feel free to ask your personal questions (or share your story) in the comments section below. We’ll do our best to provide you with a quick, individual response.

ADDICTION BLOG: How can mothers get help for addiction?
Where can they go?
Is assistance provided by social services?
What are the steps a mom can take to get help… anywhere in the country?

NCADD PHOENIX: Mothers often struggle with disclosing their challenges with addiction, in large part due to the stigma associated with such a struggle. Fortunately, there are many options for help. Assistance to address addiction can come in many forms.

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1. The first and most critical step a mother needs to take is to ask for help. She can do this through her primary care physician, through local self help groups (12 step programs, SMART Recovery, Celebrate Recovery, and others), and of course through a host of treatment options.

2. Addiction treatment can be provided at many different levels – from weekly individual counseling to long term, intensive residential treatment. The right treatment intervention is assessed when a mother works with a treatment provider to have an assessment completed.

3. Treatment is available for a mother from any walk of life, class, race, creed, and citizenship status. Depending on her individual circumstances, treatment options can be found to help. Our national office has a help line that can help a mother connect to a local NCADD affiliate who can direct to the array of treatment services that might be available in her area. Our HOPE LINE is 1-800-NCA-CALL (800-622-2255). A link to connect to the database can be found here: https://ncadd.org/get-help

4. Also, NCADD’s national website can assist those in need in getting navigated to services specific to the area/region the person is in. In Maricopa County, there are several residential treatment programs that accept women and their children. Depending on the program, there can be age limits on the children that can come into the treatment setting. However, there are other important community resources that can help overcome such a barrier – for example, Crisis Nursery in the Phoenix area.

ADDICTION BLOG: If a women is drug or alcohol addicted AND PREGNANT, what can she do to decrease the dangers of harming the unborn baby?

NCADD PHOENIX: First and foremost, get treatment. Addiction treatment for women is available all over the U.S.

Advocates can help a woman navigate the treatment process.

Also, be sure to get prenatal care and strive to be honest with medical professionals. They can help guide a woman on the best steps to take to stop using.

It is important for a woman to know that whatever she is putting in her body – food, drugs, alcohol, etc. – her baby is also exposed to that substance. So, if she experiences withdrawal, her baby also experiences the same. She needs to have a medical professional help her establish what steps to take to stop using. All of this requires reaching out for help, which is the best thing she can do reduce the chances of harming her unborn baby.

ADDICTION BLOG: Mothers need to know that there IS A WAY, and that there is help for them to raise healthy and happy children, despite the fight with addiction. Would you like to share a success story with us?

NCADD PHOENIX: We have many success stories. Here is one testimonial:

My story begins with a childhood of trauma, drugs and domestic violence. I was born into a lifestyle of chaos and homelessness. I had no parental guidance, my mother was on drugs and was unmedicated for her mental illnesses. I witnessed things I will never forget as a child, things that are embedded in me forever.

I ended up addicted to drugs myself at 14. It was a long road ahead; I had behaviors so ingrained in me that I knew no other way or how to even start to get out. I was a teen mom; I was stripping to make money for drugs and became involved in criminal acts. I was doing the same behaviors I saw my own mother do, the cycle had repeated itself.

I went as hard and fast as I could. Trying every day to drown my sorrows in alcohol or smoke and snort my way to emotional freedom. That only lasted so long before my life started crashing down on me. Getting high was no longer fun, it was now a chore. I felt ugly inside every day, extreme guilt for what I was putting my son through and useless. In my mind, I deserved pain, which led me to an abusive criminal where I got pregnant again. By the time I was 20 I was addicted to heroin, meth, pain pills and ecstacy. Some days I hoped I would die from doing so much.

I knew I had a problem for a long time. The drugs had such a hold on me that part of me wanted out but more of me didn’t want to stop. Giving birth to my daughter was life changing for the best. Although I hoped and prayed she would be enough for me to quit, sadly, she wasn’t. CPS (now DCS) got involved due to a meth psychosis and I was referred to NCADD in 2011.

Treatment was new to me. Sitting in groups made me feel embarrassed, I did not talk much but I picked up on others’ happiness, even with a few months sober and wanted it. I graduated after 9 months or so. I was not working an outside program and did not stay in touch with my support system so eventually I relapsed. Somehow I found my way back and NCADD and was surprisingly welcomed with open arms. The staff that did remember me placed no judgment on me. They told me I could do it this time around, that I was worth it.

I was even more damaged this time around. I will never forget the day I surrendered, that if I did not do this, I knew I might not make it much longer out there. I decided I would give treatment a shot. I knew I was dying inside and I have my 2 kids looking to me for love that I had no idea how to give.

Treatment was in groups, one-on-ones and case management all helped me stay accountable for my actions, while teaching me to trust and love again. I was given opportunities to re-write the story of my childhood and start over. NCADD truly cares for the women who come in. With all of our behaviors, and when they’re doing well and when they aren’t 100%.

As a woman who struggled with trusting women, I started to depend on my sisters and the staff. I wasn’t being abused anymore. From there, my recovery flourished, and as a result of all the work on myself I now have an undeniable bond with my daughter. I see her and hope that with a stable mother she will never walk the road I was traveling but see a strong and loving mother who is responsible and who she can depend on. I am her role model.

After I did 2 years in intensive treatment, my life has meaning. You get what you put into treatment and how much your willing to work. I wanted it so badly the second time that I was willing to take suggestions from the women around me.

If it wasn’t for a program like NCADD, I wouldn’t be where I am, that’s without a doubt. I realized a long time ago I could not do it on my own and now I have dependable women that walk beside me, supporting me and showing me the way. My traumas are still there, but now I have coping skills I was taught to maintain stability when they surface, or when I am triggered. Simple things like picking up the phone and reaching out make sense to me now. Before, my ego would keep me from doing this.

I am proud to say I am 3 years free of any and all mind altering substances. I work full time and am a parent full time. I have worked hard with the foundation that I built. With the women who have encouraged me, I am succeeding. I still turn to my supports, my case managers, and my counselors when needed and NCADD is a big blessing in my life. They didn’t let me face my demons alone, and for that I will forever be grateful to the agency and the staff.

ADDICTION BLOG: What kinds of services are out there for pregnant women? Are there specialized social programs helping these women to stay sober and deliver a healthy baby?

NCADD PHOENIX: This is an area in addiction treatment where we perhaps see the most stigmatization. Expectant mothers who abuse alcohol and drugs often avoid help out of fear that they will be judged or that they could lose their child when the baby is born. This often leads women to avoid the very places that can be most helpful.

Many treatment programs offer services for pregnant women. NCADD Phoenix offers an intensive case management service for pregnant women called Healthy Connections for Moms to Be. The purpose of this program is to provide pregnant women with supportive services that can help them deliver a healthy baby.

Often, when women come to Healthy Connections, they have received no prenatal care out of fear and avoidance. The sooner a pregnant mom can stop using during a pregnancy, the better it is for both mom and the baby. Our goal is to help mom deliver a healthy and happy baby. Our case managers walk through each step of the pregnancy with mom as an advocate. Case managers attend prenatal appointments with mom if she would like and have even been at some deliveries.

We strive to connect pregnant women to the array of services that are available to them in the Phoenix area. We collaborate with many other women’s treatment providers to help women connect to a comprehensive array of services. This may include:

  • long-term, residential treatment
  • supportive housing
  • connecting with an OBGYN

Having a baby is a daunting process in and of itself, so combining struggles with addiction with this process can be incredibly overwhelming. We strive to make the recovery process for a pregnant woman as accessible and supportive as possible. We wish to be a port in the storm for each woman who walks through our doors.

ADDICTION BLOG: What are the challenges that pregnant women face in maintaining long-term sobriety? Also, what typically happens regarding addiction treatment after delivery?

NCADD PHOENIX: Pregnant women face similar challenges in maintaining long-term sobriety as other mothers and newly recovering individuals. However, newly post-partum women are vulnerable to post-partum depression, which has challenging symptoms associated with it. This can make a woman especially vulnerable to relapse, much like any individual who struggles with co-occurring mental health challenges and addiction.

Also, being a new mother is a high stress time. Women are sleep deprived as they strive to care for a new baby. That’s why our supportive case management continues until six months after delivery. Treatment doesn’t stop when she delivers.

ADDICTION BLOG: We understand that NCADD use strengths based case management approach to help pregnant women. Can you tell us something more about this approach, what is the process and what are the goals?

NCADD PHOENIX: We recognize that pregnant women are especially vulnerable to stigmatization. In addition to this, their own internal, critical voice is often even more negative than those that stigmatize pregnant women. As such, using an approach that focuses on all that is negative and wrong in an individual’s life is counter to the outcomes we hope to achieve.

Every person, no matter how much they struggle in a given moment, has strengths. However, it is critical that they be able to identify what those strengths are so that they can draw on them to get to where they wish to go. This notion is at the heart of a strengths based approach to treatment. Just because someone has addiction, doesn’t mean that they are not a full, multidimensional person beyond struggling with a disease. For example, someone with diabetes also has strengths to draw on to treat their illness. The same holds true for someone who has addiction.

ADDICTION BLOG: Are there any other best practice approaches in treating pregnant women? How these programs differ compared to treatment for mothers with children?

NCADD PHOENIX: A great resource to better understand best practice approaches for different women is the Addiction Technology Transfer Center Network (ATTC).

As for differences in treatment for women pregnant women in comparison to treating mothers with children, it is primarily context specific. For pregnant women, early intervention and a healthy and safe pregnancy are the priority. This may call for a combination of harm reduction and strengths based approaches.

However, the same approaches might be utilized, but catered to an actively parenting mom. Therapeutic models might include motivational interviewing techniques and other person-centered approaches. These approaches can be found in many evidence based therapeutic models.

At NCADD Phoenix, we are inclined to utilize therapeutic approaches that are relationship centered and gender specific (see Dr. Stephanie Covington for more on particular curricula) Link to ATTC/SAMSHA information: http://www.attcnetwork.org/learn/topics/women/treatment.asp

ADDICTION BLOG: Are there any limitations in treatment for pregnant women? If yes, how can they be overcome?

NCADD PHOENIX: There are often barriers to treatment. As I have highlighted throughout this interview, for pregnant women, stigma is likely the chief amongst them. Stigma makes it difficult for the community to simultaneously acknowledge that pregnant women of all walks of life might struggle with the disease of addiction and for the woman struggling to acknowledge her own struggle or seek out help.

Denial is a common feature of the disease of addiction. This is not only true for the addict who is in the midst of the illness, but also of the community surrounding the addict. In the history of substance abuse treatment, it has been incredibly difficult for society to accept that an individual can be a woman, along with the many roles that she holds as a woman – mother, daughter, expecting mother, sister, etc. – and an addict. As such, society is inclined to either ignore that a pregnant woman is an addict or they are inclined to stereotype her. Both positions are counter to the solution, which is to seek help and treatment.

ADDICTION BLOG: What would you say are the differences between male and female addicts , in terms of specific needs during treatment and how they respond to treatment?

NCADD PHOENIX: Differences in gender roles calls for differences in treatment approaches. Long term treatment that focuses on relational connections and community seems to be the best treatment environment for women to recover in. Women appreciate a treatment community they can connect to and feel comfortable in.

At NCADD, we focus on gender-specific treatment, which includes all women groups and services. We have found that women often thrive in such a treatment setting and are inclined to discuss issues associated with gender roles and gender identity and substance abuse when compared to participation in a mixed group setting. This is not to say there isn’t value in both – undoubtedly, there is. However, women who have had certain experiences – trauma, abuse, domestic violence – tend to thrive in a gender-specific environment.

ADDICTION BLOG: How many residential treatment centers for mothers with children (staying with them in the facilities) currently exist in the U.S.? What kinds of costs do mothers face and does the insurance cover some costs for the children too?

NCADD PHOENIX: It is difficult for us to say how many treatment centers in the U.S. accommodate women and their children. That information might be found through the SAMSHA website. As for insurance costs, this will depend entirely on the insurance provider.

ADDICTION BLOG: It is hard for women, especially mothers, to get back to every day life after being treated for addiction. How does NCADD Phoenix help women/mothers to get track on track, get a job or continue with education? How do you work with them to help develop their skills and grow stronger? Also, do you monitor their progress after the treatment is finished?

NCADD PHOENIX: Any time any person makes a significant life change, getting back to “every day” life can be challenging. This is especially true for those in recovery.

Prior to entering into addiction recovery, a function of “every day” life often includes the ritual of using drugs. In addition to addiction being a part of the daily routine, many mothers might have incurred some significant legal, financial, or educational set backs that can be incredibly difficult to overcome. Basically, it’s not just about getting sober, but also about sustaining and maintaining recovery for the long term.

NCADD’s primary treatment component is premised on evidence based interventions particularly catered to women. There is a long term after care component that women can engage in to receive continued support as they navigate getting back into the stream of life. In addition to aftercare, we have several career and education development services to help women obtain meaningful employment that will serve to support their family. We offer a GED group, personalized job coaching, and each woman who enters our program develops a career/vocational plan as a part of her journey here.

In addition to this, we have a work adjustment program called Sustain that allows women to learn job skills that can help them when they enter the job market. We also offer financial coaching and other life skills services to help a woman sustain change after treatment.

Photo credit: froot

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