Research

Maternal Substance Abuse - Effects on Children & Families
Policy & Funding Issues
Cynthia Crone, APN, MNSc

There is a high prevalence of maternal substance abuse in Arkansas

• 17% of women receiving pregnancy tests at 19 clinics across Arkansas tested positive for illicit drugs (ADH, 1998); does not include tobacco and alcohol
• 29% of Arkansas mothers with children under age 18 need treatment (ADH, 1999)
• Statewide estimates of TANF recipients needing alcohol and drug abuse treatment range between 30% and 60% (DHS, 2000)

Substance abuse is often an intergenerational problem within families

• 70% - 90% of women needing substance abuse treatment had a parent with a substance abuse disorder
• Today’s children growing up in homes affected by substance abuse are more likely to be tomorrow’s substance abusing adolescents and adults

A high percentage of substance abusing women suffer from a concurrent psychiatric diagnosis. Often, the diagnoses are post-traumatic stress disorder (PTSD) related to abuse and violence, anxiety disorder in response to living situations, or depression.

• Dual diagnosis rate among substance abusing women is estimated to be 80%-90%
• 80%-90% of substance abusing women have been violence victims; 67% of substance abusing women have been sexually abused, usually before age 16
• Integrated treatment addressing mental health and substance abuse issues is more effective than sequential, linked, or parallel treatment
• Unresolved issues of depression or prior abuse increase a woman’s risk for relapse following treatment for alcohol and drug abuse

Persons who abuse alcohol and other drugs are unlikely to obtain or sustain employment making a livable wage.

• Substance abusing women are unlikely to have marketable job skills and are likely to be unemployed with poor work histories due to their substance abuse
• A study by ADH showed that drug use by women of childbearing age who made less than $20,000 per year was 27.6% higher than the sample population as a whole (1999)

Poor women with substance abuse problems are likely to be incarcerated.

• 75% - 80% of incarcerated women have a substance abuse disorder and need treatment; their addiction leads to jail, not treatment
• 55% of 47,125 women arrested in Arkansas tested positive for illicit drugs at the time of arrest (ADH, 1999)
• 80% of incarcerated women are mothers; their children are at risk for permanent out-of-home placement and poor outcomes including addiction and incarceration
• Substance abuse treatment in prison is inadequate – 30 days in length; 20% of 134 responding Arkansas correctional facilities report providing substance abuse treatment (86% state prisons; 10% jails; 17% juvenile facilities) (DHHS, 2000)

Substance Abuse Treatment is Cost Effective

• The costs of substance abuse treatment are minimal when compared to the resulting savings, according to a national study of over 5,000 clients receiving CSAT-funded treatment services
• The average cost savings in the year following treatment was more than three times the cost of one treatment episode; these figures actually represent underestimates, because the data do not include savings accrued while clients were receiving treatment
• Ambulatory outpatient and residential treatment programs have the highest benefit-to-cost ratios (3.7and 3.6 to1, respectively)
• The cost savings for a mother and her children would be even greater, considering improved birth and child health outcomes and prevention of foster care due to child abuse and neglect or incarceration

Click on the links below for more detailed information:

Seventy-two (72) pregnant women with substance abuse disorders treated at Arkansas CARES had significantly better birth outcomes than 23 women who were evaluated but did not receive treatment

Clients completing treatment with their children at Arkansas CARES showed improvements compared to non-completers on key post-discharge outcomes nearly one year after clients left the program (*p<.05 **p<.01); (89% had at least one post-discharge follow-up visit)

Addiction, Trauma, & Relapse