Mothers with substance abuse issues are generally victims of sexual and domestic violence. Often, the underlying reasons for addiction among mothers are untreated post-traumatic stress and/or major depression disorders, precipitated by the injuries of sexual and domestic violence.

Families struggling with substance abuse issues are therefore offered few opportunities to find treatment and recovery for themselves and their families:

• The Uniform Facility Data Set found that only 6 percent of the treatment programs surveyed included prenatal care and 11.5 percent provided childcare.

Parents involved in the child welfare system are especially impacted by the dearth of drug treatment programs available to families:

• Between one-third to two-thirds of parents involved in the child welfare system require substance abuse treatment, yet existing treatment meets less than one third of that need.
• Alcohol and drug-related cases are more likely to result in foster care than are other child welfare cases.
• Only ten percent of child welfare agencies report that they can successfully find substance abuse programs for mothers and their children who require the treatment in a timely manner.  

Family Treatment Outcomes

Although family-based treatment represents a small percentage of the overall treatment available, family treatment programs enjoy consistently high levels of success.

In 2001, the Center for Substance Abuse Treatment (CSAT) evaluated its Pregnant and Postpartum Women and Their Infants Program, which provides comprehensive, family-based treatment for substance abusing mothers and their children. Major findings of this study, at 6 months post treatment, include:

• 60% of the mothers remained alcohol and drug-free. 
• Drug-related offenses declined from 28% to 7%.
• 38% obtained employment and 21% enrolled in educational/ vocational training.
• 75% of the mothers had physical custody of one or more children.

In 2003, an additional cross-site evaluation of 24 residential family-based treatment programs 6 months after post-treatment revealed successful outcomes for mothers and their children:

• 60% of the mothers remained completely clean and sober 6 months after discharge.
• Criminal arrests declined by 43%.
• 44% of the children were returned to their mothers from foster care.
• 88% of the children treated in the programs with their mothers remained stabilized and living with their mothers, 6 months after discharge.
• Employment rose from 7% before treatment to 37% post-treatment. 
• Enrollment in educational and vocational training increased from 2% prior to treatment to 19% post-treatment.

Family-Based Comprehensive Treatment

The terms "family-based treatment", "family treatment", and ‘comprehensive treatment" describe programs that provide the following services in tandem or provide referrals for the following services: Substance abuse treatment, children's early intervention services, family counseling, legal services, medical care, mental health services, nursery and preschool, parenting skills training, pediatric care, prenatal care, sexual abuse therapy, relapse prevention, transportation, and job/vocational training or GED classes.