Substance, structure and stigma: parents in the UK accounting for opioid substitution therapy during the antenatal and postnatal periods

Chandler, Amy and Whittaker, Anne and Cunningham-Burley, Sarah and Williams, Nigel and McGorm, Kelly and Mathews, Gillian (2013) Substance, structure and stigma: parents in the UK accounting for opioid substitution therapy during the antenatal and postnatal periods. International Journal of Drug Policy, 24 (6). e35-e42. ISSN 0955-3959

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Abstract

Background: Parenting and pregnancy in the context of drug use is a contentious topic, high on the policy agenda. Providing effective support to parents who are opioid dependent, through early intervention, access to drug treatment and parenting skills training, is a priority. However, little is known about opioid dependent parents' experiences and understanding of parenting support during the antenatal and postnatal periods. This paper focuses on the position and impact of opioid substitution therapy (OST) in the accounts of parents who were expecting, or who had recently had, a baby in the UK. Methods: Semi-structured qualitative interviews were held with a purposive sample of 19 opioid dependent service users (14 female, 5 male). Longitudinal data was collected across the antenatal and postnatal (up to 1 year) periods, with participants interviewed up to three times. Forty-five interviews were analysed thematically, using a constant comparison method, underpinned by a sociologically informed narrative approach. Results: Participants' accounts of drug treatment were clearly oriented towards demonstrating that they were doing 'the best thing' for their baby. For some, OST was framed as a route to what was seen as a 'normal' family life; for others, OST was a barrier to such normality. Challenges related to: the physiological effects of opioid dependence; structural constraints associated with treatment regimes; and the impact of negative societal views about drug-using parents. Conclusion: Parents' accounts of OST can be seen as a response to socio-cultural ideals of a 'good', drug-free parent. Reflecting the liminal position parents engaged in OST found themselves in, their narratives entailed reconciling their status as a 'drug-using parent' with a view of an 'ideal parent' who was abstinent. © 2013 Elsevier B.V.

Keywords:buprenorphine, methadone, opiate, narcotic analgesic agent, abstinence, adult, article, child parent relation, clinical article, expectant parent, family life, female, heroin dependence, human, longitudinal study, male, methadone treatment, opiate addiction, opiate substitution treatment, parental attitude, parental behavior, perinatal period, pregnancy outcome, prenatal period, priority journal, psychological aspect, semi structured interview, stigma, United Kingdom, young adult, drug use, family relation, interview, Opioid-Related Disorders, parent, postnatal care, pregnancy, prejudice, prenatal care, procedures, psychology, public opinion, qualitative research, stereotyping, treatment outcome, Adult, Analgesics, Opioid, Drug Users, Family Relations, Humans, Interviews as Topic, Longitudinal Studies, Parenting, Parents, Scotland, Treatment Outcome
Subjects:L Social studies > L310 Applied Sociology
L Social studies > L431 Health Policy
B Subjects allied to Medicine > B760 Mental Health Nursing
Divisions:College of Social Science > School of Social & Political Sciences
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ID Code:18699
Deposited On:26 Jan 2016 17:34

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