Understanding Addiction in the Context of Perinatal Substance Use: A Reflection for Clinicians

Abstract

Society determines what substances are legal and not, and some people can use a variety of substances without negative consequences. Substance use occurs on a continuum from use to harmful use, to addiction [1,2]. It is important that support and treatment take into consideration the complex pathways, consequences and outcomes of substance use, harmful use, and addiction [4]. Perinatal harm reduction focuses on building relationships to empower women with knowledge about the harms associated with substance use when pregnant, and choice about the type and extent of change she wishes to make [3,5]. The medical model explains 'addiction' as a treatable disease which is helpful in removing stigma and explaining how physiology can affect behaviour [6]. It helps women and families associate problematic substance use with substance use disorder and not as a weakness of the person. Substance use disorder is commonly rooted in childhood trauma, stressors, feelings of shame or 'less than'[1,3,6]. Building on recovery capital when women are inspired during pregnancy and postpartum can be an opportunity for change, growth, healing, and empowerment. Humans are complex biopsychosocial and spiritual beings, so the treatment, recovery, and healing require a holistic approach. This does not mean you need a big team… just time, trust, and patience... and a commitment to support change![8]