Reduce Stigma for Pregnant People with SUDs
Introductory Paragraph
Write a few sentences offering some introductory background information on this topic. The information here should be what you would want a reader to know about this topic and why it is important. This section should be high-level enough to provide an overview of the issue and/or strategy for professionals who may not be subject matter experts or well-versed on this topic.
Key Information
“SAMSHA’s working definition of recovery states that recovery is “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” SAMSHA lists health, home, purpose, and community as essential dimensions of support for a life in recovery.[1] Stigma is a barrier in recovery. When a person with substance use disorder finally reaches out for help, he or she is often met with responses that are less than helpful or are judgmental and this is often the result of stigma. Many examples of stigma are not overt and are more subtle. Stigma comes in the form of language used, pity, disdain, silence, or rejection. Persons with mental health and substance use problems are exposed to an array of stigma components that interact to endanger their mental health. These components include stereotypes, prejudice, and discrimination.[2]
Studies have shown that people with substance use disorder experience labeling, shame, and rejection from family members, friends, teachers, co-workers, supervisors, and health care professionals. This stigma can get in the way of the support that people in recovery --and early recovery especially -- need. Outside stigma can become internalized, leading people in recovery to embody and adopt inaccurate beliefs about themselves due to their exposure to external stigmatizing forces.[3]
Women have different experiences with SUD both biologically as well as culturally as they are seen as caregivers and mothers. Barriers and challenges include:[4]
- Women are at highest risk for developing SUDs during reproductive years
- Polysubstance use is common
- Unintended pregnancy rate among women with SUD is ~80%
- Substance use in pregnancy connected to many complications/negative health outcomes for mom & baby
- As many as 70% of women entering addiction treatment have children and primary responsibility for children
- Family responsibilities can interfere with regular attendance in treatment sessions including challenges with childcare
- May be more hesitant to seek treatment for fear of legal action or legal issues including child protective services
Relevant Research
Treatment for substance use disorders in pregnant women: Motivators and barriers[5]
Substance Use Disorder Treatment in Pregnant Adults[6]
Impactful Federal, State, and Local Policies
States policies surrounding pregnant women with SUD vary by State. This variation includes:
- Child Abuse
- Grounds for Civil Commitment
- Reporting
- Testing
- Targeted Program Created
- Pregnant People Given Priority Access in General Programs
- Pregnant People Protected from Discrimination in Publicly Funded Programs
The Guttmach Institute provides State Policies on Substance Use During Pregnancy by individual State.[7]
They indicate currently:
- 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and 3 consider it grounds for civil commitment.
- 25 states and the District of Columbia require health care professionals to report suspected prenatal drug use, and 8 states require them to test for prenatal drug exposure if they suspect drug use.
- 19 states have either created or funded drug treatment programs specifically targeted to those who are pregnant, and 17 states and the District of Columbia provide pregnant people with priority access to state-funded drug treatment programs.
- 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people.
Available Tools and Resources
Anti-Stigma Toolkit: A Guide to Reducing Addiction-Related Stigma[8]
Reducing Stigma in Pregnant & Parenting Women with Substance Use Disorder A presentation by The Mountain Plains Addiction Technology Transfer Center & SAMHSA [9]
Your Safe Solutions Reduce Stigma[10]
YouTube: Dr. Mishka Terplan, MD, MPH -- “Gender & Use, Misuse, Treatment and Recovery[11]
Promising Practices
Safe Project No Shame Pledge[12]
Sources
- ↑ https://www.samhsa.gov/sites/default/files/programs_campaigns/02._webcast_3_resources.pdf
- ↑ -Corrigan P. W. “How stigma interferes with mental health care,” American Psychologist. 2004;59(7):614–625. Pp https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7348456/#r20
- ↑ https://attcnetwork.org
- ↑ https://infantcrier.mi-aimh.org/perinatal-substance-use-an-update-and-reflection-on-the-importance-of-relationship/#respond
- ↑ https://pubmed.ncbi.nlm.nih.gov/31704383/
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK572854/
- ↑ https://www.guttmacher.org/state-policy/explore/substance-use-during-pregnancy
- ↑ https://attcnetwork.org/sites/default/files/2019-04/Anti-Stigma%20Toolkit.pdf
- ↑ https://www.ndsu.edu/fileadmin/centers/americanindianhealth/files/Maternal_Health_Learning_Collaborative_Session_2.pdf
- ↑ https://www.yoursafesolutions.us/wiki/Reduce_Stigma
- ↑ https://www.youtube.com/watch?v=siC6Cd4Q3MQ&t=33s
- ↑ https://www.safeproject.us/noshame-mental-health-addiction/