Mothers, Opioid Use, and Child Protection Services: A Transatlantic Qualitative Comparative Analysis

• In Event: Novel Methods In Drugs and Health Research

Abstract

Mothers using opioids face surveillance from Child Protection Services (CPS), which can lead to child separation. While substance use disorder (SUD) is recognized as a chronic disease influenced by adverse social conditions, a critical gap remains in understanding how increased CPS surveillance affects parenting and recovery for these mothers. This transatlantic study employs Qualitative Comparative Analysis (QCA) to investigate the social-ecological environments, social supports, and service provider interactions of mothers who use opioids in the United Kingdom and the United States. The initial analysis identifies (1) cross-national similarities and differences and (2) conditions that distinguish mothers who maintain legal custody from those who do not while under CPS supervision. The aim is to identify causal combinations of conditions that lead to mothers retaining legal custody while under CPS surveillance. Using secondary ethnographic data from the UK and the US, we analyzed cases of mothers involved with CPS between 2021–2022. QCA was selected to bridge qualitative depth with set-theoretic logic, treating each country’s sample as a series of configurations. Initial analysis reveals that social-ecological environments are comparable across the UK and US samples, suggesting these broad factors do not independently confound the outcome. However, a key distinction emerges when comparing mothers who maintained custody with those who experienced child removal. By establishing conditions before and after separation, we identify divergent causal combinations. While mothers who lost custody often faced a lack of specific social "safety nets," those who maintained custody while under surveillance benefited from unique configurations of social support and service provider interactions.

Authors

• Miriam W. Boeri, North Jersey Community Research Initiative

• Natascia Boeri, Bloomfield College

• Aukje Lamonica, Southern Connecticut State University

• Jasmine B Herreras