Maternal Substance Abuse and its Impact on Adolescent Daughters

Writing about such an important topic has prompted me to reflect on the adolescent girls with whom I have worked in multiple settings all across the country and outside the country, as well as those with whom I have come in contact outside of work. It is interesting to observe some adolescent girls’ interactions with their mothers; even more so are their mothers’ responses. As I continue to work with families I hear from some the following comments: 

• “I don’t know what’s wrong with these girls today. It seems like some of them have lost their minds.”
• “When I was their age my mother didn’t allow me to talk like that.” 
• “She needs to go and sit her fast self down.”

It might be advisable to think about the following questions: Are any of the behaviors about which these mothers complain the result of their daughters observing their own behaviors? What part, if any, do alcohol and drugs play in the mothers’ behaviors? Do these mothers recognize the here-and-now stressors in the lives of their adolescent daughters? Are these mothers able to reflect on their own adolescent years while recognizing that times are different?

Before addressing the adolescent daughter’s substance use, it is necessary to understand the etiology and risk factors for women who are addicted. One of the areas which serves as a psychosocial risk factor is family alcohol and other drug (AOD) history and/or dysfunctional family history. Substance-using women tend to have a higher rate of dysfunctional family history/family AOD history than their male counterparts (Sun, 2009). The variable family AOD history refers more to environmental factors than to genetic ones in that the background people in the person’s life could include not just AOD-abusing parents, siblings, and relatives, but also friends in the house while the person is growing up (Sun, 2009). If you ponder the aforementioned statements and think about the adolescent girl who is exposed to alcohol and drug activity in the home from that many sources, it is not just about the alcohol and drug activity but the behaviors that result from it. Modeling behavior includes, but is not limited to affect regulation, thinking skills, parenting practices, and responses and reactions to crisis situations.

The variable of dysfunction history may mean a broken family with one or both parents missing or a family with members who exhibit deviant or pathological behaviors. Adolescent girls who are subject to the challenges of dysfunctional family practices are at risk for multiple problems, including the use of substances, delinquency, sexual abuse, poor affect regulation, and running away, any of which can lead to a premature entry into adulthood. It is important for mothers to understand that they are the primary same-sex role models for their daughters outside of school. That is not to say that female teachers are not important role models for their female students, but teachers are not exposed to the immediate microsystemic home life challenges that mothers and daughters face with each other every day. 

The substance-abusing mother is a serious problem for parenting and represents a considerable burden to society. Estimates suggest that 50 to 80 percent of child welfare cases involve a parent who abuses alcohol or other drugs, and mothers make up the majority of substance-abusing parents in the child welfare system (Niccols et al., 2012). In order to understand the risk factors for adolescents it is necessary to understand the risk factors for substance abuse for women. Rates of substance abuse in women have been increasing and substance abuse in women is associated with a unique constellation of risk factors and needs, including greater vulnerability to adverse physiological consequences than men, greater prevalence of mental health problems, histories of physical or sexual abuse, serious medical problems, poor nutrition, relationship problems, including domestic violence, and deficits in social supports (Niccols et al., 2012). The unique risk factors and presenting needs of women have resulted in the development of women-specific comprehensive treatment models. However, it is important to remember that, in addition to having gender-specific needs, women with substance abuse issues also have unique needs as mothers. 

Moving forward, how can women who are mothers who have abused substances not only reestablish their parental roles, but repair and restore the affectional bonds and reestablish prosocial modeling? It is necessary for mothers to come to grips with and own the real possibility that their drug use and corresponding behaviors have impacted their adolescent daughter’s behavior. For example, as a result of maternal drug use, a mother was not available to provide a consistent pattern of soothing introjects, which aid in affect regulation and facilitate a calming internal state. Further, a mother’s alcohol and drug use impacts her ability to communicate and demonstrate appropriate and prosocial problem-solving skills. It will also affect her physical and emotional accessibility and availability to her daughter and her ability to respond to her daughter’s psychological and emotional needs. 

From a further examination of modeling behaviors, alcohol and drug use can be a self-centered activity. In this author’s opinion, the greatest modeling example is the modeling of empathy, which adolescent daughters learn primarily from their mothers and other women they encounter in their daily lives. Empathy has two components: an affective component and cognitive one. Affective empathy refers to the sensations and feelings one gets in response to another’s emotions. It can involve mirroring what the other person is feeling or simply feel stressed when detecting another’s fear or anxiety. Cognitive empathy, sometimes called “perspective taking,” involves the ability to identify and understand other peoples’ emotions. 

For substance-abusing women to reconnect with their daughters, family therapy would be a must, along with a trauma-informed substance abuse group for women. The daughters in such a situation would benefit from individual therapy and a group with other girls in which they could feel safe enough to discuss the months or years of not having access to their mothers emotionally and physically as a result of drug use.

It is important for both mother and daughter to understand that repairing the relationship will take time and patience. An important approach for a family therapist is the operationalization of hope, even when the family session is falling apart, that the mother-daughter relationship can once again be restored. 

Niccols, A., Milligan, K., Sword, W., Thabane, L., Henderson, J., & Smith, A. (2012). Integrated programs for mothers with substance abuse issues: A systemic view of studies reporting on parenting outcomes. Harm Reduction Journal, 9, 14.