Keri, now 35 and studying to become an addiction treatment counselor in Illinois, learned she was pregnant in 2016. In those first days and weeks, she was a mess of uncertainty and confusion. She did not know how she was going to care for a child, whether her partner would be supportive, or even where they would live. But one thing she did know was that she did not want to use drugs while she was pregnant or parenting.
The problem was, she was addicted to heroin.
People who use drugs while pregnant and parenting are one of the most stigmatised populations in the United States. There is a pervasive idea that parents—particularly women—have a duty to sacrifice everything for their child, even down to their comfort and enjoyment.
It’s not enough to ensure that a child is well cared for; society expects mothers to also behave in a manner that looks caring. Once someone becomes a mother, she enters into an unspoken agreement to be scrutinized by just about everyone. If illegal drugs are on the scene, she is instantly labeled the Worst Person Ever. And this discrimination is greatly exacerbated for parents of color.
According to the Centers for Disease Control, “substance abuse” is a risk factor for child maltreatment. There are certainly risks associated with use of illicit drugs, though it’s worth noting that many of those potential dangers stem from the criminalisation of drugs, rather than from the drug use in itself.
For example, someone who injects heroin in the home might be at risk of overdose. But this peril is increased both by the secretiveness that illegality demands, making it more likely the person will use alone, and by prohibition’s tendency to incentivize production of more potent drugs—see the widespread presence of fentanyl in US heroin supplies in recent years. Lack of access to the opioid overdose antidote naloxone also compounds the risk.
Regardless of the reasons, the danger of a parent overdosing while alone with a child is real, and cause for concern. Other issues could be that a parent with an active, severe substance use disorder might not have enough money to provide for basic needs like food and appropriate clothing, or might be too intoxicated to notice cues that indicate a child is ill.
But these are only possibilities; drug use takes place on a spectrum. The mere fact that a parent uses a drug does not mean he is not taking good care of his child. And it certainly doesn’t mean he doesn’t love his child.
“Not everyone has access to buprenorphine or methadone, and not everyone can remain abstinent throughout their pregnancy or during the time they have children. That’s a reality; it doesn’t make them bad parents,” says Justine Waldman, medical director of the REACH Project, a harm reduction-oriented equitable health hub in New York State.
“I think what makes them really good parents is making sure—especially with opiates—that there is somebody present who is in a position to watch the children and be capable to care for their needs during the parent’s use. That is the safest method and that’s what we would encourage. So: not using alone, making sure there’s [naloxone] on site, making sure drug use is not occurring in front of or near children, and making sure someone can watch the children if the person using becomes what I would call inebriated.”
Unjustified Child Removals
That is exactly what Suzanne Sellers did. Sellers, who is now the executive director of Families Organizing for Child Welfare Justice, had her first child, a toddler at the time, removed from her care in Illinois in the early ‘90s. A few years later, her second child was removed at birth. She admits to using crack cocaine and alcohol problematically, but adamantly denies abusing either of her children.
“A call was made to the hotline alleging I was neglecting my toddler-aged daughter, saying I was not adequately caring for my daughter because I would take her to the home of family and friends while I would go on drug binges,” she says. “While it was true that I took my daughter to the home of family and friends and I would be away for two to three days at a time, I did so because I wanted my daughter to be properly cared for while I was away. In my mind, that was the most loving, caring thing I could do for her while being an addict.”
Nonetheless, Sellers’ rights to parent her daughter, and later her son, were terminated. She has been sober since 1997, after engaging in drug treatment of her own accord, but custody was never returned. When her rights were permanently terminated in 1999, she had been sober for two years. She now has loving, bonded relationships with her adult children, and fights so that other families don’t also have to endure the trauma of wrongful separation.
“If someone is using drugs and not abusing their child, that is not child abuse,” Sellers insists.
Waldman also talks about the importance of acknowledging the spectrum of drug use. Someone who uses cocaine recreationally on the weekends is probably going to get high when she uses. And during that time, she might be over-excitable, energetic, have difficulty concentrating, or even become paranoid or agitated. These aren’t traits conducive to the most effective parenting; as Waldman notes, it’s a good idea to have someone else there to make sure the child is safe during use, or to do what Sellers did, and drop the child…