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Federal government websites often end in. The site is secure. Preview improvements coming to the PMC website in October Learn More or Try it out now. CTEW were 5. Missing 1—2 days in the past month because the participant did not want to go into work was associated with increased odds for use of marijuana, cocaine, and NPO use. Having written drug policies was associated with reduced odds for cocaine use, and workplace tests for drug use during hiring and random drug testing were also associated with lower odds of marijuana use. CTEW are a high-risk population for drug use. Precarious employment is associated with higher prevalence of drug use while some workplace drug policies were associated with lower prevalence. Coupled with reports of high overdose mortality among CTEW, these findings suggest that prevention and harm reduction programming is needed to prevent drug-related morbidity and mortality among CTEW. As of June , there were approximately 7. These workers have high injury and fatality rates; in , the nonfatal injury rate among construction trade and extraction workers CTEW was 3. The well-documented hazards to CTEW safety and health include fatal and non-fatal injuries such as slips, trips and falls, electrocution, musculoskeletal disorders from overexertion, being struck by or caught in heavy machinery, and chronic health conditions from exposure to toxic chemicals Bentley et al. Musculoskeletal disorders in particular can lead to treatment and self-treatment with pain medication, including opioids Webster et al. A study of industrial workers in a specialty metals corporation, who like CTEW are at risk of acute occupational and repetitive strain injuries, found that receiving at least one opioid prescription increased from Another study suggested that laborers and related workers are significantly more likely to have long-term opioid treatment for work-related injuries Berecki-Gisolf et al. CTEW are at increased risk for substance use and disorders. Individuals in construction occupations have higher likelihood of binge drinking Prins et al. Moreover, substance use is an important risk factor for work-related injuries among CTEW, with lifetime cocaine but not marijuana use Dong et al. In an analysis of workers compensation records in Washington state, substance abuse diagnoses have also been found to be associated with a 1. In Ohio, construction workers were seven times more likely than other workers to die from an opioid overdose between — Dissell, The extent and correlates of drug use, and particularly nonmedical prescription opioid NPO use, among CTEW are not well characterized in representative population samples or relative to other occupational groups. Using a decade worth of data from nationally representative samples of US adults, we estimated the prevalence of current past-month marijuana, cocaine, and NPO use, as these are among the three most common drugs or drug categories used in the US Substance Abuse and Mental Health Services Administration, The sampling frame each year was obtained in four stages. All participants provided informed consent and were compensated for their participation Substance Abuse and Mental Health Services Administration, Surveys were administered via computer-assisted interviewing which was administered by an interviewer and audio computer-assisted self-interviewing in which participants were provided with a computer and headphones and asked to complete the survey. Interviewers were trained to not look at the screens in order to maintain privacy and confidentiality and to increase honest reporting. We focused on the last ten cohorts that were asked about their occupation; this question was excluded from surveys after Response rates ranged from Sampling weights were provided by NSDUH to address unit- and individual-level non-response and additional information on methodology can be found elsewhere Center for Behavioral Health Statistics and Quality, We utilized an imputation-revised employment variable which allowed us to compare those who are currently employed to those who reported an occupation but are currently employed in a clean manner. That is, what is your occupation? Those with multiple jobs were asked to describe one job. Respondents indicating an occupation were also asked about workplace alcohol and drug policies. They were first asked if there is a written policy about employee use of alcohol or drugs, whether they have ever been given educational information about alcohol or drug use, and whether they have access to employee assistance programs or counseling for employees with alcohol or drug problems. There were also questions on workplace drug screening and testing. Specifically, they were asked if their workplace ever tested its employees for alcohol or drug use, whether testing was part of the hiring process, whether random testing was administered, and workplace policies regarding positive drug test results. Response options for positive drug testing were: handled on an individual basis, termination, referral to treatment or counseling, and nothing or something else. For this analysis, we focused on self-reported use of marijuana, cocaine, and NPO. NPO use was defined as using a prescription pain-killer opioid when not prescribed or only for the experience or feeling it caused. The reliability of these measures has been well-documented Harrison et al. These comparisons were computed using chi-square. Separate logistic regression models were used to examine each drug outcome. Survey year was also included in all multivariable models to adjust for any potential cohort effects or secular trends in drug use. We then estimated prevalence of use of each drug according to each occupation, and compared whether CTEW were at differential risk of drug use compared to other occupations i. Finally, among CTEW, using separate logistic regression models controlling for the aforementioned covariates , we examined whether factors assessed via work-related follow-up questions were related to past-month drug use. All models were adjusted for the complex survey design and used sample weights provided by NSDUH to account for oversampling of young participants and non-response to derive nationally representative estimates Heeringa et al. Table 1 presents sample characteristics. CTEW were less likely to have health insurance. Table 2 compares prevalence estimates between CTEW and the other 13 occupations. CTEW had the second highest estimated prevalence of past-month marijuana use CTEW had highest estimated prevalence of past-month cocaine use 1. Associations between past-month drug use among CTEW and work-related characteristics are reported in Table 3. We added a category for 0 hours worked in the past week to prevent listwise deletion of those currently unemployed aOR not generated or presented as we include a variable indicating whether the individual is employed. These findings are consistent with previous literature reporting that the most common drugs used among CTEW are marijuana followed by cocaine Hersch et al. The reasons for the elevated prevalence of drug use among CTEW cannot be completely elucidated in the NSDUH, as there are no data available on some key risk factors such as injury or stress. CTEW may be more likely to use pain-relieving substances such as opioids and marijuana due to the labor intensive nature of their work as well as high rates of injuries Bunn et al. Among truck drivers, cocaine use has been associated with managing fatigue and being paid based on productivity Williamson, CTEW also deal with fatigue and productivity-based payments as well as other job-related stressors Ajslev et al. Studies have demonstrated that performance-based pay is associated with work stress and injuries Ganster et al. In examining work-related correlates of drug use among CTEW, precarious employment appears to be a potential risk factor for drug use. This is suggested by increased odds of drug use among those who were unemployed and had more employers e. Collectively, this suggests CTEW who face precarious employment are at higher risk for drug use. This is also supported by previous literature which illustrates that precarious employment such as temporary employment, job changes, and unemployment are associated with the use of antidepressants Virtanen et al. Specifically, workplace alcohol testing, drug testing during the hiring process, random drug testing, and working for an employer that fires employees with a positive drug test, were all associated with lower odds of marijuana use. This is consistent with previous literature demonstrating workplace drug testing by construction companies has been associated with lower levels of marijuana use Carpenter, Work policies on drug testing may also have an added health impact as drug use is associated with work injuries Carpenter, ; Olbina et al. Drug testing is associated with decreases in accidents Gerber and Yacoubian, ; Minchin et al. Companies that have drug testing policies have also been shown to have increased productivity and quality of the work produced as well as lower employee turnover Gerber and Yacoubian, Marijuana use may be particularly sensitive to workplace drug policies for reasons related to prevalence and detection of drugs. Second, smoked marijuana often has a noticeable and distinctive odor Declues et al. Thus, it may be that those who smoke marijuana may be more likely to be tested or approached with educational materials in the workplace. Third, drugs have different detection times in urine tests. Thus, there is more opportunity to detect marijuana use as compared to cocaine and NPO. Not all studies, however, suggest that drug testing is effective. One study, for example, found slightly lower and nonsignificant levels of injury associated with drug testing programs in small construction agencies Schofield et al. Many states have passed medical marijuana legislation at this writing, 34 states, the District of Columbia, Guam, Puerto Rico, and the U. This may be because testing positive for opioids can be attributed to drugs prescribed for pain Smith, We also did not have data on whether nonmedical use was related to prescribed opioids. However, strict workplace drug policies also have the potential to harm companies as it may result in understaffing and difficulty fulfilling contractual obligations Gerber and Yacoubian, NSDUH has not asked participants about occupation since the survey so we did not have access to more current data. Therefore, results should be interpreted with caution as the drug landscape has changed in more recent years. Individuals living in non-institutionalized group quarters e. Educational attainment is likely underestimated as the NSDUH does not ask about trade or vocational schools. There were no data on injuries or pain levels and therefore two important risk factors for substance use among CTEW could not be examined. Relatedly, data on paid sick leave were also not available. Data on timing of drug use i. Data were cross-sectional so temporal associations could not be deduced. CTEW who are more precariously employed were more likely to report drug use while those working in companies with drug and alcohol-related policies were less likely to use some of these drugs—particularly marijuana. Coupled with reports of increasing overdose mortality among this occupational group Dissell, ; Harduar Morano et al. Moreover, given the limited amount of research in this area, future studies are needed to determine additional risk factors for drug use among CTEW as well as the effectiveness of either workplace or individual-level harm reduction strategies that are implemented in this high risk workgroup. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. As a library, NLM provides access to scientific literature. Drug Alcohol Depend. Author manuscript; available in PMC Dec 1. Danielle C. Ompad , a, b Robyn R. Palamar b, c. Robyn R. Joseph J. Contributors D. Ompad conceived of the study, designed the analyses and led the writing of the manuscript. Palamar conducted the analyses and contributed to writing the manuscript. Gershon and S. Sandh both contributed to writing the manuscript. Acosta conducted analyses. All authors reviewed and approved the final manuscript. Correspondence: Danielle C. PMC Copyright notice. The publisher's final edited version of this article is available at Drug Alcohol Depend. Results: CTEW were 5. Conclusions: CTEW are a high-risk population for drug use. Methods 2. Measures 2. Demographic Data. Employment and Occupation Data. Drug Use. Results Table 1 presents sample characteristics. Table 1. Open in a separate window. Figure 1. Table 2. Table 3. Table 4. Limitations NSDUH has not asked participants about occupation since the survey so we did not have access to more current data. Footnotes Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. Conflict of Interest No conflict declared. Pain Res. Treat , Investigating risk factors for slips, trips and falls in New Zealand residential construction using incident-centred and incident-independent methods. Ergonomics 49 , 62— Pain Med. Relationships of physical job tasks and living conditions with occupational injuries in coal miners. Health 45 , — Work-related injuries in a state trauma registry: Relationship between industry and drug screening. Trauma Acute Care 77 , — TABLE 1. Incidence rates of nonfatal occupational injuries and illnesses by industry and case types, Accessed 29 Jan National census of fatal occupational injuries in Department of Labor, Washington, DC: pp. Table B-1a. Employees on nonfarm payrolls by industry sector and selected industry detail, seasonally adjusted. Current Employment Statistics. Accessed 24 July Workplace drug testing and worker drug use. Health Serv. Res 42 , — Accessed 1 Feb Forensic Sci. Opioid overdose deaths: Which jobs are at risk? Accessed on 29 Jan Occupational and non-occupational factors associated with work-related injuries among construction workers in the USA. Health 21 , — Performance-Based Rewards and Work Stress. Manage 31 , — An assessment of drug testing within the construction industry. Drug Educ. MMWR Morb. Rep 67 , — Comparing drug testing and self-report of drug use among youths and young adults in the general population. Accessed 21 February Applied survey data analysis. Substance use in the construction industry: a comparison of assessment methods. Use Misuse 37 , — Effect of repeated cocaine administration on detection times in oral fluid and urine. Toxicol 30 , — Sociol 92 , — Gender differences in occupational stress among professionals in the construction industry. Eng 20 , — Unemployment and substance use in young adults: does educational attainment modify the association? Res 21 , — Case for drug testing of construction workers. Eng 22 , 43— Marijuana overview. Accessed on 24 July National Conference of State Legislatures, b. State medical marijuana laws. Drug testing practices in the US construction industry in Econ 29 , — Identification of hydrocodone in human urine following controlled codeine administration. Toxicol 24 , — Barriers to accurately assessing prescription opioid misuse on surveys. Drug Alcohol Abuse 45 , — Med 60 , — Risk of job-related injury among construction laborers with a diagnosis of substance abuse. Med 40 , — Mental illness, drinking, and the social division and structure of labor in the United States: — Med 62 , — Comparing medical and recreational cannabis use among employees: associations with health and work-related outcomes. Psychiatry 30 , — Safety and health in the construction industry. Public Health 16 , — Musculoskeletal injuries in construction: a review of the literature. Hyg 16 , — Injury rates, severity, and drug testing programs in small construction companies. Safety Res 44 , 97— Urinary excretion of norcarboxydelta9-tetrahydrocannabinol and cannabinoids in frequent and infrequent drug users. Toxicol 23 , — Alcohol Alcoholism Stata Statistical Software: Release Med 59 , — Temporary employment and antidepressant medication: A register linkage study. Relationship between early opioid prescribing for acute occupational low back pain and disability duration, medical costs, subsequent surgery and late opioid use. Spine 32 , — Injury surveillance in construction: injuries to laborers. Med 42 , — Predictors of psychostimulant use by long-distance truck drivers. Epidemiol , — Med 58 , — Occupation, job characteristics, and the use of alcohol and other drugs. Pers 31 , — Copy Download. Entertainers, Sports, Media, and Communications. Technicians and Related Support Occupations.

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There is a growing number of women who use drugs. Furthermore, the responsibility for family care is still attributed solely to women. This study aimed to describe the meanings constructed regarding mothering by women in treatment for drug use. Eight life story thematic interviews were carried out. The analysis resulted in four themes: 1 Mothering as the woman's choice; 2 Learning with drug consumption experiences and using this to warn and educate children; 3 Drug consumption interfering in mothering and 4 Drug consumption understood in different ways throughout the treatment. The meanings attributed to mothering consist of moral and gender discourses regarding the responsibilities attributed to women and the difficulties solely attributed to their drug use. The image of the contemporary woman is constructed by different discourses, dictated throughout our history Ettorre, Ettorre, E. Revisioning women and drug use: Gender, power and the body. London: Palgrave MacMillan. Rio de Janeiro: Graal. The focus on sexual differences has designed the knowledge about the female body and its function in society Vieira, Vieira, E. Rio de Janeiro: Fiocruz. Del Priori. Thus, the identity of women is defined regarding the attributes of their personality and their behavior, denying the cultural and subjective aspects Vieira, Historically women's rights equality appears linked to the achievement of reproductive rights and the struggle for sexual rights. However, sexual and reproductive hierarchies still exist in our society, which cause mothering to be included in expected standards race, class, age and partnerships. Therefore, the more women deviate from the normal spectrum, the more they are classified as inferior. G Interface Botucatu , 16 40 , According to Gergen and M. Gergen Gergen, K. Rio de Janeiro: Instituto Noos. The various discourses that define normality constitute the multiplicity of possible identity descriptions about people Burr, Burr, V. Social constructionism 2nd ed. New York: Routledge. Revista Latino-Americana de Enfermagem, 13 N. Parenting knowledge among substance abusing women in treatment. Journal of Substance Abuse Treatment,27 3 , According to Prado and Queiroz Prado, M. Estudos de Psicologia Natal , 17 2 , Vita et Sanitas, 2 2 , The construction of what mothering would be for these women is permeated by different discourses that contribute to a negative view regarding their identity, which becomes socially restricted to that of a drug user, hindering the construction of new roles, such as being a mother. However, according to Hardesty and Black Hardesty, M. Mothering through addiction: A survival strategy among Puerto Rican addicts. Qualitative Health Research, 9 5 , The authors also point out that there are many difficulties for women to fulfill their responsibilities as mothers, however, when women who use drugs manage to maintain their habits and provide care for their children, they are valorized by other users. The constructions regarding women in the context of drug use are located in a historical moment in which drug use is increasing, while simultaneously divisions regarding gender roles are still very present in our society Ettorre, Ettorre, E. Pegoraro and Caldana Pegoraro, R. A study conducted between and with 4, patients women undergoing their first hospitalization for treatment of drug-dependence, highlighted that in , 35 of the 36 women in the sample In subsequent years there was an increase in women hospitalized due to the multiple drug use diagnosis, and in the number reached 87 women, 28 of these Journal of Addictive Diseases, 33 1 , In addition to the physical differences, women suffer greater judgment and marginalization, a fact that ultimately impacts on their health conditions, as they have few resources of social support Galera et al. Drogas de abuso e gravidez. Prado and Queiroz Prado, M. According to Narvaez et al. Kapczinski, F. Childhood trauma, impulsivity, and executive functioning in crack cocaine users. Comprehensive Psychiatry, 53 3 , The authors point out that the life story of these women is often marked by restricted parental models, with sexual, physical and emotional victimization, as well as other factors such as psychiatric clinical conditions. Many also experience feelings of loss and low selfesteem, reported due to not having had the chance to give and receive love from the family and being constantly devalued Galera et al. Jornal Brasileiro de Psiquiatria, 57 1 , According to Galera et al. Corradi-Webster Corradi-Webster, C. How do they experience this function? How do they perceive mothering and the drug consumption? How do they perceive mothering and the treatment? From these questions, this study aimed to describe the meanings produced regarding mothering by women undergoing treatment for drug use. They comprehend that these constructions happen in relationships, due to the influences of the social discourses and life experiences of the person Gergen, Gergen, K. O movimento do construcionismo social na psicologia moderna. Revista Internacional Interdisciplinar Inthertesis, 19 2 , In the process of meaning construction, several positions are assumed, resulting in a wide range of possibilities to tell stories about themselves, depending on the context and the interactive moment Guanaes, Guanaes, C. O discurso construcionista social. Gergen, Gergen, K. Introducing qualitative research in psychology: Adventures in theory and method. New York: Open University Press. The following were used as guiding themes: 1 involvement and care provided with mothering; 2 mothering and social support network; 3 mothering and substance consumption; 4 mothering and treatment. With this instrument, used to create a conversational space regarding the subject in question, the intention was to broaden the discussion of mothering by women in treatment for drug use. The invitation to the participants was held in the welcome groups for women of the service by one of the researchers. The interviews took place at the treatment location in a private room, where only the interviewer and the participant remained. Furthermore, the interviews took place after the Informed Consent form was signed. All the interviews were audio recorded. Analysis of these was performed according to the following steps: 1 verbatim transcription of the interviews; 2 exhaustive reading of them; 3 construction of a table containing two columns, with the interview inserted in the first column and the highlighted sub-themes that were related to the study object and were addressed in the reports in the second; 4 examination and reorganization of these sub-themes into thematic axes that gave visibility to the proposed discussion; 5 selection of excerpts from the interview that illustrated the themes; 6 discussion, based on the literature, of the content constructed Spink, Spink, M. In order to characterize the participants, Table 1 was prepared containing some of their characteristics. The participants had a mean age of It was observed that 5 of these did not have a partner in the household, while 1 resided only with her children. The reasons which led them to seek treatment were varied, however, for the majority 5 women the reason appeared directly related to concerns for the children. It should also be noted that the drug use began in childhood and adolescence, with a mean age of onset of consumption of Regarding the drug used at the time of seeking treatment, 7 reported using cocaine, with 3 of these consuming it in the form of crack. The length of treatment of the women varied, with a minimum time of 7 days and maximum of 13 years. Thumbnail Table 1 Description of the Participants. With the analysis of the data, the following four thematic axes were constructed: 1 Mothering as the woman's choice, constructed from her life experiences; 2 Learning with drug consumption experiences and using this to warn and educate children; 3 Drug consumption and other developments that interfere with mothering; 4 Drug consumption comprehended in different ways throughout the treatment. In this axis, the process of becoming a mother was described as a choice of the woman, being related to her own experiences of being cared for throughout her life. Simultaneously, the experience of being a mother was presented as support for the re-signification of the meanings regarding care, considering the inclusion of the women in a historical context and moment. In the statement of Alexandra, the perception of having behavior similar to that of her mother was described in a negative way, recognizing her own experiences in her daughter: ' I wanted to have a child while at the same time I didn't. So I started doing with my daughter what my mother did with me, rejecting her'. Alexandra described the feeling of rejection regarding the experience as a daughter and highlighted a reproduction of this practice. In the statement of Leandra, the experience as a daughter also appeared as a reference in being a mother, however, it made her reflect and try to construct a different relationship with her son:. There's were lots of things that I didn't have and I felt such a lack, of love, of affection from my mother, I think that I have to give this to him. I think that I can show him that he can trust me, so that when he is going through a problem he can come and open up to me Nobody showed me 'look you can trust me', so I hid a lot of things, because I was afraid. If, when I started using drugs, I had spoken to my mother maybe today I would be free, but I did not have the courage. Because that was the way it was with my mother. Faced with this discovery, it was possible to reflect on new ways of being in this mother and child relationship. The literature states that context and family experiences can have great influence on behavior Galera et al. However, Alexandra and Leandra, in the experience of being mothers, re-signified the possibilities of the mother and child relationship. Galera et al. In this study, this is illustrated in Table 1 , in which it can be seen that the majority of the women sought treatment motivated by the concern for their children. The statement of Kate highlights this motivation: ' Because you think, hey I can't continue this life, I have to stop, if I don't stop for me at least for my children, I have to stop for my children'. The inclusion in a particular historical and cultural moment allows certain constructions, which are guided by meanings seen as natural Burr, Burr, V. In the statements of the women interviewed, there is their responsibility regarding their own bodies and their children, as they described themselves as responsible for the care of their children, for the difficulties in the relationships with them and even for their own 'lack of control'. In the excerpts below, the meanings attributed to mothering are represented by the tasks that the women were responsible to perform, with mothering being a complex task in itself which, added to the meanings and experience of drug consumption, becomes more difficult and fraught with moral values and new duties. The statement of Kate discusses the meanings of being a mother and her responsibilities:. My difficulty is, to take care of the child alone is not easy, you have to be very responsible, to care, everything is on you, but it is good, because it brings much joy, but if we don't have responsibility to care for them Because you do not take care of a child just with rice and beans Because it's better to give to them than to spend it on drugs, much better. In the statement of Jane about a patient in treatment, the responsibility for getting pregnant, for the consumption and for the treatment is attributed to the woman, with acquiring control of herself being the solution she highlighted:. The woman only becomes pregnant if she wants to, there are woman who becomes pregnant and blame the boy She became pregnant and she started to use crack, it's so sad. Then she wants to stop, but in a moment goes there and does it again. It's a question of attitude, it's her thing, she has to organize her life, organize her mind, it's sad that she can't control herself, you know. Vieira Vieira, E. In this way, the identity of these women would be marked by the inability to care for themselves and for their children described many times and commonly as 'crack mothers' , making it impossible for resources and positive bonds to also be legitimized. Substance use and the mothering relationship were linked in the interviews at points such as the relationship between the experience of consumption and its consequences and the care of the children. Thus, as mothers, they could pass on these lessons to their children, promoting a re-approximation with them. In the following statement, Diana reported that, through her experiences related to drug consumption, she could now warn her child. He had some problems at school last year, then I went to him and said, I experienced this, I suffered this with my father, I used this, I had trauma and today I don't want you to use this, I can't take it. In this statement, it can be seen that Diana the mother used what was learned as Diana the user and as a daughter of a user to think about the care of her child. The views and experiences of several mentally ill mothers: A qualitative study. Social Psychiatry and Psychiatric Epidemiology, 39 6 , However, some of these discussions position women who have a disorder as unfit to care and do not allow discussions in which the experience of the disorder in the mother and child relationship can also lead to the development of the skills of those involved. The statement of Leticia shows that proximity with the children supports the motivation to continue the treatment: ' Today, my daughter was marvelous, I went to pick her up from school yesterday and when she saw me and came 'mummy', she herself realized that I want to change'. The study by Leppo Leppo, A. International Journal of Drug Policy, 23 5 , It can be observed in interviews that, even after the pregnancy, the women were still trying to act responsibly for their children and to seek treatment Table 1 in order to provide care for them, so that they follow different trajectories. In the statements of Daniele and Leandra, actions of harm reduction for the children were performed, such as avoiding the use of drugs in the presence of the children and during pregnancy. Daniele said:. I live with my children, I just don't do anything right in their sight, they have only seen me drink beer, but I could never use in front of them, and I do not want them to see me as a junkie. Leandra highlighted that the concern with pregnancy made her interrupt the use, however it was not possible to maintain the interruption after the birth of the child: ' When I got pregnant with my son I did not use anything, I thought it was funny that later I restarted the use'. In the interviews, the children provided the motivation for the women to continue in treatment, to perform harm reduction actions for themselves and for the children and to preserve the maternal identity. The mother and child relationship is a possibility for women who use drugs to amplify the descriptions of themselves as more than drug consumers and to follow a trajectory of mothering, as a narrative of change Radcliffe, Radcliffe, P. Motherhood, pregnancy, and the negotiation of identity: The moral career of drug treatment. In the narratives, substance consumption was described as interfering with mothering, with the proximity to the children and with the possibilities for the women to see themselves as 'good' examples and to exercise maternal authority. The fragile relationship with the children appears as a representation of the consequences of the consumption. Contextual elements that impact in the care of the children and in the consumption of these substances were also described. In the statement of Andreia, the impact of the substance use in the distancing from her children and from being at home was highlighted:. But I say that they stay away from us, you arrive home, when you go home, it is never the same thing, you come home all dirty, filthy. Sometimes, I even saw the girls going to school, as their father had organized them, I spoke with them, greeted them, but it was never the same thing, you know. It was observed that despite the participants making use of different drugs crack, cocaine and marijuana and using them with various consumption patterns, all of them described the distancing from their children, relating this to the consumption of drugs. Leandra, in one of her statements, described a situation of lack of family support in caring for the child. While striving to maintain this care, including financial, she highlighted the use of the drug as a factor that distanced her from her son:. I am a great mother, but when I take the drug, the drug speaks louder than him, because when I'm with him I am like that, I educate him, I worked a lot because his father could not afford to support him because he also used drugs. Me, even with my addiction I worked more than usual, to support my addiction and sustain him. Aids, drogas e 'ser mulher'. Relatos de mulheres soropositivas para o HIV. These discourses contribute to the construction of moral beliefs, which may cause shame and guilt Ettorre, Ettorre, E. In the statements of Alexandra and Leandra family support is mentioned as important in the process of care for the child and the treatment. For Alexandra: ' You know, people have relapses, I think it is sad when the family rejects the person, who is not well understood, the person feels frustrated and that's when she starts using'. Franco and Figueiredo Franco, F. Therefore, these women often have to cope alone with these emerging situations and need to develop other ways to understand what it is to be a woman and a mother. Feelings of guilt due to the consumption, the consequences of drug use that affect the children and the distancing are points that need to be considered, because they demonstrate the need for new representations of these women, so they can construct new possibilities to describe themselves, in which the reality in which they live is included. With treatment, the drug consumption began to be described in various ways in addition to the pleasing effect, opening space for new possibilities of interaction and motivation. The perceptions of consumption and mothering are described in a historical moment in the life of these women who sought treatment, among others circumscribers. In the statements of the participants, it is described that the temporary effect of the drug later leads to problems and pressure that are greater than the initial ones. The statement of Diana illustrates the social pressure regarding the consumption of substances and the 'controversies' about using different drugs:. It's what I told you, at the time you say 'wow, it's such a great pleasure'. You say: 'wow, I feel good'. But then after 10 or 15 minutes you come to that reality, the reality of the treatment, but this is a society in which you talk about drink and drink is not prohibited, but it is a drug. The comprehension of their own consumption and treatment is continually reconstructed, and, thus, other activities can become representative in the lives of these women. In the statement of Jane, the comprehension of the drug consumption was re-signified and, thus, care was possible and received, in a space of treatment and not judgment:. It was this that helped me, you know, to talk to other people, to say what was happening, I could speak. Because of the fear of people finding out about the problem, that I did not think was a problem, I thought it was just fun and I did not speak to anyone. It is worth highlighting that while Diana had been in treatment for 11 years, while Jane had only been in it for 4 months, although both reported changes in the way of comprehending the drug consumption after the experience of care in the service. It is clear, therefore, that even shorter treatment helps these women resignify the meaning of the consumption and, thus, think about strategies of change. Campos and Ferreira Campos, G. Estudos de Psicologia Campinas , 24 2 , The work of the health network encounters, according to Prado and Queiroz Prado, M. This is because drug use is also inserted into discourses of illegality and therefore makes explicit a social group characterized as incapable and marginalized. The exclusive focus of the treatment on the difficulty and distancing with respect to mothering can make it difficult for the women, who feel that it becomes too 'heavy'. In addition, these mothers need policies that support better care for the children, before removal from the family environment is necessary. It should be noted that this study had some circumscribers. One was the inclusion of only women being treated in the CAPS-ad. Female drug users living on the streets may present other characteristics and meanings related to mothering. The same could be the case for women seeking monitoring in religious institutions, in groups or in therapeutic communities. Therefore, studies are suggested that seek to understand the context of mothering for women who are not in treatment or being monitored outside the healthcare services. In addition, this study did not consider the presence of comorbidities in relation to the use of drugs and other diagnoses of mental disorders, therefore, studies are necessary that seek to investigate this experience, which presents other challenges for the mothers and the mental health services. Another circumscriber that should be highlighted refers to the use of only the reports of the women, without knowing how their children experience this relationship. Studies that observe and talk to the mother and child dyad could provide further clarifications about the condition as a whole. This study showed that treatment was critical due to offering the women a place of acceptance and reflection, so that they could strengthen their bonds. Therefore, the comprehensions regarding their own consumption, mothering and treatment could be continually re-signified, inviting new practices. The growing number of women making use of substances and the consequent impact on their children highlights the need for planning policies that support them and their different requirements. Thus, we think that this is a possible way to construct relationships in which healthier positions, among them being a mother and caregiver, can be used as conducive to new paths of life and descriptions of themselves. The authors acknowledge Santander for the financial support provided for the development of this project. Open menu Brazil. Estudos de Psicologia Campinas. Open menu. Abstract Resumo English Resumo Portuguese. Text EN Text English. Abstract There is a growing number of women who use drugs. Keywords: Family relationships; Substance-related disorders; Women. Results and Discussion In order to characterize the participants, Table 1 was prepared containing some of their characteristics. Table 1 Description of the Participants. Acknowledge: The authors acknowledge Santander for the financial support provided for the development of this project. References Bittar, D. Campos, G. Carneiro, T. Corradi-Webster, C. Del Priori, M. Diaz-Caneja, A. Elbreder, M. Ettorre, E. Franco, F. Freire, K. Galera, S. Gergen, K. Guanaes, C. Psicologia: Teoria e Pesquisa, 19 2 , Guanaes-Lorenzi, C. Hardesty, M. Leppo, A. Mattar, L. Moreira, M. Narvaez, J. Oliveira, J. Pegoraro, R. Prado, M. Radcliffe, P. Soibet, R. Spink, M. Velez, M. Willig, C. Yamaguchi, E. Publication Dates Publication in this collection Oct-Dec This is an open-access article distributed under the terms of the Creative Commons Attribution License. Contributors M. MELO participated in the preparation of the study design, data collection, tabulation and discussion of the results and preparation of the article. Tables 1. Stay informed of issues for this journal through your RSS reader. PDF English. Google Google Scholar. Meanings about mothering by women in treatment for drug use.

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