Living a normal life? Follow-up study of women who had been in opioid maintenance treatment during pregnancy

Welle-Strand, Gabrielle; Abel, Kristine Fiksdal; Chalabianloo, Fatemeh; Sarfi, Monica

doi:10.1016/j.jsat.2020.108004

Cited by 5 publications

(5 citation statements)

References 41 publications

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“…This study contributes to our knowledge of recovery as a non-linear process that encompasses a complex interplay of turning point experiences and contextual dynamics, and widens our understanding of the relational and situational character of change processes (Addison et al 2021). The findings further support the idea of recovery as a long-term process in developing continued wellbeing and stability in life, recognizing the changing nature of addiction and recovery processes over the life course and the importance of gradually building recovery resources (Bjornestad et al 2019;Welle-Strand et al 2020). The results counteract the idea of change as an all-or-nothing event caused by a single turning point and highlight that turning point experiences are not binary conditions bound to singular events but impact someone's life course over the long term, through complex, evolving, and time-varying dynamics (Kougiali et al 2017;Schinkel 2019;Addison et al 2021).…”

Section: A Contextualized Understanding Of Turning Points and Recoverysupporting

confidence: 59%

“…Parenthood supported respondents' recovery by triggering a reevaluation of their life course, functioning as an intrinsic motivator to develop a life in recovery (e.g. to gain back child custody), providing a sense of meaning and responsibility, and/or stimulating treatment initiation or re-engagement (Radcliffe 2011;Jessup et al 2014;Welle-Strand et al 2020). However, our findings also highlight how participants' fear of losing custody over their children can act as a barrier to treatment entry, anticipating stigmatizing notions of parenthood and drug use (Gueta and Addad 2013;Gueta 2017).…”

Section: The Role Of Multiple Turning Point Experiencesmentioning

confidence: 99%

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Turning points toward drug addiction recovery: contextualizing underlying dynamics of change

Bellaert

Steenberghe

Maeyer

et al. 2022

Addiction Research & Theory

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Background: A life course approach recognizes the role of turning points in adding twists and turns in individuals' addiction recovery processes. The notion of certain key life events that trigger turning point experiences offers a valuable theoretical construct for understanding processes of change. The current study aimed to identify turning points and assess the role of contextual dynamics in generating longterm changes, based on lived experiences of persons in drug addiction recovery. Method: A qualitative research design was applied using a Lifeline Interview Method (LIM), allowing a retrospective lens to elicit recovery narratives. Purposive sampling was utilized to compose a heterogeneous group of thirty persons in self-defined drug addiction recovery in Flanders (Belgium). An interpretative phenomenological approach was adopted during a thematic analysis, grounding the research claims in respondents' lived experiences. Results: Key moments of change that were reported by participants are: (1) adverse drug-induced experiences; (2) becoming a parent; (3) 'hitting rock bottom'; (4) (dis)engagement of social networks and environments; and (5) addiction treatment. The findings illustrate the role of contextual dynamics that can facilitate (or hamper) experiencing these life events as turning points toward change.Conclusions: This study contradicts the notion of a single event or turning point causing abrupt changes in individuals' addiction trajectories. Contextual dynamics and meaning-making processes simultaneously influence whether specific life events can facilitate change. Treatment providers, researchers, and policymakers should take into account the process-based, situational, and relational nature of recovery.

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Section: A Contextualized Understanding Of Turning Points and Recoverysupporting

confidence: 59%

Section: The Role Of Multiple Turning Point Experiencesmentioning

confidence: 99%

Turning points toward drug addiction recovery: contextualizing underlying dynamics of change

Bellaert

Steenberghe

Maeyer

et al. 2022

Addiction Research & Theory

View full text Add to dashboard Cite

show abstract

“…Another explanation may be the difference in support and follow-up between pregnant women and mothers in the OMT group, compared to that of mothers with different types of addiction problems. The relatively low rates of mental health problems found in our sample of exposed children living with parents may be associated with the mothers’ low use of illegal drugs—but high rates of smoking as we have shown in the previous studies [ 23 , 50 , 61 ]. Considering the negative effects of smoking on the fetus and the developing child, focus on smoking cessation interventions should be a priority in treatment of opioid-dependent pregnant women, similar to what is recommended in the Norwegian national guidelines for pregnant women in opioid maintenance treatment guidelines [ 20 ].…”

Section: Discussionsupporting

confidence: 48%

“…These women are also subjected to close healthcare surveillance after delivery and the threshold for removing the child from home is low, compared to most other countries’ practices. Norwegian studies show that most women enrolled in OMT during pregnancy were able to abstain from illicit drug use during pregnancy, and 2, 4, and 8 years after delivery [ 21 – 23 ]. However, the same studies show elevated maternal mental and physical health problems and psychosocial difficulties—factors associated with CWS interventions and removals of children from home.…”

Section: Introductionmentioning

confidence: 99%

Mental health and use of health care services in opioid-exposed school-aged children compared to foster children

Sarfi

Eikemo

Welle-Strand

et al. 2021

Eur Child Adolesc Psychiatry

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Given the concerns raised regarding the effects of prenatal exposure to methadone and buprenorphine on the developmental outcomes of the children, this study assessed mental health and use of services in a national sample of school-aged children (N = 78) born to women enrolled in opioid maintenance treatment during pregnancy, compared with a group of foster children (N = 140). The majority of the opioid-exposed children lived with their birth parent(s) at the time of assessment (N = 62), while 16 lived in foster homes. Caregivers completed the Strengths and Difficulties Questionnaire (SDQ) and the Reactive Attachment Disorder scale. Teachers completed the SDQ. Three kinds of services were included in measuring service use: school-based education services, child mental health services, and hospital-based habilitation services. The main finding of the study is that children prenatally exposed to methadone or buprenorphine living with their family of origin had significantly better mental health status than their foster-placed counterparts and that of the comparison group of foster children. In addition, the exposed children living at home had less child welfare involvement, and only half of them were using any of the three services measured. The odds for using services increased significantly in accordance with increasing mental health problems, independent of group affiliation, indicating a need-based access to services. In line with other studies, we found that the odds for using one or more services was 2.3 times greater for boys than for girls. Our results contribute to a more-nuanced understanding of the developmental outcomes of prenatal exposure to methadone and buprenorphine, and factors associated with increased service use in groups of at-risk children.

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“…Previous publications from this study group have addressed various aspects of both parental and child functioning (17,35,(38)(39)(40) throughout the 8-year follow-up-period. Here we analyze key outcomes across the whole study period, focusing primarily on parenting stress and child behavioral problems.…”

Section: Methodsmentioning

confidence: 99%

Children born to women in opioid maintenance treatment: A longitudinal study of child behavioral problems and parenting stress

2022

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In the wake of the “opioid epidemic”, there is considerable concern regarding potential harmful long-term effects of prenatal opioid exposure. Opioid misuse and addiction confer increased exposure to lifestyle stressors and health burdens. Accordingly, it is challenging to disentangle effects of prenatal opioid exposure per se from factors related to maternal stress. In this study, we followed 36 women enrolled in comprehensive opioid maintenance treatment (OMT) program and their children alongside 36 age-matched mother-child dyads from a community sample (COMP) from pregnancy until child-age 8 years. Across five sessions, we used a battery of well-established questionnaires to investigate trajectories of parenting stress and mental health symptoms as well as child behavior problems. The 8-year retention was relatively high (OMT: 72%, COMP: 67%), and the OMT sample remarkably stable and well-functioning, with minimal concomitant illicit drug use. Mixed effects regressions showed significantly different trajectories of child behavior problems (F = 3.8, p = 0.024) and parenting stress (F = 3.1, p = 0.016) in the two groups. Differences in experienced stress were largely explained by more distress specifically related to the parenting role in the OMT group (F = 9.7, p = 0.003). The OMT sample also reported higher psychological distress (F = 15.6, p < 0.001) than the comparison group, but notably few participants presented with problems that warranted clinical intervention. The results underscore the benefits of tailored follow-up of children prenatally exposed to opioids and their families beyond infancy and toddlerhood. Long-term direct effects of prenatal opioid exposure on behavior problems are likely modest, given an otherwise stable caregiving environment conducive to healthy development.

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Living a normal life? Follow-up study of women who had been in opioid maintenance treatment during pregnancy

Cited by 5 publications

References 41 publications

Turning points toward drug addiction recovery: contextualizing underlying dynamics of change

Turning points toward drug addiction recovery: contextualizing underlying dynamics of change

Mental health and use of health care services in opioid-exposed school-aged children compared to foster children

Children born to women in opioid maintenance treatment: A longitudinal study of child behavioral problems and parenting stress

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