How can we tackle child safeguarding without risking disengagement? DDN hears a cautionary perspective from public health nurses. This focus on child protection is a good thing \u2013 but there are real consequences of focusing on it too much,\u2019 said Karen Hammond of the Centre for Alcohol and Drug Studies, speaking at the recent HIT Hot Topics conference in Liverpool. Hammond gave insight into the changing role of public health nurses in relation to mothers who used drugs \u2013 and described a very fragile relationship. Having access to families had been seen as \u2018an opportunity for surveillance\u2019, with nurses expected to take on an additional social work role, reporting on cases that they felt were high risk. The effect of this could be to breed an \u2018atmosphere of fear\u2019 and \u2018erode an already fragile trust\u2019, denying these women a valuable source of support. One-to-one interviews with public health nurses who worked with this group of women revealed problems with engagement: women were tending to withdraw from contact with nurses, for fear of having their children removed. This failure to keep appointments was being blamed on their engagement with drugs and the notion of their \u2018chaotic lives\u2019, rather than \u2018the cycle of fear and mistrust that had been created\u2019. The consistent issue to be highlighted was lack of training; many of the nurses had only had child protection as a training route to deal with these issues and thought they only needed to know about the names of drugs. This gave them perceptions such as: \u2018addiction results in a loss of control and affects the ability to parent properly\u2019; and \u2018recovery is equated with abstinence\u2019 \u2013 so any continued use signalled danger to them. Hammond relayed some typical comments from the interviews with nurses: \u2018The drug use takes over \u2013 that\u2019s all they think about,\u2019 and \u2018They want to stop it but they can\u2019t \u2013 the pull is just too strong.\u2019 Children were also still deemed to be at risk when they were not actually present during drug-taking, and had been left with family members. \u2018Nurses still thought wouldn\u2019t manage their intoxication and it would end in chaos,\u2019 she said. \u2018Overall it was quite shocking \u2013 the belief that drug use makes you a bad mother,\u2019 said Hammond. \u2018We need to not only teach parents about risks, but also be able to facilitate some critical self-reflection that\u2019s lacking at the moment. \u2018Professional practice should reflect the evid\u00adence base, not political or moral frame\u00adworks,\u2019 she said. \u2018What we really need is to dismantle prohibition \u2013 but in the meantime we need to recognise that the way we\u2019re dealing with it makes it worse.\u2019 During the question time at the end of this session, a woman from Belfast commented: \u2018I asked for help and my children were taken off me. You\u2019re damned if you do ask for help and damned if you don\u2019t.\u2019 More from Hit Hot Topics in our next issue.