a qualitative study of what it is like to be a parent who uses drugs damage limitation: strategies to reduce harm and maintain normalcy in family life

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1 Parents who use drugs Accounts of harm and harm reduction Tim Rhodes, Kathrin Houmøller, Sarah Bernays, Sarah Wilson 1

2 outline a qualitative study of what it is like to be a parent who uses drugs damage limitation: strategies to reduce harm and maintain normalcy in family life damage acceptance: representations of harm and agency in relation to it accounts: strategies of child protection and self protection through damage limitation 2

3 context policy Parental drug use is harm producing to children at every age from conception to adulthood [ACMD, 2003] services Emphasis on child protection; fear of disclosure [ACMD, 2003] research For most children living with chronic substance-misusing parents, life can be very painful, difficult, frightening or dangerous [Kroll & Taylor, 2003] It is only under conditions of stringent and controlled drug use that children are not negatively affected [Barnard, 2007] 3

4 accounts have a context: I was very conscious of appearing to be on drugs I felt exposed, as if it was obvious that I was a bloody junkie in charge of a kid [Zed] are co-produced: we take into account how the other person is [Baker, 1982]; a mix of the real and the representation [Dingwall, 1997] narrate a self: portray experience (relations between parent and child) at the same time as making sense of that experience (relations with self) while representing it to others (relations between self and interview situation) 4

5 methods the Family Life Project children, significant others, parents, other experts parents, n=26 / men; 13 women; average age children, ages 6 months to 36 years (most 5-18 years) all but one parent heroin or crack use as many daily users as occasional users, 6 in recovery thematic analysis damage, damage limitation, secrecy, ambiguity, normalcy, looking back 5

6 damage limitation strategies maintaining normalcy basic parental responsibilities separating the worlds of drugs and children maintaining secrecy investing in ambiguity preventing disruption and chaos maintaining income preventing withdrawal controlling drug use (including OST, not injecting, less crack) creating a safety net should disruption occur partner support (including non-using partners) family and friends care, and social service support 6

7 maintaining normalcy We did our best to maintain a kind of normalcy. You know, celebrate birthdays, you know, the whole thing Just the business of living, you know We would go to his parent s evenings and stuff, and, you know, try and maintain this kind of front, really But we could do it, we could do all those sorts of things, even if we were pinned. [ ] We were living a family life, and bringing up [Simon], and it wasn t a lie but there was a certain amount of covering up inevitably. [Zed] 7

8 separate worlds We didn t want him to be brought up in an environment where hard drugs were, you know, being used. Or we didn t want him to know that, we didn t want him to be conscious of that, because it might, you know, it might affect his behaviour at a later date I suppose. And that s, that s the kind of ongoing, kind of theme I suppose, is trying to keep it a secret you know, from [Simon] primarily, but from everybody else too. [Zed] 8

9 separation strategies time when in bed when at school space behind closed doors separate spaces hiding paraphernalia cleaning up and eliminating i evidence keeping drug using friends at a distance We d park him in front of the box, and go into the bedroom, close the door, barricade the bloody door, put something in front of it, and use He d call through the door, and we d go Yeah, yeah, hold on. [Zed] 9

10 unseen drug use Unseen is unknown, and undamaging He s walked into a room a couple of times when there s quickly been some shuffling around, and I know he must have thought What the, what s Dad doing?. But he s never actually, no, I ve never allowed Jack to actually see me taking drugs. [Rob] 10 I d Id hide the stuff, but no, he never saw me taking anything. I can say for a fact, he never saw me taking it. [ ] I think he sensed that I was doing something, but he never saw. He didn t see me do it. [Mary]

11 fragility of strategy risk of disruption interruption withdrawal cumulating evidence something is up You have to be careful. When I m trying to do my thing, he s always trying to get a look at it. [Ziggy] He waltzed in, and we tried to hide it, but he sort of sussed out, What you doing? I know you re hiding something. [Ebbe] I d take him to school and be in a real state [withdrawal], and he would look at me askance, sort of, What s wrong with you?. [ ] I knew I was in a state, and he looked at me like I was a state. [Zed] 11

12 investment in ambiguity Strategy maintained despite its fragility My son would say, Who was this? And I d say it was a friend, like, everyone was a friend. Maybe, in his head, he might have had an inkling, I don t know. But as far as I was concerned, no, they were just friends, and he didn t know anything else. He was none the wiser as far as I was concerned. [Mary] I didn t want them to actually catch me doing it. I didn t want them to see my paraphernalia. But then, there has been three occasions where I know that I come home and found my paraphernalia plonked right in the middle of whatever s gone on, where they ve thrown things 12 all over the place with their anger and frustration. [Mwansa]

13 investment in ambiguity Strategy maintained as a personal investment I don t know if he knew, but, to me, he seemed, it was like he was confused what was going on. And that s the way I wanted to keep it. He didn t know what was going on, do you know what I mean? That s the way I wanted to keep it. I have to ask him if he knew. I m not really sure. But he probably did. [Mary] I always wanted to have the illusion that I was alright. It was an illusion that I was okay. [ ] For me, that was very important, yeah, for him to see me looking normal. Yeah, and not high, or not, you know, like a crack head. [Mary] 13

14 the conversation Postponing Jack and I have actually never talked about it. We have never had a conversation about my drug addiction. Never. I ve Ive always kept it quiet from him.[ ] If I am successful in cleaning up, then I m sure I would, I m sure I would have a conversation with Jack, six months, a year down the line. [Rob] 14 I know we re going to have the conversation, I know we will. But right now, I mean, I m not ready for it now. And I think he s, kind of, like, I think he s waiting for me, to me, to actually come to him. [Mary]

15 the conversation delaying until the children indicate they know disclosing when the children are about to find out accepting that they know, but it remains unsaid accepting the investment in ambiguity as illusionary She knows a lot, more than we ever knew she knew. [Nadine] I knew deep down inside me, and I just, you know, you re trying to sort of like [whispering] They don t know, they don t know. You try and shield them, but really they ain t stupid They want to know everything, and they do.. [Ebbe] 15

16 damage qualified Not all drug users are bad parents We tried hard and were good enough parents We got our priorities right My children s basic needs were covered The damage caused was not severe Other drug users can be worse 16

17 damage qualified Drug users need not make bad parents You ve got this stereotype, that all drug users are dirty, and it s not like that at all. You know, there s hundreds of women out there that are going about their everyday business, taking their children to school, and then they re going home and using, you know. They re going back and picking up their children and trying to engage in what we think is the norm. [Mwansa] 17

18 damage qualified Good enough parents We re doing what, as best we can. OK, we ve got a drug problem. But, you know, we re not abusing him, we re not neglecting him. We re probably quite defensive about it really in some ways, but with, there is, you know, an argument that um, it s, it s not necessarily, it doesn t necessarily mean that the children, the child is neglected, or you know, not looked after properly. I know other people who are junkies or were, and have got children, you know, it s a mixed bag really. But most of, in fact all, the kids are pretty together. You know, they ve grown up in to be very nice young adults. [Zed] 18

19 damage qualified Children s basic needs were covered I tried my best. They were fed, they were clothed, they were, Il loved dthem. [Kirsty] 19 He s always got clean clothes and food at home. He gets to school on time. [Ali] He is happy and everything, you know, he s always been a happy child an that. [Jenni] We did our, our best, you know, giving him love and sort of, you know, making sure his upbringing was as stable as possible There was no violence involved, no, it wasn t that chaotic really, we managed to be functional, functioning i addicts. [Zed]

20 damage qualified Damage not as severe as might be imagined I m Im hoping Im I m not in denial about, you know, any real huge damage I ve done, but I, for the life of me I, I cannot remember, you know. I ve Ive never left him alone. He s never, he s never been in a car when I ve bought drugs. He never saw it, or how can I say it, he never suffered too much cause his Dad always had the money to buy the drugs, and if you ve got the money then um, you don t get into that whole gutter lifestyle, you know what I mean? [Rob] 20

21 damage qualified Damage is unseen and largely emotional 21 Drug addiction makes you a very selfish person, very self- centred, very me, me, me, very insular. When you re a drug addict, you re not emotionally available. [Rob] They ve always eaten, and they ve always had good meals, and they ve always had the best of the best. They ve been at school. They never missed out because I still made sure those things were okay. But they re not okay because mentally I ve harmed my children. You know, I have harmed my children. [Mwansa]

22 damage qualified Other drug users are worse Some people aren t proper parents that s the truth, you know, so people do neglect their children, and put their drugs more in front. [ ] We were never, sort of, like, we never, like, some people get totally out of their heads, well we wouldn t. We were never like that. [ ] It s never been chaotic really. [ ] I was never wrecked. [Ebbe] 22 I wasn t the normal crack user that didn t have anything. I had electric, I had gas. My children were well dressed, you know, there was nothing wrong. They weren t missing school. [Mwansa]

23 damage accepted acceptance of damage caused acceptance of conflicts of interest acceptance of investment in secrecy and ambiguity as inherently fragile as well as self-serving looking back as a process towards repair 23

24 damage accepted Accepting damage She says, I ve ruined her life. [ ] And she s right I hate to admit it but she is right.[ ] They re being neglected in one way or another. [Kirsty] I messed up at a very crucial time for my eldest son. [ ] I wasn t there because I was so zoned out in my head. I chose what I wanted to do over my children. [Mwansa] I know now that I neglected my son Ididn t give him a normal life. [Jenni] 24 It was a choice, and I chose crack cocaine for ten years. I was not in his life properly for ten years. [Mary]

25 damage accepted Accepting conflicts of interest If we carry on using, we re gonna lose them. Because this, I m telling you, can t work. I don t know nobody. Maybe there is somebody there, they use and they manage Maybe you are rich, you have a lot of money But if not, drugs is what makes you have nothing. You need to go outside and make the money, and you spend all that money on drugs. How can that work? Kids, they don t want, they don t wanna have nothing. You don t wanna take them to go to school because you are too busy making money or want to score drugs. It s impossible. All the people I know [who] had kids and they still using, they 25 lose the kids. [Carmen]

26 damage accepted Accepting secrecy as illusionary They pick up on everything. They are so in tune with what s going on around them. People think they re stupid, you know, like Oh, they don t know. Don t they?! [Kirsty] Accepting appearance of normalcy as self-serving It s all excuses though h You find excuses, and you find ways to make yourself feel better about it. [ ] You have to, you just blank it out. You just, it becomes normal, so you just hide it away, and just think That s alright, she doesn t know what I m doing, so it doesn t matter. [Nadine]] 26

27 looking back Accounting in a process of recovery You know what? I think he always knew. When he was young, I think he always knew. But I didn t actually, sort of, comprehend that, you know. I always think he knew I think, looking back on it I think he did know that his mum was on drugs. [ ] And that s t just come to me now, you know what I mean? [ ] And I would say things like, you know, Oh, in time, I will tell you why I m not with you. Not knowing he already knew [Mary] 27

28 looking back Accounting in a process of recovery Really and truthfully, and I know it s weird for me to even say this, but I think that kids, that if they are with parents that are on drugs, like, heavily, then they should be taken into care until they sort themselves out. Honestly. And it s hard for me to say that, t because I wanted my kids with me all that time, you know. When they took them off me, I blamed them for years But, like, looking back on it truthfully, yeah, no, it shouldn t be. Kids should be kids. [Kirsty] 28

29 conclusions 29 accounts accounting occurs in a social context experience making sense of it representing it defending, protecting, repairing self damage not all drug users make bad parents good enough parenting through damage limitation damage limitationi i appearance of normalcy through investment in ambiguity presented as child protection, but also self-serving serving conflicts of interest, and denial of damage recovery accepting conflicts of interest, t denial, and need for repair investment in ambiguity not necessarily harm reducing

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