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Dissertation/Thesis Abstract

The Lived Experience of Postpartum Women Attending Outpatient Substance-Abuse Treatment for Opioid or Heroin Addiction
by Proulx, Donna M., Ph.D., University of Massachusetts Lowell, 2019, 107; 13863846
Abstract (Summary)

Background: The United States (U.S.) is facing an epidemic of opioid and heroin related deaths. One hundred and thirty Americans die in the United States every day from an opioid overdose. In the last fifteen years, opioid overdose deaths have increased 265% in men, and 400% in women. Women are more likely to have more chronic pain, be issued prescribed pain medication at higher doses, and use them longer than men. Illicit opioid abuse during pregnancy includes the use of heroin and the misuse of prescription opioids, which are associated with a risk of adverse maternal and neonatal outcomes. The current opioid crisis and associated heroin epidemic has exhausted the limited community services that are available to substance users, with only about 12% of substance abuse treatment facilities offering special programs for pregnant women. Some states have reported extended wait times as long as 12 weeks to enter treatment. Little information is known about the lived experience of postpartum women in outpatient substance abuse treatment programs, who are working towards abstinence and caring for a newborn infant. The extended wait time and limited specialized treatment programs for pregnant women further highlights the significance and urgency of understanding the experience of postpartum women who attend substance abuse programs for opioid abuse during pregnancy.

Aim: The purpose of this phenomenological study was to explore the lived experience of postpartum women attending outpatient substance abuse treatment for illicit opioid or heroin use.

Method: Individual interviews were conducted with 10 postpartum women with opioid use disorder (OUD) engaged in outpatient substance abuse treatment programs. The women ranged in age from 23 to 33 years of age (mean age = 26.4). All women identified as Caucasian and non-Hispanic, most were unemployed, single, and had earned a high-school diploma or completed some college. Their infants ranged in age from 2 to 20 weeks old (mean = 8.4 weeks). A four-step conceptual framework as suggested by Moustakas was used to understand and synthesize the lived experiences shared by the women.

Findings: Five themes emerged from the analysis of the raw data: the presence of a stigma in providers of healthcare services, a fear of being reported to family services, children are primary motivators to remain engaged in treatment, concern for the welfare of the infant, and barriers to treatment.

Conclusion: Postpartum women with OUD and their newborn infants have complex needs that can best be served by treatment programs that offer comprehensive care. Reaching out to engage women in treatment services at the point of delivery may be an effective method of engaging women in treatment. Health care services provided to this population could be improved by offering standardized education for direct care providers related to OUD. Further research is suggested to explore the potential benefits of providing standardized education to staff related to best practices when caring for patients with substance abuse, including health policy law.

Indexing (document details)
Advisor: Fantasia, Heidi C.
Commitee: Koren, Ainat, Meyer, Marjorie C.
School: University of Massachusetts Lowell
Department: Nursing
School Location: United States -- Massachusetts
Source: DAI-B 80/11(E), Dissertation Abstracts International
Subjects: Obstetrics, Nursing, Clinical psychology
Keywords: Heroin, Lived-experience, Opioid, Outpatient, Postpartum, Substance abuse treatment
Publication Number: 13863846
ISBN: 978-1-392-26456-0
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