BackgroundThere are few women-centered treatment programs for substance use disorder. We therefore undertook an exploratory study to better understand the treatment experience, barriers, and facilitators of mothers with substance use disorder.MethodsWe conducted two focus groups with a total of ten women with a history of substance use disorder in Kingston (Canada). Women were recruited from a community program for mothers with substance use disorder. The focus groups were recorded, and the resulting data were transcribed, coded, and thematically analyzed. Barriers, facilitators and treatment needs were identified.ResultsThe mean age of the participants was 31.1 years, 30% were currently using substances, and 60% had a child in their care. A key concern for women regarding substance use treatment was the welfare of their child(ren). Agencies charged with child protection were a barrier to treatment because women feared disclosing substance use would result in loss of child custody. In contrast, when agencies stipulated that women must attend treatment to retain custody, they facilitated treatment engagement. Other barriers to treatment included identifying treatment programs and completing admission requirements, wait times, counselor ability to address woman-centered issues, fear, safety, and stigma. Women’s personal motivation for treatment was a facilitator. Suggestions to improve treatment programs included to allow children to accompany their mothers, involvement of peer support, and women-only programs.ConclusionsThis small but novel study provides important data to inform treatment programming for mothers with substance use disorders.

BackgroundIron deficiency in early childhood has been associated with poor developmental outcomes. Little is known about the nutritional health of young children receiving care at Canadian Community Health Centres (CHCs). Our objectives were to describe iron deficiency among toddlers at an Ontario CHC, to compare young children attending CHCs and non-CHCs, and assess the feasibility of conducting research on children in CHC settings.MethodsOne CHC, Kingston Community Health Centres (CHC) with two clinical sites and one community programming site was added to the nine non-CHC pediatric and primary care clinics in the existing TARGet Kids! research network. A cross-sectional feasibilitystudy was conducted.and. Healthy children, ages 12–36 months were Enrolled. iron deficiency without inflammation (ferritin< 14 μg/L and CRP < 10 mg/L) and serum ferritin were assessed. Adjusted multivariable regression analyses were used to evaluate an association between CHC enrolment and iron status.ResultsThe CHC cohort (n = 31) was older, had lower household income, lower maternal education, higher nutrition risk scores, higher cow’s milk intake, shorter breastfeeding duration and higher prevalence of unhealthy weights compared with the non-CHC cohort (n = 875). There was no association between CHC status and serum ferritin (difference in median serum ferritin 4.78 μg/L, 95% confidence interval [CI] -2.5, 14.3, p = 0.22) or iron deficiency (OR 0.55, 95% CI 0.11, − 2.73, p = 0.46) using multivariable linear and logistic regression, respectively.ConclusionDespite differences in sociodemographic variables, we did not detect a difference in iron status between toddlers enrolled at CHCs compared to non-CHC settings. Further research is needed to understand the health effects of poverty generally, and iron deficiency specifically among children receiving care at CHCs.

Objective: The shortage of treatment options for substance use disorders (SUD) has been further challenged by the opioid crisis. We therefore sought to identify the treatment barriers for an underserved population, women with SUD. Methods: Women with SUD attending methadone/buprenorphine clinics, a healthcare clinic for marginalized populations, and addiction medicine clinic in Kingston and the Kingston area anonymously completed an 11-item questionnaire. The items pertained to the women's substance use and SUD treatment history, barriers to accessing SUD treatment, and missing services. Descriptive frequencies were reported. Results: Sixty-seven women completed the questionnaire, their mean age was 33 years. Most women (70%) had at least 1 child in their care; the mean age of the children was 8.7 years. Thirty women (44.8%) were currently using substances on a regular or semiregular basis. Substances frequently used included opioids (85.1%), marijuana (65.7%), methamphetamines (52.2%), and cocaine (47.8%). Most women (62.5%) had ever participated in a SUD treatment program. A majority also responded that although they had wanted to attend a SUD treatment program at some point in their life they were unable to. Common reasons for not attending a SUD treatment program among women were fear of losing child(ren) (65.9%), no care for child(ren) (48.8%), and waiting list (46.3%). Almost 50% of respondents indicated that parenting resources, parenting skill building programs, parenting support, and childcare were needed services. Conclusions: Expanded and targeted programs for the unique circumstances and childcare needs of women with SUD are warranted. Objectif: La pénurie d’options de traitement pour les troubles liés à l’utilisation de substances (UDS) a été encore plus contestée par la crise des opioïdes. Nous avons donc cherché à identifier les obstacles au traitement pour une population mal desservie, les femmes avec UDS. Méthodes: Des femmes atteintes de UDS fréquentant des cliniques de méthadone / buprénorphine, une clinique de soins de santé pour les populations marginalisées et une clinique de toxicomanie à Kingston et dans la région de Kingston ont répondu anonymement à un questionnaire de 11 questions. Les items se rapportaient à l’utilisation de substances par les femmes et aux antécédents de traitement des UDS, aux obstacles à l’accès au traitement des UDS et aux services manquants. Des fréquences descriptives ont été signalées. Résultats: Soixante-sept femmes ont rempli le questionnaire, leur âge moyen était de 33 ans. La plupart des femmes (70%) avaient au moins un enfant à leur charge; l’âge moyen des enfants était de 8,7 ans. Trente femmes (44,8%) utilisaient actuellement des substances de façon régulière ou semi-régulière. Les substances fréquemment utilisées comprennent les opioïdes (85,1%), la marijuana (65,7%), les méthamphétamines (52,2%) et la cocaïne (47,8%). La plupart des femmes (62,5%) avaient déjà participé à un programme de traitement de UDS. Une majorité a également répondu que même s’ils avaient voulu participer à un programme de traitement de UDS à un moment de leur vie, ils ne pouvaient pas. La peur de perdre un ou des enfants (65,9%), de ne pas prendre soin d’un ou de plusieurs enfants (48,8%) et d’avoir une liste d’attente (46,3%) expliquent généralement le fait que les femmes ne participaient pas à un programme de traitement. Près de 50% des répondants ont indiqué que les ressources parentales, les programmes de renforcement des compétences parentales, le soutien parental et les services de garde étaient des services nécessaires. Conclusions: Des programmes élargis et ciblés pour les circonstances particulières et les besoins de garde d’enfants des femmes avec UDS sont justifiés.