Adolescent Mothers: The Effect of Children on Substance Use Treatment Outcomes

Abstract

Adolescent motherhood is correlated with negative health and social outcomes for both the mother and the child. Few research studies have explored the impact of adolescent and young adult motherhood on substance abuse treatment and recovery. The aim of this study was to identify characteristics associated with successful completion of a substance abuse program by adolescents and young adults with children. Data were from female adolescents and young adults in the Treatment Accountability for Safer Communities (TASC) program, a case management criminal justice diversion program for substance users that is an alternative to incarceration and involves drug rehabilitation placement. Variables included demographics (i.e. race, marital status, employment, education, insurance status), criminal history, substance dependence diagnosis, and program outcome (categorized as positive/indeterminate versus negative). Chi square analyses for categorical data and ANOVAs for continuous variables were used to determine univariate associations between variables. A binary logistic regression analysis was completed to determine the characteristics associated with adolescent and young adult women with children. A total of 874 adolescents and young adult women 21 years of age and under (range 15-21) were analyzed; 271 had children (31%). The mean age of the group was 19.7 years. Of those with children, 33 (12.1%) lost custody and 26 (9.6%) were involved in a current child protective services court case. Univariate analysis showed adolescent and young adult mothers to be more likely to have negative treatment program outcomes (e.g. not completing the program, etc.) than non-mothers (39.9% vs 26.5%, p < 0.01). There was no difference in type of substance dependence between mothers and non-mothers. Multivariate analysis showed mothers to be more likely than non-mothers to be non-white (p < 0.01, OR 3.0), have current or past marriage (p < 0.01), have Medicaid (p < 0.01, OR 12.2), and live with their spouse and children (p < 0.01, OR 15.9). Adolescents and young adults in substance use treatment who had completed more than a high school education were less likely to be mothers (p < 0.01, OR 3.4). There was no difference in treatment program outcome between adolescent mothers and non-mothers when accounting for other variables including race, living situation, education, and insurance status. Adolescents and young adult women who have children and are involved in the criminal justice system have negative substance abuse treatment outcomes (e.g. failure to complete the program) more often than adolescents and young adult women without children. However, these differences did not remain significant when taking socioeconomic factors such as living situation, employment, and education into account. Future research needs to be conducted to explore optimal strategies to address economic, educational and social challenges for adolescent and young adult mothers receiving treatment for substance dependence in the correction system. As well, studies are needed to assess the children of adolescent and young adult substance users and develop sustainable educational and youth development programs that engage the parent and the child longitudinally.