Alcohol and marijuana are the drugs of choice for Barbadian women who struggle with substance abuse, and many of them are afraid to seek treatment out of fear for their children’s welfare and the stigma of rehab, a National Council on Substance Abuse (NCSA) study has revealed.
Putting their family’s needs above their own and fearing the loss of a job and child custody, many women downplay the need to seek help, said the research, released on Monday at the NCSA’s Belleville, St Michael offices.
At the same time, the study suggests that drug treatment facilities should behave less like “prisons”, confining women without more friendly amenities.
The NCSA has recommended that childcare services be made available for mothers in drug treatment, according to the study conducted by its Research Department entitled Barriers to Substance Abuse Treatment in Barbados: Factors Hindering Women’s Use of Treatment.
Already more highly stigmatised than men, women opt not to seek treatment in an attempt to avoid negative labels, said NCSA Research and Information Officer Laura Foster.
Their hesitation to attend the Psychiatric Hospital for assessment or drug treatment sessions was also revealed as a barrier to treatment, owing to the highly stigmatised nature of mental illness, she said. Foster found a link between mental health and substance use disorders. She indicated that between 21 per cent and 33 per cent of those admitted to the Psychiatric Hospital between 2018 and 2021 had both psychological disorders and substance abuse issues.
“Participants were afraid to lose their jobs if their drug use was discovered by employers and colleagues,” said Foster.
“This coincides with the findings of NCSA’s recent pilot workplace survey. Fear of job loss is made worse by the absence of drug policies. This may make some persons downplay their addiction and avoid seeking treatment.
“The lack of protocols can also delay treatment access. The negative impact [that] the absence of drug policies has on treatment-seeking is concerning, as drug use in the workplace can be dangerous and costly,” she added.
Noting that a support system is key to treatment success, the NCSA researcher further revealed that individuals in active treatment had been found to receive higher levels of social support from their partners, families, friends and community than those not in treatment.
Foster said: “Those with strong social support networks have been found to remain in treatment longer, have better recovery outcomes and a reduced likelihood of relapse. Some women do not have good relationships with their families and, therefore, lack a strong family support system. Some families are not supportive of treatment.
“A substance-using partner can discourage women from seeking treatment. Research has shown that having a drug-using partner can decrease the likelihood of treatment entry and increase the possibility of drop-out and relapse. Some drug dealing partners can expect women to assist with preparing or selling the drug. This can make it difficult for them to seek help because their family income is dependent on the same drug they use.”
Residential treatment clients and providers who were interviewed for the study also suggested that if a woman’s basic needs are not met, she will be less inclined to seek treatment for her substance use disorder, which is further compounded if she has children that she would want to provide for and prevent them being taken by the State.
While treatment centres try to assist using their existing budgets and/or by directing clients to relevant social services, there is an absence of formalised partnerships between treatment centres and social agencies, according to the study.
There is also a heavy reliance on the relationships that treatment personnel have developed with staff in the various agencies, said Foster.
But she said the restrictive nature of residential treatment was also identified as a barrier by clients, particularly the inability to go out, watch the news and listen to the radio, and limited access to up-to-date newspapers, making the treatment facility feel more like a prison.
“Concerns were also raised about the lack of inpatient detoxification,” Foster said.
It was also reported that some clients and providers identified a lack of knowledge about treatment services as a barrier.
The NCSA study said: “Most of the identified barriers were external in nature, which means that they can be more easily addressed through policy and programming initiatives, such as those proposed. While the internal barriers may pose a greater challenge, initial efforts can also be guided by the proposed recommendations.
“This study’s findings and recommendations can be used to guide policy and programming initiatives with a view to increasing treatment uptake and retention among women on the island. This will be critical as treatment must be utilised by a large percentage of those in need of such services if it is to have a substantial public health impact.”
Speaking at the study’s release, Minister of Home Affairs Wilfred Abrahams said he hoped the research would open the door to addressing the barriers to treatment head-on with a view to increasing treatment uptake among women.
He said that in so doing, the country would be better placed to facilitate recovery among members of this valuable population and, by extension, ease the adverse effects associated with addiction both personally and at the wider national level.
“For these reasons, I encourage the treatment providers, policymakers and other stakeholders present here today to take note of the findings and look for ways that you can use them to inform the work you do with women,” Abrahams said.