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Henry MC, Sanjuan PM, Stone LC, Cairo GF, Lohr-Valdez A, Leeman LM. Alcohol and other substance use disorder recovery during pregnancy among patients with posttraumatic stress disorder symptoms: A qualitative study. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 1:100013. [PMID: 36843908 PMCID: PMC9948915 DOI: 10.1016/j.dadr.2021.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
Background About 5% of women are pregnant at substance use disorder (SUD) treatment entry, and pregnant women with SUD often belong to marginalized groups experiencing social, economic, and health care barriers associated with stigma from prenatal substance use. Pregnant women in SUD treatment have high rates of trauma and posttraumatic stress disorder (PTSD). This study sought to (1) examine the lived experiences of pregnant individuals with PTSD symptoms in SUD treatment and (2) understand the roles of systematic or contextual barriers to the pursuit of prenatal abstinence. Methods We draw upon in-depth semi-structured interviews to examine relationships between SUD, psychological trauma/PTSD experience, social resources, and lived experiences among patients in prenatal SUD treatment with PTSD symptoms. Our sample was pregnant patients (N = 13) with prior DSM-5 Criterion A trauma and current PTSD symptoms enrolled in a comprehensive program integrating prenatal care, substance use counseling, medication for opioid use disorder and case management at three sites affiliated with an urban academic medical center in New Mexico. Results Using thematic analysis, four main themes identified structural forces influencing alcohol and drug use: (a) lack of access or ability to obtain resources, (b) substance use to cope with negative affect, (c) social stigma, and (d) interpersonal relationships. Conclusions Despite receiving high-quality integrated prenatal and SUD care, these pregnant patients with PTSD symptoms in SUD treatment still experienced substantial social and structural hurdles to achieving abstinence during pregnancy.
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Affiliation(s)
- Melissa C. Henry
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
| | - Pilar M. Sanjuan
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
- Department of Family and Community Medicine, University of New Mexico School of Medicine MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, United States
| | - Lisa Cacari Stone
- College of Population Health, University of New Mexico Health Science Center, 1001 Medical Arts Ave NE, Albuquerque, NM 87102, United States
| | - Grace F. Cairo
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
| | - Anthony Lohr-Valdez
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Boulevard, SE, Albuquerque, NM 87106, United States
| | - Lawrence M. Leeman
- Department of Family and Community Medicine, University of New Mexico School of Medicine MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, United States
- Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131, United States
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