Daughters' Perspectives on Maternal Substance Abuse: Pledge to Be a Different Kind of Mother.

Introduction Due to the substance abuse epidemic that peaked in the mid-1980s (Reinarman & Levine, 1997), there are a significant number of young adults who grew up exposed to maternal drug use. Today, more than 20 years later, many of these young people are now parents themselves. The present study grew out of our increasing clinical awareness of the need for parenting guidance expressed by young mothers reared by mothers who abused drugs. The purpose of this grounded theory (Strauss & Corbin, 1998) study was to explore the experiences of racially and culturally diverse young mothers whose own mothers abused substances two decades ago when substance abuse peaked in inner city, urban neighborhoods in the United States and to identify the factors that have influenced how they parent their own children today. There is evidence to suggest that drug use is on the rise again with 1.2 million new cocaine users in 2001, a level not reached since the late 1970s when incidence of cocaine use generally rose to a peak in 1980 when there were 1.7 million new cocaine users (Substance Abuse and Mental Health Services Administration, 2003), in the United States. These levels have remained constant from 2002 through 2008 based on the most recent statistics of crack use in persons 12 years and older (Substance Abuse and Mental Health Services Administration, 2009). Parental drug abuse has a significant impact on children. In the late 1970s through the 1990s, the number of children residing in foster homes due to abuse or neglect increased throughout the United States (Tyler, Howard, Espinosa, & Doakes, 1997) with the majority having a biological parent/s who either abused drugs or was involved in the drug trade (Simms, 1991) placing these children at-risk for a wide range of medical and developmental problems (Dicker, Gordon, & Knitzer, 2002). The World Health Organization (WHO) and the International Society for Prevention of Child Abuse and Neglect (ISPCAN; World Health Organization, 2006) suggest training health care professionals to identify and to refer adult survivors of child maltreatment, and provide parent training strategies to prevent child maltreatment in the next generation. The Adverse Child Experiences study (Anda, Felitti, Bremner, Walker, Whitfield, Perry, et al., 2006; Felitti, Anda, Nordenberg, Williamson, Spitz, Edwards, et al., 1998) found that deleterious physical health outcomes were associated with childhood maltreatment. Diseases in adulthood, specifically obesity, diabetes, cancer, heart disease, and skeletal fractures have been traced back to childhood experiences of emotional, physical, or sexual abuse, and household dysfunction. According to the WHO and ISPCAN, it is essential to identify those parents with histories of adverse childhood experiences and provide them with support in order to break the intergenerational cycle of poor physical and mental health outcomes in the next generation of children. Among the most significant factors influencing the adjustment of all children is the quality of attachment to their primary caregivers, derived from family relationships and family processes (Bowlby, 1969; Hill, Fonagy, Safier, & Sargent, 2003; Owens & Shaw, 2003; Pawl, 1995; Steele & Steele, 2005), which influence development and affect risk of psychopathology (Rutter, 2000; Shonkoff & Phillips, 2000). The impact of trauma on early personality development coupled with the question of how parents' unresolved traumatic experiences affect their subsequent parenting of their own children is gaining increasing attention in the trauma literature and in attachment research (Lieberman, 2004; Osofsky, 2004; Siegel & Hartzell, 2003; Steele & Baradon, 2004). The intergenerational cycle of risk of poverty, crime, psychological distress, and illness is well-documented in the literature (Chase-Landsdale, Wakschlag, & Brooks-Gunn, 1995; McLoyd, 1998). To provide a context for our study, we first will review the risk factors associated with poverty, drawing attention to the childhood experiences of maternal substance abuse from the perspectives of young women whose mothers were addicted to drugs. …