Texas Child Protection Law Bench Book

2024 version: As effective October 1, 2024

B. Substance Use Among Women

Substance use in women tends to be multifaceted and can be related to family or partner use or co-morbid mental health conditions such as depression, anxiety, and eating disorders. Additionally, SUDs in women are strongly correlated with histories of trauma as well as experiences during childhood with personal violence. As a result of using substances, women could experience physical complications, may be at higher risk of losing custody of children under their care, and could be at increased risk for co-occurring mental health disorders and exposure to partner violence. Additionally, women who use substances during pregnancy have an increased risk of infant fetal alcohol spectrum disorders, long-term cognitive deficits, low birth weight, and miscarriage or maternal death.^{^[155]}

A gender-responsive approach to the treatment process and recovery for women includes the importance of relationships and family, the prevalence and history of trauma and violence, common patterns of co-occurring disorders, and, when applicable, particular recognition of caregiver responsibilities.^{^[156]}

According to a 2009 Substance Abuse and Mental Health Services Administration (SAMHSA) publication, pregnant women may be reluctant to seek prenatal care due to fear of losing custody of the infant or other children. Most mothers who are in SUD treatment feel a strong connection with their children and want to be good mothers. Most of these mothers want to maintain or regain custody of their children and become “caring and competent parents.” Women who believe they have not cared for their children adequately or who believe that they are perceived as having neglected their children carry enormous guilt. Therefore, for many women, maintaining caring relationships with their children is sufficient motivation to keep them in treatment. Unfortunately, they often have inadequate role models in their own lives or lack the information, skills, or economic resources that could make motherhood less difficult.^{^[157]}