Perinatal Substance Abuse : Characteristics of Parents at Risk

by Child Welfare Information Gateway

(Page 4 of 7)

CASE VIGNETTE: Lisa had not seen her father since she was around 8 years of age. Her mother was an unemployed recovering alcoholic who lived with her boyfriend. Before her pregnancy Lisa had been a model for 3 years and reported that she was introduced to illicit drugs by friends at work who "partied" in the evenings. Through these friends, Lisa met Johnnie, the father of her child. Johnnie was a photographer who used drugs regularly and encouraged Lisa to join him. Drugs became part of their relationship, and before long Lisa lost her job and moved in with Johnnie. Although he was very jealous and sometimes abusive, Lisa stayed with Johnnie because she cared about him and because he also supplied her with drugs.

Parents who abuse alcohol and/or other drugs come from all walks of life, all ethnic backgrounds, and all socioeconomic levels. Further, alcohol and other drugs are not discriminatory in their effects on individuals who abuse them. This chapter describes the most common behavioral patterns associated with substance abuse that can be observed across the entire societal spectrum.

By the time they are identified by professionals, substance-abusing parents generally have progressed to the final stage of chemical dependency, and their long-term alcohol and/or other drug use is deeply entrenched and seriously disabling. If they do not have substantial financial and family supports to provide for them, these parents/caregivers often have limited ability to meet their own survival needs, let alone those of their dependent or, particularly, medically fragile children. However, even when substance-abusing parents do have financial and family supports, and therefore may be "invisible" to child welfare systems, their alcohol and/or drug abuse problem still has a devastating impact on family functioning and their children's healthy development.

Thus, a basic knowledge of the dynamics and effects of alcohol and other drug abuse is fundamental for professionals working with substance-abusing families. Many chemically involved parents are sincere in their desire to meet their children's needs, but they are limited in their physical, financial, social, and/or emotional abilities to do so. Substance abuse has a profound impact on a parent's capacity to provide the consistent nurturing and hands-on care that children require in order to thrive. Unless professionals are aware of the nature of substance abuse; the chronic, often relapsing nature of this disorder; and the unique characteristics and problems of chemically involved parents; services provided for parents and children may prove inappropriate or inadequate.

Substance abuse is a problem that affects all aspects of an individual's personal and family life. Strategies for intervention, therefore, generally acknowledge the following three basic assumptions:

A true chemical dependency becomes the central organizing force around which the life of the substance abuser revolves, and that dependency affects every significant aspect of that person's functioning.

The abuse of alcohol or other drugs on the part of even one family member, particularly if that person happens to be a parent, has a profound impact on the lives of all members of that family.

The chemically involved parent has a range of serious medical and/or psychiatric problems, some of which may predate his/her alcohol and/or drug use and some of which may be the consequence of the dependency. All of these problems need to be addressed if intervention is to succeed.

The Nature of Substance Abuse

The impact of alcohol and other drug abuse varies widely from individual to individual. The following characteristics seem fairly universal, however, regardless of the substance or substances of choice, and can help us to understand the nature of most chemical dependencies. By building upon this understanding, professionals will be better equipped to design realistic service plans that are more likely to be effective.

Alcohol and other drug abuse is progressive. People do not set out to become alcoholics or addicts. First-time users universally resist the notion that they could ever become dependent on any chemical. It is with an accumulation of time and experience that the casual user becomes a substance abuser and that life can no longer be endured "clean and sober."

Experimental use. Early use is described as experimental. The user generally is motivated by curiosity or social pressure to try substances reputed to alter ways of thinking and feeling. Use during this phase is occasional, frequently unplanned, and involves little, if any, reorganization of lifestyle to accommodate it. Similarly, there may be no detectable deterioration in health, relationships, or ability to function as expected.

Intensified use. Progressively more regular use begins to impact the user's life in more significant ways. Because it is both planned and more frequent than experimental use, increased amounts of time, thought, energy, and money go into the acts of "scoring" and using. At this stage, one's social life may revolve around getting high, and peer relationships often change accordingly. The economic and personal costs escalate as the ability to function at school or work declines, and mood swings become more prominent.

Habitual use. Habitual use marks the onset of chemical dependency. Tolerance to the original drug of choice has developed, a problem remedied either by using larger amounts of the same drug or recourse to drugs that will produce a more intense experience. Solitary use increases; now the emphasis is on simply getting high, rather than on the social experience of "partying" with one's peers. The user is increasingly preoccupied with drug use and may turn to dealing or other criminal activity to support a growing dependency on more potent and more expensive drugs. Deterioration in all significant areas of functioning is present.

About the Author

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Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.