Parental Status of Women Injection Drug Users and Entry to Methadone Maintenance

Abstract

This article examines patterns of methadone maintenance treatment entry among 9018 adult women injection drug users (IDUs), with special attention to parental-status differences. The data originate from a statewide drug-treatment database covering all women IDUs who entered drug treatment in the State of Massachusetts over a four-year period. Through the use of logistic regression analysis, the study found that among these women IDUs, those who resided with their children were significantly more likely to enter methadone maintenance than women who were mothers but did not reside with their children. Mothers residing with their children were 73% more likely to enter methadone maintenance than mothers who do not reside with their children. The authors discuss specific programmatic and policy implications including the need to determine whether methadone maintenance should be promoted as an alternative drug treatment option in order to preserve family unification or promote family reunification.

• Women
• Injection drug use
• Parental status
• Drug treatment
• Child welfare

Resumen

Este papel examina patrones de entrada a tratamiento de mantenimiento con metadon de 9018 mujeres adultas que inyectan drogas, con atención especial a la diferencia entre estados paternales. Los datos analizados se originaron en una base de datos sobre tratamiento de drogas a lo largo del estado, cubriendo todas las mujeres usuarias de drogas intravenosas que entrap al tratamiento de drogas en el estado de Massachussets durante un periodo de cuatro años. A través del uso del método de análisis de regresión, la investigación encontró que entre éstas mujeres usuarias de drogas intravenosas, aquellas que viven con sus hijos tenían más probabilidad de entrar a un mantenimiento con metadon que mujeres que eran madres pero no vivían con sus hijos. Madres viviendo con sus hijos tenían 73% más probabilidades de entrar a un mantenimiento con metadon que madres que no vivían con sus hijos. Los autores discuten las implicaciones programáticas y de política especificas, incluyendo la necesidad de determinar si el mantenimiento con metadon se debería promover como una optión para alternativas de tratamiento de droga para poder preservar la unificación de la familia o promover la reunificación de la familia.

Résumé

Cet article etudie des echantillons de traitements par methadone sur 9018 femmes utilisant des drogues par injection (IDUs), avec une attention toute particuliere aux differences de statut parental. Les donnees analisees proviennent d'une base de donnees d'Etat sur les cures de desintoxication qui concerne toutes les femmes ayant commence une cure de desintoxication dans l'Etat du Massachusetts Durant les quatre dermieres annees. Par le biais de l'analyse logistique par regression, l'etude montre que sur toutes ces femmes “IDUs,” celles qui resident avec leurs enfants sont significativement plus a meme de supporter un traitement par methadone que les meres ne resident pas avec leurs enfants. Les meres residant avec leurs enfants sont 73% plus a meme de prendre un traitement de methadone que celles qui ne vivent pas avec leurs enfants. Les auteurs discutent des programmes et des politiques a mettre en place, notamment le fait de savoir s'il vaut mieux promouvoir la methadone comme une option alternative aux cures de desintoxication pour preserver l'unite familiale ou la reunification familiale.

Notes

^aIt is recognized that there is considerable confusion and disagreement with respect to defining and capturing ethnic-racial identification. For example, some view Latinas/os as a language-cultural group, rather than an ethnic group. The majority of individuals identified as Latina/o or Hispanic in this study were of Puerto Rican ethnicity (81%). The remainder were from a variety of ethnic groups including Central Americans (6%), Dominicans (1.5%), and Mexicans (1%)

Additional information

Notes on contributors

Lena M. Lundgren

Lena Lundgren, Ph.D., is an Associate Professor of Welfare Policy at Boston University School of Social Work. Dr. Lundgren is currently directing four multiyear research efforts on the releationships of injection drug use, HIV, and substance abuse treatment. These studies are funded through through grants from the Robert Wood Johnson and the Center for Substance Abuse Treatment (CSAT).

Robert F. Schilling

Robert Schilling is a Professor of Social Welfare at the School of Public Policy and Social Research at UCLA. In his research, Professor Schilling seeks to develop, adapt, and test sociobehavioral interventions designed to ameliorate social and health problems of low-income populations in the United States and the developing world. Dr. Schilling's studies have been conducted in sites as disparate as small soup kitchens, street outreach programs, sexually transmitted disease clinics, emergency departments, and primary care, detoxification, and methadone clinics.

Therese Fitzgerald

Therese Fitzgerald, M.S.W., L.C.S.W., works as a Research Associate at the Center on Work and Family at the Boston University School of Social Work. She is a clinical social worker and a doctoral student in the Interdisciplinary Sociology and Social Work Ph.D. Program at Boston University. She has coauthored a number of articles in the areas of work–family issues and substance-abuse treatment. Her research interests include women and substance abuse, harm reduction in social work, and substance abuse and parenting.

Karen Davis

Karen Davis is completing a dual master's program in Social Work and Public Health at Boston University. In 1999, she received her bachelor's in Anthropology and Psychology from the University of Texas at Austin. She is currently a Research Coordinator at the Center on Work and Family at Boston University. Her research interests include health expenditure and care for historically underserved populations, particularly indigenous populations.

Maryann Amodeo

Maryann Amodeo, M.S.W., Ph.D., is the Director of the Alcohol and Drug Institute for Policy, Training an Research at Boston University, and Associate Professor at the School of Social Work. She has over 20 years of professional experience in the alcoholism and drug abuse fields as a clinician, trainer, and researcher. Her research interests include the use of drug abuse treatment by injection drug users, resilience in women raised in alcoholic families, and cross-cultural interventions with substance abusing clients.