By Sofia Ramirez, AOHC Communications Lead

Mothers with substance use problems are an extremely vulnerable population. They face multiple barriers- both at systemic and social levels.

At a systems level, substance-dependent mothers are hesitant to seek drug addiction treatment for fear of the immediate questions about the custody of their children. They feel powerless as their children are often taken away from them; the very idea often prevents them from seeking out treatment.

Women in this position also face stigma from service providers and are challenged with navigating a fragmented system that takes too narrow a focus. In traditional care settings, women are often turned away due to the complexity of their situations; situations that often intertwine with trauma, mental illness, and housing issues.

On a social level, women may not be supported by their family or friends. In some cases, pregnant women are living with partners who also use and are unwilling to support the change in lifestyle.

All of these factors make it very difficult to succeed. Understanding the personal and social barriers, the determinants of health, faced by mothers is the key to improving the outcomes of these woman and their children. A woman in this position should not have to face the decision of choosing between treatment and caring for her children.

Black Creek Community Heath Centre (BCCHC) has created a supportive setting for these mothers through an innovative program called Bridges to Moms (BTM). The program works in a holistic and culturally responsive manner to reduce harm to pregnant and parenting women who use substances. Through this program they are also aiming to improve the lives of their young children.

“If we can support one person, one parent, to better health and improved life conditions,” says BTM program manager Audrey Taylor, “then we have the possibility of also improving the lives of their children and their chances for the future.”

Bridges to Moms arose as a collaborative initiative between the Black Creek Community Heath Centre, The Jean Tweed Centre and Addiction Services of York Region. The program services a wide region and is modeled after the Pathways to Healthy Families program at the Jean Tweed Centre. Support is provided to women who are pregnant or have children in the crucial developmental stage of zero to six years old.

Following the release of a report showing an increase of opioid use in Ontario, the program was funded by the Central Local Health Integration Network (LHIN) to focus on pregnant and parenting women with opioid addictions. The LHIN’s goal was to reduce the need for hospital care.

The program is in the initial stages, only in its sixth month. Current efforts have been focused on outreach, partnerships and informing other service providers of its existence.  The program is led by a highly qualified interprofessional team which provides support with referrals, counseling, assistance with child welfare issues, access to parenting programs and child development services.  They also help with education and consultation on the issues of substance use, pregnancy and parenting.

Rather than demand abstinence, a harm reduction approach is taken, moving women gradually to less harmful substances. “Women’s backgrounds are so varied and their life experiences are as well. Most have experienced a life trauma and some use with their partners. Each woman is unique and you have to meet them where they are,” says Taylor.

If opioids are the addictive substance, then replacing it with methadone, which is less harmful to the baby, is recommended. The harm reduction approach is favoured because sudden withdrawal can sometimes lead to shock for the babies and it also has a higher likelihood of bringing people to a place where they can cope.  

Creating an anti-oppressive space is also critical. This recognizes the lack of power these women have and attempts to shift it by being inclusiveness and accessible. An example of this is shown through the way reporting requirements of Children’s Aid Services are fulfilled. In these cases, the woman themselves make the calls to CAS rather than the program workers. This not only deepens the trust with the team, but it also increases a woman’s perception of power and self-efficacy.   

The needs of substance-dependent women and their children are often separated and polarized.  Instead, this unique program supports the growth of the mother-child relationship (imperative to their wellbeing) that is often ignored and seen as less important than dealing with the substance-use issues.  

The second stage of the program, “Mom & Kids Too,” focuses on strengthening the bonds between a mother and her children. Mothers are able to spend time with their kids while in the presence of an ECE worker that observes and provides support to the mothers. Both the children and the mothers are then involved in activities that help them develop personally.

In this way, a woman in the program is empowered to focus on developing her role as a parent at the same time that she addresses her addiction to drugs; a truly revolutionary approach.

Bridges to Moms and Mom & Kids Too promote a collaborative, integrated, person-centered approach to service delivery. These programs are examples of the Model of Health & Wellbeing in action.

Click for an overview of the Bridges to Moms program and contact information.

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