Mothers have been misunderstood, under-represented and ignored – it’s time to redress the balance, says Anna Millington. I am a mother, a drug user, an activist, a researcher, a trainer and a professional. I’ve used drugs from the age of 13 – I was a problematic user when my child was young, I’ve been to prison on several occasions, been sentenced to various criminal justice orders and traversed through the whole spectrum of drug treatment. I also had my child put into the care of my mother for a period before regaining full rights. During the last 15 years I’ve worked within the drug treatment sector at national level, with the government, academia and the probation service, and within prisons. I’ve been on the ground floor helping my peers voluntarily for a long time – I’m passionate about making sure there are effective ways out for people if they want it, and help and harm reduction if they don’t. For the last eight years I’ve worked extensively providing harm reduction equipment and wide-ranging peer support to mothers who use drugs. Those in hiding and in fear, those with extensive needs who feel alone and trapped, unable to come forward. These mothers may not make up the majority of the using community, but they can be one of the highest-costing sectors societally, generationally, and economically. Providing what may be termed as high-risk support to this group is demanding, and has had both positive and negative outcomes, but I believe that risk is inherent in anything – including doing nothing at all. Skewed System Let me be clear before I continue – I think the work and focus on women by activists, peers, workers, managers, and leaders is fantastic. I’m not trying to diminish nor take anything away from that, because I champion the need in this male-dominated system to finally address us, listen to us and understand our needs, as well as adapt services and service provision. However, if we’re going to fully embrace women and finally make major changes to include their needs in everything we do it’s impossible to discuss us in relation to the criminal justice system, harm reduction, drug treatment and recovery without including within that – as a priority – motherhood. It’s clear this sector of our using community has continually been misunderstood, underrepresented, and constantly ignored unless under the guise of a misguided and ill-judged child protection rhetoric. A tokenistic head nod when discussing ‘women’ generally without specifics of who we are and what we explicitly require as mothers, as part of a family unit, is not acceptable. It’s not just professionals that avert their gaze and interest from us either – recovery/peer community led projects do too. Stern Judgements We face harsh and complicated barriers when accessing harm reduction services, and we face sterner judgements and discrimination both societally and within professional and peer services. It’s almost impossible to be a drug using mother and for that to be okay in and of itself. We can use drugs without this automatically causing harm to children. It’s not a given that risk and harm naturally follow from the use of drugs themselves. It’s often the lifestyle and the associated links that tend to be a problem. If services work from the belief that parental drug use is negative, that it equates to risk or harm or its ‘user representatives’ hold this belief then it’s most likely that they are incapable of addressing this topic adequately, logically, and impartially. Nor can they effectively and fairly represent, or proactively work with, this group. It’s doomed from the start. We’re required to make superhuman leaps in the drug treatment system. We are punished if we don’t adhere to unrealistic goals within unrealistic time limits. We are expected to move quickly through a recovery journey that we cannot choose freely, without the appropriate support needed by us and our children and end up as a fully recovered person as defined by other people. We’re told what we must do, what way we must do it and when we must do it by. The consequences for failing any of this can be severe. It can lead to the loss of your children. I really want that to sink in for people. It’s a reality. Intentionally or not, the normal expectations and requirements for a person who uses drugs do not apply to us. Outdated Terms I had some input into the original Hidden harm work. Its title is as outdated as some of the content – using titles like ‘hidden harm’ for specific pieces of work or for specific workers has clear implications that you are saying from the start that there is harm. It’s hard to move forward positively from this point if it starts from a negative stance. The mothers I work with have told me that this type of thing is what immediately scares them – the title can put them off from engaging and it doesn’t really matter what people try to explain about the role or work. They’ve already mentally disengaged, run a mile, or remained hidden. I think that a lot of the roles themselves are often positive, exciting and innovative, but may end up becoming under-used and tokenistic if we can’t get the people who need this the most to engage, or if the right workers who understand these intricate and often very demanding and challenging clients and issues aren’t employed. Double Standards I continually come across double standards and contradictions in relation to mothers who use drugs. We are often accused of putting our children at risk of harm and damaging them, but equally nothing appropriate or realistic is offered – no real tools or therapy are given, or real time invested to help mothers mitigate or deal with their issues. There are no strong cross links with children’s mental health services that may be able to provide the type of family therapy needed. We are then blamed and labelled as failures at motherhood when things go wrong, or we aren’t seen to comply. We have complex needs which require complex treatment plans. We need specific and targeted medication and psychosocial help. We need this provided by people who understand the reality of our situations, who are both qualified and onboard with our struggle to come forward and access suitable, sustainable, effective harm reduction services and drug treatment. It’s possible. It can work, there can be a positive successful outcome. But it only happens when services and organisations are invested in really wanting to make it work. In thinking outside of the box. Anna Millington established a non-funded, non-affiliated support network for mothers who use drugs. It seeks to work collaboratively with professionals – on its own terms. firstname.lastname@example.org We're Not Going Away Motherhood is for life, regardless of whether you have your child with you or not. Those whose children are not in their care appear to somehow lose their motherhood status. Mothers in treatment who don’t have their children with them still require appropriate and specific psychosocial help around this. Where do we fit in? What is harm reduction for mothers? What does it look like? How can we identify and try to reduce the risk and harm if there is any? How would we assess it? Can we change the discourse and views on mothers who use drugs so it can instead be used as a motivating positive factor for engaging in treatment? Why is this not a topic with any real spotlight? Why is no one trying to answer these vital and important questions? I think many organisations and services remain silent because they think it’s impossible to fix. But surely we should try to fix what we can. I don’t claim it’s easy, I just claim it’s needed. I’m not asking for the impossible. I’m not expecting there to suddenly and easily be some ‘eureka’ answers. What I am asking people to do is put it on the table. Discuss it, evaluate it, look at your way of working, service and organisation. It is time to stop ignoring us. We need you onside.