Women with histories of cocaine or heroin use who lose child custody

Abstract

This exploratory study used grounded theory methodology to develop a substantive theory regarding women with histories of cocaine or heroin use who lose child custody. The primary aims were to obtain information directly from women, to identify common concepts evidenced in their stories, and to suggest hypothetical relationships among the concepts.Audio-taped interviews were conducted with 15 women recruited through 3 sites who had lost custody of 1 to 4 children each. All women had abstained from drug and alcohol use from five days to three years at the time of the first interview and the majority of them were white. The 32 children lost to custody ranged in age from newborn to 11 years at the time of custody change. Published personal narratives were also reviewed.The constant comparative method was used to analyze the verbatim interview transcripts and narratives. An overarching process that accounted for much of the variability in the data was Handling the Hurt. Hurt and pain were frequently mentioned by the participants, not only regarding the custody loss of the child but also regarding actual or potential negative effects on the child associated with prenatal drug use and/or drug usage in the home, the mother's own family of origin/childhood issues, and/or frequent histories of abuse. Strategies that women used for Handling the Hurt were: (1) Numbing Out (using drugs to cover or escape feelings), (2) Giving Up (having suicidal/despairing thoughts or behaviors), (3) Running Away (physically leaving an unsafe or problematic locale), (4) Cleaning Up a Little (making temporary efforts to remain abstinent), (5) Cleaning Up a Lot (using treatment and other resources to build trust and develop a balance between parenting and recovery), and Dealing with Feelings (addressing feelings without the use of drugs/alcohol). The women's stories demonstrated fluidity among all strategies except for Dealing With Feelings, which could only be truly attained through Cleaning Up a Lot. Professionals may be better able to assist mothers who use drugs to maintain abstinence and utilize available services by being aware of the mothers' hurt and the strategies they may use to handle this hurt.