Parents who misuse substances: implications for parenting practices and treatment seeking behaviour

Abstract

This paper considers parents who misuse substances. The potential impacts of their substance misuse on their ability to parent effectively and safely (parenting capacity) are explored, as are some of the barriers many parents face when attempting to seek treatment for problematic substance misuse. The terms ‘use’ and ‘misuse’ are used interchangeably in this paper and ‘substances’ refers to alcohol, illicit drugs and overuse of prescribed medicines. It is important to make the distinction between parents whose use of substances does not constitute dependency and might be best described as ‘recreational or hazardous’. Such individuals might not seek treatment and estimates of prevalence rates of use among this cohort are difficult as they remain hidden from services. Parents who might already be in treatment services or who might be seeking treatment might be described as ‘problematic or dependent’ although presentation at services is neither necessary nor sufficient to assume that the individual's misuse of substances is problematic or indicative of a dependency. The use of substances is associated with numerous harms to the individual: psychologically, socially, interpersonally and physically, and is a risk factor towards negative parenting practices. The use of substances in itself is not an indication of neglectful or harmful parenting, as many parents who use substances have adequate parenting skills, however, it is more frequently associated as a risk rather than a protective factor when considering potential harms. Most of the research refers to mothers although we are aware that some fathers may have sole parenting responsibility for their children. Parents, in particular mothers, face many barriers when trying to access substance misuse treatment services. When they are in treatment, services often lack the skills and experiences to be able to balance managing child protection issues and engaging the parent in treatment. A full review of the issues associated with parenting and substance misuse is beyond the scope of this paper and the reader is referred to Fowler (2003), Cleaver et al (1999), Velleman and Templeton (2007) and Day and George (2005) and the British Psychological Society's Child Protection Portfolio (2007) for further discussion.

An evaluation of a nurse-led Comprehensive Child Development Service in Hong Kong

“…Pre-term delivery and low birth weight can be found in mothers engaging in substance abuse (McGlade et al, 2009;Walton-Moss et al, 2009). Huxley and Foulger (2008) point out that children of substance-abusing parents have an increased risk of child neglect and physical and emotional abuse.…”

La paternité dans un contexte de consommation maternelle abusive d’alcool et de drogues

“…Au-delà de ces expériences et perceptions, il importe de mentionner que la majorité des futures mères qui abuse des drogues continue à le faire durant leur grossesse (Kukko et Halmesmäki, 1999) et que l'exposition aux drogues durant la grossesse est considérée comme un facteur pouvant entraîner des conséquences négatives pour la mère et le nouveau-né (Meredith, Jaffe, Ang-Lee et Saxon, 2005;Jasinski, 2004;Miles, Lanni, Jansson et Svikis, 2006;Kuczkowski, 2007;Huxley et Foulger, 2008). Il est aussi reconnu que l'usage de drogues durant la grossesse apparaît en présence de facteurs environnementaux et contextuels (c.-à-d.déficit nutritionnel, pauvreté, polyconsommation, manque de soins prénataux) qui peuvent également affecter la mère et le nouveau-né (Jones, Finkelhor et Halter, 2006).…”

Experiences of mothers with substance dependence: Informing the development of parenting support

“…). Yet mothers with a history of substance dependence and their families, in particular, can experience difficulties accessing these child and family health services because of a variety of complex and hidden barriers (Huxley & Foulger , Harvey et al . ), which may include the sense of being constantly under surveillance (Silva et al .…”

“…). During this period, improved access to mainstream parenting services, and the support and education offered, can increase parenting confidence and capacity (Huxley & Foulger ). Unfortunately, despite high levels of motivation, substance use relapse and involvement of child protection services are common outcomes (Bromfield et al .…”

“…In Australia, free universal child and family health services are readily available to support parents with infants and young children (Schmied et al 2010). Yet mothers with a history of substance dependence and their families, in particular, can experience difficulties accessing these child and family health services because of a variety of complex and hidden barriers (Huxley & Foulger 2008, Harvey et al 2012, which may include the sense of being constantly under surveillance (Silva et al 2013). This lack of support often results in a perpetuation of intergenerational inappropriate and often punitive parenting with significant social and health costs to the community (Thornberry et al 2009).…”