Ashleigh Rider panicked when she returned to her townhouse one day to get the business card of a child protection services worker stuck in the jamb of her front door.

She’d feared this could happen, but she was also tired of the shame and guilt she felt for with alcohol, crystal meth and opiates. For years, she’d avoided looking for treatment, terrified that opening up about her dependence would imply having her young daughter removed from her.

“I knew I was not making the appropriate decisions, but I was desperate not to lose my kid,” says Rider, 30, of Kingston, Ont. “I thought doing drugs will be better than her not being with me.”

Mothers like Rider are often faced with what Kingston doctor Adam Newman calls an “impossible option.” If they don’t seek treatment for their substance use, they could lose custody of their kids. However, to get the treatment they need so as to maintain their families, they are expected to leave their children for months at a time as most facilities are not setup to allow families to remain together.

“If your motivation is to be a mom who is on the ball and is looking after her children, you need to abandon your children,” says Newman, a family physician who specializes in obstetrics and addiction medication.

Newman and a team including physicians, nurses, social workers, and people who have lived experience are suggesting a solution that would be a rarity in Canada. They’re looking to construct a residential center in Kingston that would enable mothers with substance-use ailments to remain with their kids as they work in their own recovery. Presently, the nearest residential rehab centre that accommodates women and children is Portage’s Mother and Child Program in Montreal, a model where the Kingston team’s job is based. Few others do the same in different areas of the country.

Yet, the increasing number of Canadian infants born annually to drug-dependent women points to an urgent need. There were 1,846 infants in hospital with neonatal abstinence syndrome in 2016-2017, up 27 percent from 1,448 in 2012-2013, in accordance with Canadian Institute for Health Information information, not including Quebec.

Since Newman explain the idea for the Kingston project arose from his group’s attempts to keep infants born to opioid-dependent girls with their moms at Kingston General Hospital. Rather than whisking off the babies to the neonatal intensive-care unit immediately after arrival for monitoring, their “rooming-in” program, implemented in 2013, provided support for mothers and babies since they were given a opportunity to bond, uninterrupted. Keeping the mothers and babies together led to better health outcomes: How many infants requiring oral morphine treatment for their withdrawal symptoms was significantly lower, and their average hospital stay was substantially shorter.

But Newman and his group realized many of those women and infants lacked support once they had been discharged.

The notion of keeping mothers and children together isn’t based on sentimentality, Newman says. There is evidence to suggest it can be helpful for the girls, too. Remedy for substance-use disease is notoriously unsuccessful for girls that are separated from their kids, he says. “She is distracted and heartsick and guilty and missing her child and feeling bad about the fact that she is not with them. It doesn’t wor”

A University of Manitoba study, published this fall in the Journal of Epidemiology and Community Health, girls tended to have higher rates of mental illness and substance use disorder diagnoses after their children were taken into care.

Elizabeth Wall-Wieler, lead author of the research, say there is a need for more preventative measures to encourage women before they are deemed unable to look after their children. And in cases where it is necessary for children to be taken into care, women need help to guarantee the separation does not lead to further deterioration of the health and well-being, because that could make it tougher for them to recover custody.

“There’s a good deal of trauma related to losing custody of a child,” she says.

Rider experienced this firsthand. After child protection services intervened in 2015, her daughter, then 6, was put in the maintenance of Rider’s dad and stepmother. Meanwhile, Rider went into a treatment center in Whitby, Ont., over 200 kilometres away.

Rider, with her kid’s name tattooed on her forearm, recalls the pain of hearing her daughter sob, “I need you, Mommy,” on the other end of the telephone. She fought the impulse to immediately run from the treatment centre to locate and comfort her. But she also knew that if she were to recover custody, she had to stay at the month-long program.

Others told me that the separation was for the best; she had the time to be away from her daughter to concentrate on herself. But to Rider, that did not ring true. “That does not happen. I am a mother. I can not disconnect [from] that,” she says.

Rider considers herself lucky that her daughter was in the care of relatives. She knows of lots of moms struggling with addiction who don’t have any one on whom to rely. She recovered custody after a few months, and she says she’s currently making positive strides. But even their comparatively short time apart has had lasting consequences. Rider says her daughter still gets anxious about being separated from her. Had the choice of staying with her daughter through treatment been available to her, Rider could have sought help long before child protection services became involved, she says. “I could have begun to make changes a good deal sooner.”

The proposed Kingston House of Recovery for Women and Children, which would accommodate 24 women with up to 2 kids each for at least six months, has a ways to go before it becomes a reality. The team behind it’s seeking charitable status and has been guaranteed a site in downtown Kingston, but it still needs to raise capital, and to plan, construct and staff it.

What’s certain, Newman says, is that the team will have no trouble filling it.

“Unless someone decides to make it a cause and to push it forward, it doesn’t matter how worthy or efficient or useful it would be, or cost-efficient, it will not happen,” he says.

Courtesy: The Globe And Mail

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