Imagine you are a mother who is battling a substance use disorder. You have depended on weekly in-person treatment services that include individual, group and parent-child therapy. Due to COVID-19, you now remain at home with your three young children, isolated from family, friends and normal support. You are also forced to adjust to your treatment services being replaced with individual telehealth sessions, if you have the time and internet availability to participate.

While COVID-19 is affecting every family, community, and business in the United States and all around the world, I’m particularly concerned about the challenges that mothers in substance use treatment programs and their children are facing due to the current crisis.

Mothers with Substance Use Disorder are Especially Vulnerable to COVID-19 Impacts

We know that COVID-19 is a respiratory illness that spreads very easily. Information regarding the risk factors of COVID-19 is limited, but the disease has severely impacted people with preexisting medical conditions such as COPD, heart disease and asthma. Other vulnerable populations include individuals who are battling substance use disorders and those who are living in long-term care facilities. Since mothers in treatment for substance use disorders are potentially more susceptible to the virus, their health and that of their children may be in jeopardy for a variety of reasons.

Traditional inpatient and outpatient substance use treatment programs offer a variety of services and supports to mothers and their children. Programs typically provide services throughout each day including individual, group and family therapy. These programs also provide coaching on different life skills; career development courses; assistance for housing, transportation and medications; child care; and self-care support. Mothers in treatment are accustomed to the daily schedules of their particular programs.

The banning of large gatherings and events due to COVID-19 is presenting some extraordinary challenges to mothers with substance use disorders. Treatment facilities have been forced to modify their programs in order to keep mothers and children healthy. Many services that they normally provide are now reduced to individual telehealth sessions. For mothers enrolled in inpatient facilities, services still remain limited while social distancing is being practiced. Mothers will not visit with family, friends or their children who are not under their direct care. What’s more, some mothers may be unable to access their medication due to COVID-19.  

In addition to the restriction of services, there is the stress of mothers losing their jobs and their child care. There have also been restrictions in place for public transportation, which many of these women rely on to get to and from work.

Parents, in general, are facing daily challenges with being isolated at home with their children during COVID-19. But again, imagine being the mother who is isolated at home with her small children, while also battling a substance use disorder. Parenting children can already be stressful for mothers with substance use disorders. Isolating with children at home or while in treatment facilities can lead to additional stress, frustration, fear and even relapse.

Adapting our Young Child and Parent Program in Light of the Pandemic

We have direct insight into the competing challenges that mothers with substance use disorder are facing during this challenging time through the Young Child and Parent Program (YCPP), an intervention that PolicyLab has collaborated with the Health Federation of Philadelphia to evaluate. The program provides therapy to mothers with substance use disorders and their young children, whether they receive inpatient or outpatient treatment.

COVID-19 has significantly impacted our ability to run YCPP—we had to put on hold all new recruitment of mothers and their children, and the weekly therapy sessions have been interrupted for mothers who are currently enrolled. The clinicians we work with have been exploring new and different ways to connect with their current clients. They are using telehealth, phone calls, and video calls to meet and check-in with clients, but are still missing their traditional face-to-face sessions with them. The clinicians told me that they are also grateful to the treatment facilities for their dedication and passion while keeping their programs up and running.

While telehealth has been the source of communication for YCPP clients during COVID-19, some mothers can face challenges in accessing this service. Without reliable Wi-Fi connections, available data or phones, telehealth may not be enough for some mothers in treatment to continue their care. We are monitoring these challenges and seeking solutions to support those mothers for whom telehealth is not a viable option.

These are the realities of mothers with substance use disorders during COVID-19. There is so much uncertainty around when we will return to our regular routines and feeling some sense of normalcy. However, we would like mothers in treatment to know that we recognize the many challenges they are facing during this time and are working to provide help and support to these women through YCPP and beyond.

Latifa Uqdah, MS, is a former research assistant at PolicyLab.