Barriers to Treatment for Substance Use Disorders among Women with Children

Abstract

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.

Improving Equity of Access Through Electronic Consultation: A Case Study of an eConsult Service

“…Likewise, patients of low socioeconomic status face their own barriers to care access, including a lack of health insurance or benefits, a complicated registration process (particularly among patients with no fixed address), negative attitudes among providers, and the necessity of focusing on other needs at the expense of managing their health, such as seeking food and shelter (19–21). Other populations with complex circumstances report their own barriers to access, such as the stigma often faced by transgender patients (22–24) or those suffering from addiction (25, 26), or the anxiety and communication issues experienced by patients with developmental disorders (27, 28). In the cases highlighted by our study, eConsult proved an effective way to mitigate the inequities commonly experienced by patients in these populations.…”

Maternal Drug-related Death and Suicide are Leading Causes of Postpartum Death in California

“…37,38 Moreover, the stigma and potential repercussions (e.g., removal of the child) of acknowledging substance use during the postpartum period may prevent women from doing so and thus receiving services or treatment. 39 Although pregnancy appears to be a motivation for many women to decrease substance use, 40 recent research shows that, while perinatal nonfatal opioid overdose rates were lowest in the third trimester, this rate quadrupled by 7-12 months postpartum, 41 suggesting that women may fall back into substance use after delivery and not continue to receive treatment.…”

Barriers to Accessing Addiction Treatment for Women at Risk of Homelessness

“…Experiences of treatment and recovery from SUD can also differ across gender (33,34). Pregnancy, childbirth, and motherhood are regularly reported as factors preventing women from accessing AOD treatment (35)(36)(37)(38).…”