scholarly journals Shame to Resilience: Trauma-informed Perspectives on Maternal Substance Use

2018 ◽  
Vol 1 (1) ◽  
pp. 53-74
Author(s):  
Heather Howard
Keyword(s):  
Substance Use ◽  
Specific Treatment ◽  
Opioid Use ◽  
Theoretical Frameworks ◽  
Case Examples ◽  
Maternal Substance Use ◽  
Trauma Informed ◽  
Recovery And Healing ◽  
The Impact ◽  
Trauma Histories

The objective of this article is to discuss the multifaceted complexity of maternal substance use and trauma histories. Methods. Overview of the impact of opioid use in maternal age women is provided, as well as its impact on families. Two case examples are presented to highlight the major barriers these women encounter in entering treatment. Results. The use of two theories, shame-resilience (SRT) and self-determination (SDT) is also discussed as a possible framework to engage pregnant women and promote recovery and healing from trauma histories. Conclusion. Providing trauma-informed, gender-specific treatment using these theoretical frameworks has the potential for transformational growth and recovery for this multifarious population. Implications. To provide the necessary comprehensive, coordinated, and compassionate care from multiple disciplines, continued training on trauma-informed, genderspecific treatment is recommended.

Supporting Women with Substance Use Issues: Trauma-Informed Care as a Foundation for Practice in the NICU

2014 ◽  
Vol 33 (6) ◽  
pp. 307-314 ◽  
Author(s):  
Lenora Marcellus
Keyword(s):  
Substance Use ◽  
Health Care Providers ◽  
Service Systems ◽  
Trauma Survivors ◽  
Significant Shift ◽  
Care Providers ◽  
Current State ◽  
Trauma Informed Care ◽  
Trauma Informed ◽  
The Impact

ABSTRACTInfants with neonatal abstinence syndrome and their mothers require extended support through health and social service systems. Practitioners are interested in exploring innovative approaches to caring for infants and mothers. There is now compelling evidence linking women’s substance use to experiences of trauma and violence. A significant shift in the fields of addiction and mental health has been awareness of the impact of trauma and violence on infants and children, women, their families, and communities. In this article, the current state of knowledge of trauma-informed care is reviewed, in particular for application to practice within the NICU. Trauma survivors are at risk of being retraumatized because of health care providers’ limited understanding of how to work effectively with them. Recognizing the impact of trauma and implementing evidence-based trauma-informed practices in the NICU holds promise for improving outcomes for women and their infants.

scholarly journals Naturalistic follow-up of co-morbid substance use in schizophrenia: the West London first-episode study

2007 ◽  
Vol 38 (1) ◽  
pp. 79-88 ◽  
Author(s):  
I. Harrison ◽  
E. M. Joyce ◽  
S. H. Mutsatsa ◽  
S. B. Hutton ◽  
V. Huddy ◽  
...  
Keyword(s):  
Substance Use ◽  
Depressive Symptoms ◽  
Negative Symptoms ◽  
Spatial Working Memory ◽  
Problem Drinking ◽  
Specific Treatment ◽  
First Episode ◽  
First Episode Schizophrenia ◽  
The Impact

BackgroundThe impact of co-morbid substance use in first-episode schizophrenia has not been fully explored.MethodThis naturalistic follow-up of a cohort of 152 people with first-episode schizophrenia examined substance use and clinical outcome in terms of symptoms and social and neuropsychological function.ResultsData were collected on 85 (56%) of the patient cohort after a median period of 14 months. Over the follow-up period, the proportion of smokers rose from 60% at baseline to 64%. While 30% reported lifetime problem drinking of alcohol at baseline, only 15% had problem drinking at follow-up. Furthermore, while at baseline 63% reported lifetime cannabis use and 32% were currently using the drug, by the follow-up assessment the latter figure had fallen to 18.5%. At follow-up, persistent substance users had significantly more severe positive and depressive symptoms and greater overall severity of illness. A report of no lifetime substance use at baseline was associated with greater improvement in spatial working memory (SWM) at follow-up.ConclusionsPast substance use may impede recovery of SWM performance in people with schizophrenia in the year or so following first presentation to psychiatric services. The prevalence of substance use other than tobacco tends to diminish over this period, in the absence of specific interventions. Persistent substance use in first-episode schizophrenia is associated with more severe positive and depressive symptoms but not negative symptoms, and should be a target for specific treatment intervention.

scholarly journals Adapting inpatient addiction medicine consult services during the COVID-19 pandemic

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Miriam T. H. Harris ◽  
Alyssa Peterkin ◽  
Paxton Bach ◽  
Honora Englander ◽  
Emily Lapidus ◽  
...  
Keyword(s):  
Substance Use ◽  
Discharge Planning ◽  
Medical Center ◽  
Health Care Systems ◽  
Opioid Use Disorder ◽  
Substance Use Treatment ◽  
New Haven ◽  
Opioid Use ◽  
Addiction Medicine ◽  
The Impact

Abstract Background We describe addiction consult services (ACS) adaptations implemented during the Novel Coronavirus Disease 2019 (COVID-19) pandemic across four different North American sites: St. Paul’s Hospital in Vancouver, British Columbia; Oregon Health & Sciences University in Portland, Oregon; Boston Medical Center in Boston, Massachusetts; and Yale New Haven Hospital in New Haven, Connecticut. Experiences ACS made system, treatment, harm reduction, and discharge planning adaptations. System changes included patient visits shifting to primarily telephone-based consultations and ACS leading regional COVID-19 emergency response efforts such as substance use treatment care coordination for people experiencing homelessness in COVID-19 isolation units and regional substance use treatment initiatives. Treatment adaptations included providing longer buprenorphine bridge prescriptions at discharge with telemedicine follow-up appointments and completing benzodiazepine tapers or benzodiazepine alternatives for people with alcohol use disorder who could safely detoxify in outpatient settings. We believe that regulatory changes to buprenorphine, and in Vancouver other medications for opioid use disorder, helped increase engagement for hospitalized patients, as many of the barriers preventing them from accessing care on an ongoing basis were reduced. COVID-19 specific harm reductions recommendations were adopted and disseminated to inpatients. Discharge planning changes included peer mentors and social workers increasing hospital in-reach and discharge outreach for high-risk patients, in some cases providing prepaid cell phones for patients without phones. Recommendations for the future We believe that ACS were essential to hospitals’ readiness to support patients that have been systematically marginilized during the pandemic. We suggest that hospitals invest in telehealth infrastructure within the hospital, and consider cellphone donations for people without cellphones, to help maintain access to care for vulnerable patients. In addition, we recommend hospital systems evaluate the impact of such interventions. As the economic strain on the healthcare system from COVID-19 threatens the very existence of ACS, overdose deaths continue rising across North America, highlighting the essential nature of these services. We believe it is imperative that health care systems continue investing in hospital-based ACS during public health crises.

Maternal pre- and postnatal substance use and attachment in young children: A systematic review and meta-analysis

2021 ◽  
pp. 1-18
Author(s):  
Noora Hyysalo ◽  
Marissa Gastelle ◽  
Marjo Flykt
Keyword(s):  
Substance Use ◽  
Young Children ◽  
English Language ◽  
Meta Analysis ◽  
Sociological Factors ◽  
Child Attachment ◽  
Maternal Substance Use ◽  
Potential Factors ◽  
Cumulative Risks ◽  
The Impact

Abstract Maternal substance use has often been associated with insecure and disorganized child attachment. We evaluated this association with a meta-analysis of young children and, further, systematically reviewed mediating and moderating factors between maternal substance use and child attachment. We performed a systematic database search of quantitative English language studies on child attachment that included substance-using mothers and their children below 6 years of age. Eleven studies (N = 1,841) met the inclusion criteria and were included in the meta-analysis of attachment security and seven (N = 1,589) studies were included in the meta-analysis of attachment disorganization. We found that maternal substance use was negatively associated with secure attachment in children, but the effect size was small (r = −.10). The association with disorganized attachment was not significant (r = .15). Related to moderating and mediating factors (k = 6), we found evidence on the role of teratogenic and sociological factors on child attachment. Most importantly, the impact of cumulative risks was vital. However, literature was scarce, and studies varied in risk of bias, leaving many unanswered questions on other potential factors underlying the development of attachment in these high-risk children. We discuss the results considering clinical implications and future directions.

scholarly journals Forgotten but Not Gone: The Impact of the Opioid Epidemic and Other Substance Use Disorders on Families and Children

Commonwealth ◽  
2018 ◽  
Vol 20 (2-3) ◽  
Author(s):  
Dennis C. Daley ◽  
Erin Smith ◽  
Daniel Balogh ◽  
Jodi Toscaloni
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Health And Safety ◽  
Clinical Settings ◽  
Opioid Epidemic ◽  
Sources Of Information ◽  
Opioid Use ◽  
Current Trends ◽  
The Impact ◽  
Public Health And Safety

This article discusses the impact of the opioid epidemic and other substance use disorders (SUDs) on families and their members, including children. We review factors contributing to this major public health and safety problem, current trends in opioid and other substance use and misuse, prevalence of opioid use disorders (OUDs) and other SUDs, and interventions to help families. Sources of information for this article include research, clinical and recovery literature, government reports, experiences of the two senior authors in clinical settings, and interviews and surveys of family members affected by a loved one’s SUD.

Impact of Personality Disorder on the Treatment of Psychiatric Disorders in People Receiving Methadone-Assisted Treatment

2019 ◽  
pp. 1-13
Author(s):  
Michael Kidorf ◽  
Stephanie Salazzo ◽  
Robert K. Brooner ◽  
Jessica Peirce ◽  
Jim Gandotra ◽  
...  
Keyword(s):  
Substance Use ◽  
Personality Disorder ◽  
Psychiatric Treatment ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Axis Ii ◽  
Hopkins Symptom Checklist ◽  
Axis I ◽  
Dsm Iv ◽  
The Impact

This study evaluates personality disorder as a moderator of psychiatric treatment response in people receiving methadone-assisted treatment. Participants (N = 125) were enrolled in a 12-week parent study that evaluated the impact of incentives on attendance to psychiatric care. All participants had a current DSM IV-R Axis I disorder and were classified based on presence of an Axis II disorder: Axis I-only (n = 46) versus Axis I + II (n = 79). All participants received an identical protocol of psychiatric and substance use disorder care. Although Axis I + II participants endorsed more psychiatric distress (on the Hopkins Symptom Checklist–Revised) throughout treatment, they reported significant reductions in distress that paralleled reductions reported by Axis I-only participants. Rates of substance use were low and similar across groups. Results support the benefits of integrated psychiatric and substance use care for people with opioid use disorder, with or without a co-occurring personality disorder.

scholarly journals Trajectories of victimization to violence among incarcerated women

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Preeta Saxena ◽  
Nena Messina
Keyword(s):  
Substance Use ◽  
Physical Violence ◽  
Negative Impact ◽  
Specific Treatment ◽  
Secondary Data ◽  
Incarcerated Women ◽  
Childhood Victimization ◽  
Multiple Forms ◽  
Women's Lives ◽  
The Impact

Abstract Introduction Limited research has focused on the trajectories of victimization to violence in women’s lives. Furthermore, literature assessing women’s use of violence has primarily focused on adult risk factors (e.g., substance use and criminal histories). Drawing from the pathway’s framework, we explored the impact of multiple forms of childhood victimization and subsequent harmful behaviors on adult-perpetrated violence among women convicted of violent or serious crimes. Methods This secondary data analysis included a sample of 1118 incarcerated women from two prisons. Based on prior literature outlining the lifelong negative impact of childhood victimization, we hypothesized that cumulatively, occurrence of abuses, arrest as a minor, number of lifetime arrests, and poly-substance use prior to incarceration, would increase the likelihood of perpetration of multiple forms of violence. GEE regression models were used to examine the relationship between the predictors and adult perpetration of intimidation and physical violence. Results Experiences with childhood victimization, early (under age 18) and ongoing criminal justice involvement, and substance use significantly increased the likelihood of adult perpetration of violence, regardless of the type of violence measured (intimidation or physical violence). Conclusion Given the documented high prevalence of childhood trauma and abuse among justice-involved women, findings from this study can be used to promote the implementation of trauma-specific treatment for at-risk juvenile girls, whose trajectories of violence might be mitigated.

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