Mothers Who Use Drugs: Closing the Gaps in Harm Reduction Response Amidst the Dual Epidemics of Overdose and Violence in a Canadian Urban Setting.

Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print Cited Medium: Internet ISSN: 1541-0048 (Electronic) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]

Epidemics* ; Harm Reduction*; British Columbia/epidemiology ; Female ; Humans ; Mothers ; Violence

Objectives. To identify key gaps in overdose prevention interventions for mothers who use drugs and the paradoxical impact of institutional practices that can increase overdose risk in the context of punitive drug policies and a toxic drug supply. Methods. Semistructured interviews were conducted with 40 women accessing 2 women-only, low-barrier supervised consumption sites in Greater Vancouver, British Columbia, Canada, between 2017 and 2019. Our analysis drew on intersectional understandings of structural, everyday, and symbolic violence. Results. Participants' substance use and overdose risk (e.g., injecting alone) was shaped by fear of institutional and partner scrutiny and loss (or feared loss) of child custody or reunification. Findings indicate that punitive policies and institutional practices that frame women who use drugs as unfit parents continue to negatively shape the lives of women, most significantly among Indigenous participants. Conclusions. Nonpunitive policies, including access to safe, nontoxic drug supplies, are critical first steps to decreasing women's overdose risk alongside gender-specific and culturally informed harm-reduction responses, including community-based, peer-led initiatives to maintain parent-child relationships. ( Am J Public Health . 2022;112(S2):S191-S198. https://doi.org/10.2105/AJPH.2022.306776).

J Subst Abuse Treat. 2021 Jun;125:108313. (PMID: 34016300)
Int J Drug Policy. 2010 Jul;21(4):321-9. (PMID: 20116989)
Int J Drug Policy. 2021 May;91:102977. (PMID: 33129662)
Addiction. 2018 Dec;113(12):2261-2270. (PMID: 30211453)
Harm Reduct J. 2020 Oct 22;17(1):84. (PMID: 33092595)
Sociol Health Illn. 2021 Sep;43(8):1903-1920. (PMID: 34468044)
Harm Reduct J. 2021 Mar 7;18(1):29. (PMID: 33678163)
Int J Drug Policy. 2020 Apr;78:102733. (PMID: 32247720)
Int J Drug Policy. 2019 Jun;68:117-123. (PMID: 30064720)
Child Abuse Negl. 2018 Mar;77:1-12. (PMID: 29287167)
J Health Polit Policy Law. 2013 Apr;38(2):299-343. (PMID: 23262772)
Harm Reduct J. 2015 Mar 07;12:6. (PMID: 25889492)
Soc Sci Med. 1996 Sep;43(5):889-900. (PMID: 8870153)
Hum Organ. 2004 Sep;63(3):253-264. (PMID: 16685288)
Int J Drug Policy. 2019 Jun;68:109-116. (PMID: 30583823)
Harm Reduct J. 2020 Nov 23;17(1):90. (PMID: 33228676)
J Acquir Immune Defic Syndr. 2015 Jun 1;69 Suppl 2:S176-81. (PMID: 25978485)
J Rural Health. 2021 Jan;37(1):35-44. (PMID: 32929780)
Child Abuse Negl. 2019 Apr;90:139-148. (PMID: 30780009)
Addiction. 2019 Sep;114(9):1602-1613. (PMID: 31166621)
Int J Drug Policy. 2015 Nov;26(11):1158-66. (PMID: 26194783)
Int J Drug Policy. 2017 Jun;44:145-154. (PMID: 28578916)
Int J Drug Policy. 2008 Apr;19(2):140-7. (PMID: 18207725)
Int J Drug Policy. 2021 Apr;90:103082. (PMID: 33373906)
Addiction. 2020 Sep;115(9):1786-1787. (PMID: 32141135)
Cult Health Sex. 2014;16(4):440-52. (PMID: 24654881)
MMWR Morb Mortal Wkly Rep. 2019 Jan 11;68(1):1-5. (PMID: 30629574)
Harm Reduct J. 2017 May 18;14(1):28. (PMID: 28521829)
Child Abuse Negl. 2018 May;79:125-135. (PMID: 29433069)

R01 DA044181 United States DA NIDA NIH HHS; 20R74326 Canada CIHR; PJT-155943 Canada CIHR

Date Created: 20220329 Date Completed: 20220405 Latest Revision: 20230912

20230912

PMC8965171

10.2105/AJPH.2022.306776

35349325