History was not kind to drug-addicted mothers, but that started to change in the 1980s
Recovery doesn’t have to involve separating moms from their children
She begged the judge for treatment. Instead he put her in prison for 70 days. She lost her four children, three to social services, and the baby went to live with his father. In jail, she detoxed, all right. Then, when she was released with $4 in her pocket and no idea where her children were, she relapsed.
Lorna Hogan was 14 when she began using marijuana and alcohol to cope with physical and sexual abuse. When that wasn’t enough, she tried cocaine and eventually crack.
Her addiction led to a series of arrests, according to a Washington Post article, and finally to that fateful day in court in June 2001.
“Do you know why they took you away from me?” she asked her nine-year-old son Dante later.
“Because you use drugs,” he said. “You need help.”
She grieved for him and her other children.
Women and mothers have very different addiction experiences than men. Historically, where men are forgiven their after-work indulgences, women are shamed and driven further into isolation. Mothers face two battles: overcoming their disease while mourning the loss of their children to state services, foster care, or, if they’re lucky, relatives. On top of that, they often face additional criminalization for endangering their offspring.
But in the late 1980s, amid an explosive crack epidemic, a radical treatment opportunity emerged in the U.S.: long-term addiction treatment houses opened their doors to mothers…and their children.
When opium first arrived in the United States in the 19th century, doctors hailed it as a cure-all. In 1879, Dr. T. Gaillard Thomas, president of the American Gynecological Society, told fellow physicians, “For the relief of pain, the treatment is all summed up in one word, and that is opium…You can educate her to become an opium eater, and nothing short of this should be aimed at by the medical attendant.”
Men and women alike got hooked, but mothers in particular were prescribed opium derivatives to soothe infants. A decade or so later, when people learned of the addictive properties and harmful effects of the drug, the medical community blamed mothers.
In an 1894 article titled “The Opium Habit in Children,” author Louis Fischer writes of “ignorant mothers, stupid nurses and careless women, who in order to get sleep at night feed their nurslings with soothing syrups, teething cordials, and other soothing liquids, not to mention the most common and also the most easily obtainable paregoric.”
In 1914, the Harrison Act made it illegal for doctors to prescribe opiates, and instantly, drug users were forced underground, seen as criminals. Drugs were now a matter for the justice system, and jails started filling up.
“There was no cure,” as Billie Holiday put it in 1940. “They don’t cut you down slow, weaning you off the stuff gradually. They just throw you in the hospital by yourself, take you off cold turkey and watch you suffer.”
By the 1960s and 70s, methadone treatment had increased in the U.S. Still, women’s “specific needs usually remained unaddressed. Early programs were male-oriented and male-dominated,” wrote Stephen R. Kandall in Substance and Shadow: Women and Addiction in the United States (1999). “Women in these programs felt pressured to conform to sexual stereotypes, and endured exploitation, voyeurism, and psychological abuse.”
Simultaneously, in 1973 U.S. investigators first described fetal alcohol syndrome, a pattern of birth defects in children born to mothers who abused alcohol during pregnancy — a discovery that compounded the female blame complex.
Then, in 1985, crack cocaine appeared in American inner cities. Concerns about crack-addicted infants intensified the vilification of poor mothers of color, in particular. States passed laws that required medical professionals to report pregnant drug users. Foster care filled up as infants and children were removed from their families and their mothers charged with criminal child endangerment.
Slowly, however, women-only treatment centers, which allowed children to remain with their mothers, opened and began to experiment.
“I needed to get sober and, at the same time, learn how to be a good mother,” a woman named Nikki told The Boston Globe in 1989.
She and her 6-month-old daughter moved in to Celeste House, a 13-bedroom brick building on 40 acres of land in Plainville, Massachusetts, about 35 miles outside of Boston. She lived alongside other mothers facing addiction; one talked about her experiences with heroin as her 3-year-old daughter played in the same room. On the wall, a sign with the 12 steps of Alcoholics Anonymous hung next to colorful crayon drawings of rabbits.
Funded by the state Department of Public Welfare, Celeste House was a pilot program that offered housing and therapy for homeless women and their children, who could stay for up to two years.
Substance abuse programs that last days or even a few months are often not enough, argued Blaise Flynn, Celeste House administrator and a Dominican nun. “There’s a time that’s needed for healing and reflection just to stabilize them.” In particular, mothers she saw experienced “this tremendous grief over the children they no longer had.”
One 23-year-old resident named Elizabeth, who brought her three-year-old daughter, Mallory, said, “Any addict wants to get straight for themselves, but we get here a lot quicker through our children…With children, we have a big responsibility. It’s something else to live for other than ourselves.”
After 16 years, though, Celeste House closed in 2005 due to Massachusetts state budget cuts.
Yet sometimes the biggest barrier is finding a place like Celeste House, or even knowing they exist. At the time, few programs intervened on behalf of children born to addicts. But in 1991, Atlanta’s Project Prevent hired former addicts to find pregnant drug abusers and offer them a bed.
Project Prevent founder and social worker Donna Carson opened the residential treatment center using money from a federal grant. She argued that getting pregnant users off the streets and into treatment before the third trimester would save taxpayers millions in medical costs, and babies were more likely to be born full-term and healthy.
After the first year of Project Prevent, Carson saw the percentage of premature infants born with cocaine in their systems drop from 35% to 12%. Preventing one baby from being born premature and sick saved $500,000 in medical costs at the time, more than the entire budget of Project Prevent.
Still, programs like these were rare, and state legislators weren’t willing to invest further. By 1998, roughly 13,000 cocaine-addicted women lived in Georgia. But there were only 54 residential treatment beds for pregnant women or women with children in the entire state.
Today, the opioid epidemic is presenting many of the same issues for addicted mothers that crack did previously. More Americans die from drug overdoses annually than from car crashes or gun fatalities. In 2014, overdoses claimed 47,000 lives; that’s 130 people per day on average. About 78 overdose deaths per day involve an opioid.
States are making efforts to curb the epidemic, but few approaches take parents and families into account, much less mothers specifically. In 2015, Republican and Democratic senators introduced The Improving Treatment for Pregnant and Postpartum Women Act, which would reauthorize residential treatment programs for mothers, supported by the federal Center for Substance Abuse Treatment. It has not been amended since it was introduced. In December 2016, the bipartisan bill to extend the Family First Prevention Services Act, which proposed child welfare finance reform, did not pass.
“The law sentences two generations at a time and continues a cycle of trauma,” writes Deborah Jiang-Stein in a 2014 opinion piece titled “I was a heroin baby.” She said the number of children younger than 18 with a mother in prison has more than doubled since 1991.
Lorna Hogan was one of those mothers for awhile. But an 18-month family treatment program not only reunited her with her children, it ensured a better future for all of them them. It broke the cycle.
She says some of the best programs she knows today are SHIELDS for Families in Los Angeles and Gaudenzia in the Northeast. But there need to be more. “The whole family has to heal,” Hogan tells Timeline. “My children basically learned how to trust me.”
Soon her children started performing better in school. After treatment, Hogan emerged clean and became a PTA mom. She began working for parent advocacy groups, taught leadership development across the country, and in 2006 testified before Congress about family-based treatment. She’s still in touch with many of the women from her program. She’s watched them graduate college and get married. In March, she will have been in recovery for 16 years.
“It not only saved me,” she says. “It saved my children.”
