Tips for Working with Mothers in Methadone Treatment

The following suggestions for working with mothers on methane and other forms of medication assisted drug treatment (MADT) are excerpted from a presentation by Lena Lundgren, Nancy Young, Therese Fitzgerald, and Cat Oettinger (2006). Visit this link on the National Center on Substance Abuse and Child Welfare’s website to access their full presentation: http://www.cffutures.org/files/presentations/MedicationAssistedTreatmentAndChildWellBeing.pdf.

View participation in methadone or other forms of medication assisted drug treatment as long-term treatment and as a measure of stability, not as long-term drug use.
Be aware that the methadone is often the primary source of support and stability for these women, and withdrawal can be extremely difficult, physically and emotionally.
- This is particularly important to consider for clients who also have mental health concerns, and for whom the effects of withdrawal will be even greater.
- Consult with methadone clinic staff and the client’s substance abuse counselor before suggesting that the client withdraw from treatmen
When assessing your MADT client’s needs and risks, identify what services are available to your client through MADT, specifically:
- What types of services other than the medication are provided at the specific clinic?
- Does the counseling take place in house, or is it referred out?
- If the counseling is referred out, does the clinic have a mechanism to follow up and verify whether clients participate in counseling?
- Is there a psychiatrist on staff?
- Are there parental support services?
- Is there a way to collaborate with counselors from MADT settings to develop joint treatment plans? If so, is my client willing to sign a release of information to allow such collaboration?
Be aware of clinics that work specifically with certain populations, for example, with opiate-dependent pregnant women. These clinics are more likely to:
- Have the knowledge and services available to work effectively with this population.
- Be able to assess needs and risks of this population (for example, recognizing an infant with narcotic abstinence syndrome).
Encourage women to remain in MADT through their pregnancies and after.
- Pregnant women and new parents face exceptional stress.
- Few personal, social, and economic resources are available to these women.
- Ending MADT would have a dangerous effect on the mother and infant, and likely lead to relapse.
Encourage clients to participate in MADT for as long as the clinic staff recommends. In general, longer participation in treatment leads to better outcomes for both mother and child. These may include:
- Abstinence from drugs
- Reduced HIV risk
- Improved mental health
- Improved dental health
- Improved physical health
- Secure employment
- Acquisition of parenting skill
Collaborate with staff at MADT clinics around issues of child safety and well-being.
- Clinic staff are frontline observers of these children, and can assess developmental and physical concerns, and concerns of parental abuse or neglect.
- Clinic staff can make referrals to outside services for these children.
Provide or make referrals to as many appropriate services as possible. These mothers are faced with many barriers to effective treatment and well-being. Arranging for these services may be helpful:
- Stable housing
- Employment assistance
- Parenting education groups
- Couples and/or family counseling (including the children

References for this and other articles in this issue

Read the February 2012 issue of Training Matters to learn more about methadone and medication-assisted drug treatment.