Substance, structure and stigma: parents in the UK accounting for opioid substitution therapy during the antenatal and postnatal periods.
Substance, structure and stigma: parents in the UK accounting for opioid substitution therapy during the antenatal and postnatal periods.
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DOI：
10.1016/j.drugpo.2013.04.004
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发表时间：
2013-11-01
期刊：
影响因子：
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通讯作者：
Mathews, Gillian
中科院分区：
文献类型：
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作者：
Chandler, Amy;Whittaker, Anne;Mathews, Gillian
背景：吸毒背景下的育儿和怀孕是一个有争议的话题，是政策议程上的重中之重。通过早期干预、获得药物治疗和育儿技能培训，向依赖阿片类药物的父母提供有效支持是一项优先事项。然而，人们对阿片依赖父母在产前和产后期间的育儿支持经验和理解知之甚少。本文旨在探讨阿片类药物替代疗法(OST)在英国孕期或新近怀孕的父母口述中的地位和影响。方法：对19名阿片依赖服务使用者(女性14名，男性5名)进行半结构式定性访谈。在产前和产后(最多一年)期间收集了纵向数据，参与者最多采访了三次。研究人员对45个访谈进行了主题分析，采用不断比较的方法，并以社会学的叙事方法为基础。结果：参与者对药物治疗的描述明显倾向于证明他们正在为自己的宝宝做最好的事情。对于一些人来说，OST被框定为通向被视为正常的家庭生活的一条途径；对另一些人来说，OST是实现这种正常生活的障碍。挑战涉及：阿片类药物依赖的生理效应；与治疗制度相关的结构性限制；以及对使用药物的父母的负面社会观点的影响。结论：父母对OST的描述可以被视为对社会文化理想的回应，即“好的”、无毒的父母。他们的叙述反映了参与OST的父母发现自己处于何种境地，他们的叙述需要调和他们作为“吸毒父母”的身份与“理想父母”节欲的观点。
BACKGROUND: Parenting and pregnancy in the context of drug use is a contentious topic, high on the policy agenda. Providing effective support to parents who are opioid dependent, through early intervention, access to drug treatment and parenting skills training, is a priority. However, little is known about opioid dependent parents' experiences and understanding of parenting support during the antenatal and postnatal periods. This paper focuses on the position and impact of opioid substitution therapy (OST) in the accounts of parents who were expecting, or who had recently had, a baby in the UK.METHODS: Semi-structured qualitative interviews were held with a purposive sample of 19 opioid dependent service users (14 female, 5 male). Longitudinal data was collected across the antenatal and postnatal (up to 1 year) periods, with participants interviewed up to three times. Forty-five interviews were analysed thematically, using a constant comparison method, underpinned by a sociologically informed narrative approach.RESULTS: Participants' accounts of drug treatment were clearly oriented towards demonstrating that they were doing 'the best thing' for their baby. For some, OST was framed as a route to what was seen as a 'normal' family life; for others, OST was a barrier to such normality. Challenges related to: the physiological effects of opioid dependence; structural constraints associated with treatment regimes; and the impact of negative societal views about drug-using parents.CONCLUSION: Parents' accounts of OST can be seen as a response to socio-cultural ideals of a 'good', drug-free parent. Reflecting the liminal position parents engaged in OST found themselves in, their narratives entailed reconciling their status as a 'drug-using parent' with a view of an 'ideal parent' who was abstinent.