Polly Radcliffe has wide experience of qualitative research in health and social care that has focused on gender and identity including in the context of substance use treatment, maternity care, and mental health care services. Her research has explored the intersectional barriers to care for groups with multiple and complex needs and how multidisciplinary care systems can respond. Recent studies have explored how parents who use drugs navigate complex care systems. She has extensive experience of accessing and engaging marginalised groups of research participants, and coproducing research with people with lived and living experience of alcohol and other drugs.

Abstract

‘I want to go there but I ain’t ready to come off my methadone’. Pressure to detox for postnatal women receiving opioid replacement therapy: Findings from the Stepping Stones Study

The Stepping Stones Study (NIHR130619) included longitudinal qualitative interviews with 36 women who used and received treatment for drug use in the perinatal period, 32 of whom were receiving treatment for opioid use. This paper used thematic analysis to explore women’s reports, postnatally of ‘felt’ and ‘enacted’ stigma surrounding community and residential substance use treatment. Where mother and baby residential rehabilitation services were available, referral was sometimes conditional on women demonstrating their commitment to reducing Opioid Replacement Therapy (ORT) and within residential rehab, they reported pressure to detox from ORT completely. Children’s social care professionals were reported to be particularly focused on the objective of abstinence. Although participants reported being keen to become free from the felt and enacted stigma surrounding substance use treatment, they also feared relapse to drug use, often born from experiencing of losing care of older children. We consider measures to address felt and enacted stigma associated with ORT for this group of women.