Addiction
Crack is rapidly becoming an equal opportunity destroyer. Thirty to
40 percent of crack addicts in this country are now women--a fourfold
increase in just 10 years.
As the ranks of crack-abusing women grow, so too do the numbers of
pregnant women who are using. Trouble is, most drug-treatment programs
are built with men in mind.
And that's a double whammy: They not only fail women, but their
children, too.
Hundreds of crack-abusing women have been slapped with criminal
charges for using drugs while pregnant. Though none have been convicted,
countless others have, in fear, refused treatment altogether.
A team of researchers from Beth Israel Medical Center in New York
learned about the lives of addicts by interviewing 50 addiction experts
and 150 indigent, crack-using mothers. All came to the same conclusion:
treatments will not work unless they address the context of women's
lives.
About half the mothers had a history of sexual assault, jail, and
psychiatric treatment and had grown up in households that were affected
by drugs and alcohol. "The history of trauma was very clearly associated
with a drug problem that included starting drug use at an earlier age,
doing more drugs, and being involved with a man who was coercing her into
using drugs," reports Wendy Chavkin, M.D., M.P.H. So, for starters, "A
successful program would have to address sexual violence and family
addiction."
Both mothers and experts cited aftercare--support after the initial
phase of treatment--as the number one missing element in existing
programs. Next was child care, the thorniest issue. Some women avoided
treatment altogether because they were afraid of losing custody of their
kids. Chavkin explains that the lack of child care in most all-day or
residential programs "puts a mother between a rock and a hard place: She
has to give up her kids to be in treatment and she can't be in treatment
if she wants to keep her kids."
Many addicts feel shame and guilt for using drugs during pregnancy.
For some that's a primary motivation to enlist in treatment. It makes
others run. "Treatment approaches that emphasize shame and anger seem
counterproductive," comments Chavkin, an associate professor of public
health and obstetrics/gynecology at Columbia University. "They don't work
for people feeling crummy about themselves to begin with."
Hostility toward drug addicts, along with the prohibitive costs of
treating them, are holding back counseling, aftercare, and child care
advancements. But money spent in the criminal justice system, foster
care, jail, and homelessness make such problems a downright bargain--to
say nothing of preventing another generation of disenfranchised, angry
children raising itself.
PHOTO: Traditional crack treatments doubly fail women with
children.
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