Influence of social factors on mothers in treatment for substance use disorders:

Consideration of women-specific issues in addictions treatment requires attention be given to the subset of women who are also mothers. For these women, the repercussions of substance use are often profound and far-reaching. Impaired decisions and parenting skills may increase risk for child abuse and neglect. This dissertation sought to better understand how the quality of a mother’s social resources and her substance use behaviors are influenced by her primary drug of choice (heroin, cocaine/crack, marijuana, alcohol). Social network characteristics and substance use behaviors were characterized at treatment entry, treatment discharge, and six months post-treatment in a sample of 246 women, with minor children, who received addictions treatment based on involvement with the New Jersey Division of Youth and Family Services. Nearly half of these women had not achieved the equivalent of a high school degree and the majority was unemployed and unmarried. At treatment entry, primary heroin users reported more frequent primary drug use, more poly-drug use, and less abstinence in the past thirty days than women with other drug preferences. However, heroin using mothers improved most during treatment, reporting similar frequencies of substance use and use-related problems at both follow-up assessments as women with other drug preferences. At treatment entry, all participants reported extensive contact with family dense social networks that supported general well-being, abstinence and treatment seeking. Primary marijuana users, however, reported networks that were more neutral towards their continued substance use than women with other drug preferences. Over time, marijuana using women reported an increase in the frequency of substance use by their network members whereas women with heroin and cocaine preferences reported decreases. Importantly, frequency of substance use by network members was the social network characteristic most highly correlated with concurrent and subsequent substance use and use-related problems. The reason for these marijuana-specific social network differences is not immediately clear, but may reflect a broad societal belief that marijuana is less physiologically, psychologically, and socially harmful than other drugs. Nonetheless, these results suggest that treatment may not adequately address the importance of social factors in the maintenance of marijuana use disorders.Psy.DIncludes bibliographical references (p. 83-91)by Nathan V. Hilto