Substance use disorder treatment, parenting, and COVID-19

Abstract

Prior to COVID-19, options for parenting support while receiving substance use disorder (SUD) treatment were limited. The transition to using mobile technology for SUD treatment due to physical distancing during the pandemic may make parenting resources for people with SUDs even more limited. The rapid integration of parenting supports into telehealth and web-based treatment delivery is essential for improving long-term outcomes for families affected by substance use.

The challenges of parenting and the provision of substance use disorder (SUD) treatment amid the physical distancing associated with SARS-CoV-2 (COVID-19; coronavirus) have both received attention in the media and in scientific communications (Clay and Parker, 2020; Cluver et al., 2020; Green et al., 2020). However, the intersection of the two is rarely acknowledged (Abramson, 2020), even though 1 in 8 children in the United States live with at least one parent with an SUD (Lipari and Van Horn, 2017). Prior to the COVID-19 pandemic, there were already insufficient opportunities for parents receiving treatment for SUDs to simultaneously receive parenting support, such as coaching/individual counseling on parenting, evidence-based programs, childcare, and other child-focused resources (Siebert et al., 2019). This is particularly alarming given that the majority of people who enter SUD treatment are also parents (Taplin and Mattick, 2015) and because abstinence from substances alone does not resolve harmful parenting practices (Suchman et al., 2011). Moreover, parents who receive parenting interventions while receiving SUD treatment are less likely to relapse compared to parents who do not receive parenting interventions while receiving SUD treatment (Moreland and McRae-Clark, 2018).

Now more than ever, SUD treatment providers are leveraging telehealth and web-based health modalities to reach clients who are unable to receive in-person treatment (American Psychological Association, 2020). While these types of modalities can be an effective alternative to face-to-face SUD treatment (Lin et al., 2019), several factors hamper the uptake of telehealth and web-based treatment delivery. First, such treatment delivery requires additional training and infrastructure for providers. Second, they require a motivation and willingness of the client to participate. Third, they require both the provider and client to have reliable and low-cost or free access to the internet. Community partners have highlighted that these challenges have meant that the provision of ancillary services, such as parenting supports, are less available at a time when they are more necessary than ever (personal communication).

Prior to COVID-19, there were cross-disciplinary efforts to call attention to the intersection of SUD and parenting as a result of the opioid epidemic, including funding announcements from the Substance Abuse and Mental Health Services Administration and the National Institute on Drug Abuse (NIDA) as well as the development of a NIDA Center of Excellence, Center on Parenting and Opioids (Center on Parenting and Opioids, n.d.), among others. These efforts have resulted in an uptick in the development of web-based parenting programs—originally as a way to improve access to services in rural communities (Benavides-Vaello et al., 2013). However, the changing service landscape due to COVID-19 demands that evidence-based programs, accessible by telehealth and web-based modalities, be available now, with a workforce trained in their delivery. These programs, such as Attachment and Biobehavioral Catch-up, Mothers and Toddlers Program, Family Check-Up, and Fathering through Change (for information on these and other programs see Moreland and McRae-Clark, 2018 and Center on Parenting and Opioids, n.d.; Berlin et al., 2013; DeGarmo and Jones, 2019; Dishion et al., 2003; Suchman et al., 2011) must be primed for rapid integration into the current provision of telehealth and web-based practices of providers. Without timely integration, we will continue to miss opportunities when working with parents with SUDs to improve parenting practices, reduce substance use, and reduce the incidence of child maltreatment long term (Moreland and McRae-Clark, 2018).

CRediT authorship contribution statement

Camille C Cioffi: Conceptualization, Investigation, Writing- Original Draft. Leslie D Leve: Conceptualization, Writing- Editing, Supervision, Funding acquisition.

Funding

The writing of this paper was supported by the National Institute On Drug Abuse of the National Institutes of Health under Award Number P50DA048756. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.