Supporting Mothers’ Engagement in a Community-Based Methadone Treatment Program

Abstract

Unmanaged maternal opioid addiction poses health and social risks to both mothers and children in their care. Methadone maintenance treatment (MMT) is a targeted public health service to which nurses and other allied health professionals may refer these high risk families for support. Mothers participating in MMT to manage their addiction and their service providers were interviewed to identify resources to maximize mothers' engagement in treatment and enhance mothers' parenting capacity. Twelve mothers and six service providers were recruited from an outpatient Atlantic Canadian methadone treatment program. Two major barriers to engagement in MMT were identified by both mothers and service providers including (1) the lack of available and consistent childcare while mothers attended outpatient programs and (2) challenges with transportation to the treatment facility. All participants noted the potential benefits of adding supportive resources for the children of mothers involved in MMT and for mothers to learn how to communicate more effectively with their children and rebuild damaged mother-child relationships. The public health benefits of integrating parent-child ancillary supports into MMT for mothers are discussed.

The Experience of Women With Opioid Use Disorder Accessing Methadone Treatment

“…Women in Canada have expressed similar concerns over accessibility to healthcare acting as a barrier to mothers participating in methadone treatment. Women's concerns included a lack of daycare services, convenient and affordable transportation, and the distance and frequency of travel between home and methadone treatment services (Letourneau et al, 2013). Overall, similarities in these findings suggest that women experience barriers to services that need to be addressed collectively and individually.…”

Examining barriers to harm reduction and child welfare services for pregnant women and mothers who use substances using a stigma action framework

“…Where women were able to access child welfare services, they expressed a lack of confidence from social workers with their ability to remain abstinent (Kenny & Barrington, 2018) or to parent (Kruk & Banga, 2011). These interactions limited information sharing between women and service providers, contributing to a lack of trusting and respectful relationships (Grosenick & Hatmaker, 2000;Letourneau et al, 2013;Salmon et al, 2000).…”

“…Often these programmes did not accept insurance, requiring women to pay upfront in cash (Jessup et al, 2003;Rockhill et al, 2008). The location and cost of these programmes heightened geographic and transportation barriers, particularly for women in rural and remote regions or whose children were in foster care in other regions (Howell & Chasnoff, 1999;Jessup et al, 2003;Letourneau et al, 2013). For women using OAT, such as methadone that requires daily access to a pharmacy, women's geographic location and transportation access posed increased challenges (Lander et al, 2013).…”

Community-led Priority Setting for Opioid Use Disorder in Pregnancy and Parenting

“…3,4 Additionally, there has been limited emphasis on social determinants of health and their impacts on those with OUD who are working towards recovery. 5,6 Research exploring the experiences of pregnant and parenting people with OUD has described many avenues for improved care, [7][8][9][10] highlighting the importance of community voices in providing direction for future research and policy work.…”