Parental Substance Use as a Child Protection Problem: A Poststructural Interview Analysis

Abstract

The use of alcohol and other drugs (AOD) by parents is a significant public policy concern, both in the UK and other jurisdictions such as Australia. Concern about the potential risks posed to children is also paramount in family court decisions, where AOD consumption is framed as a child protection issue in itself. There is a need, however, for more critical inquiry into the ways in which parental use is understood and conceptualised in family court practice. Based on interviews with social workers, lawyers and judges who have worked in Family Courts in England and Wales, the aim of this paper is to pay closer attention to the constitution of parental substance use as a child protection problem. Using methodological tools devised by Bonham and Bacchi (2016), and adopting their poststructural approach to interview analysis, the aim was to pay close attention to the ways in which “reality” was made in and through participant accounts. The focus on the granularity of what, precisely, was said in the interviews unveiled some valuable insights into the ways in which parental subject positions were produced and maintained. For example, the ‘traumatised’ parental substance user was a recurring motif which, while rooted in a more empathetic understanding of the challenges faced by parents, could – I suggest – have unintended consequences.

Introduction

The majority of care applications in England and Wales are thought to involve some concerns about parental substance use (PSU) (DoE, 2021). Although it has been established in law that the use or ‘abuse’ of alcohol and/or other drugs (AOD) does not itself amount to a significant risk of harm to children (Children Act 1989, s.6) or authorise a child’s removal from their family, ¹ a failure to abstain or engage with treatment services could be a significant factor in the decision to deprive parents of their children (Flacks, 2023a). AOD use has been associated with various health and development difficulties and is understood by researchers to be ‘a leading cause of child abuse and neglect’ (Harwin et al., 2016, p. 5).

Although a number of studies have addressed how PSU affects children, and some have engaged with the problematisation of PSU in policy and legal discourses (Flacks, 2019a, 2019b; Whittaker et al., 2020), research on the interpretation and constitution of PSU by family court actors is lacking. This paper is based on interviews with social workers, solicitors, barristers, psychiatrists, and district judges, with the aim of exploring how participants understood the relationship between parental AOD use and child protection. It uses Bacchi and Bonham’s (2016) Poststructural Interview Analysis method to examine the data. Based on the assumption that interviews are knowledge practices, just like any other practices (policy, law, and so on), this approach amends Bacchi’s ‘What’s the Problem Represented to Be?’ (WPR) method for the interpretation of interviews. It contributes to a broader body of scholarship that has sought to examine the ways in which concepts such as ‘drugs’ and ‘addiction’ become stabilised, potentially limiting alternative ways of understanding different phenomena.

I make a number of observations from the data, particularly in relation to questions about subjectivity, risk, and ‘recovery’. First, I consider how PSUs were, through the way of ‘dividing practices’, constituted as victims of trauma and/or poverty, and in some cases, as disabled. While the production of these subject positions resulted from attempts to empathise and understand the challenges faced by parents, I consider any unintended consequences of such practices for families involved in care proceedings. Second, I examine how risk was produced and stabilised in participant accounts, particularly in its relationship with gender and how this might affect decisions about child protection, potentially resulting in greater surveillance of mothers. Finally, I consider how the question of ‘recovery’ was constituted and considered by participants, including its implications for attributions of responsibility. Although addiction could be framed in terms of passive victimhood, participants acknowledged the agency of parents in recovering or retaining care of their children by making active decisions to abstain, as manifested through the way of the drug tests. I suggest that this could limit the value of other means of risk reduction, and the possibilities for practising ‘safe’ or ‘good enough’ parenting (valentine et al., 2018). The findings are important for understanding how practitioners view and constitute the relationship between parental AOD use, child harm and care proceedings, and they will have resonance in other jurisdictions beyond England and Wales.

Background

The proposed relationship between trauma and addiction has been the focus of a large body of scholarship. Underlying much of this research is the claim that addiction, and sometimes substance use itself, can be explained—as pathological states—by past traumatic experiences. The use of drugs is thus posited as a means of ‘self-medication.’ In a key paper, valentine and Fraser (2008) draw on qualitative interviews with service providers and clients to explore the relationship between disadvantage, trauma, and drug use. They argue that associating problematic drug use with trauma “can easily shift to a reinscription of users as deficient; where problematic drug use represents proof of trauma and nothing else” (p.412). Pleasure is thus ‘reserved’ for the non-traumatised. It is well established that pleasure in general is a subjugated knowledge within the discourse on drugs (O’Malley & Valverde, 2004; Race, 2009). valentine and Fraser (2008, p. 411) add that overly deterministic arguments about drug use “can work teleologically, so the incapacity of drug users and the givenness of their drug use is confirmed rather than questioned.” Emphasising the links between agency, discourses, and social environments (Bourgois, 1995), they note the missing role of pleasure in many such accounts, while also acknowledging the relationship between injustice, disadvantage, and drug use. As such, they argue that a deeper understanding “involves the recognition that drug use is the result of agency as well as trauma, and may involve pleasure as well as, or as part of, the mitigation of pain” (ibid.).

Seear and Fraser (2014), meanwhile, in their study of Australian victims of crime compensation laws, consider how the incompatibility of addiction with victimhood prompts courts to reconcile this ‘dilemma’ by describing addiction as a consequence of trauma, violence or abuse. The authors note that, whereas this could be understood as a more understanding or less stigmatising approach, new challenges ensue which may undermine claims to citizenship. Beyond critical drug studies, there has been some limited critique of the prevalence of the ‘hot topic’ of trauma and trauma-informed practice within social work and other professional and academic practices. Radstone (2007), referring to academic debate in the Humanities, has troubled the ways in which theories of trauma presume that a ‘wound’ has been caused by an exceptional event, cementing a distinction between the ‘normal’ and the ‘pathological.’ Within social work, there has been an increased focus on, and critique of, Adverse Childhood Experiences (ACE) and their associated effects on future life chances and challenges (Kelly-Irving & Delpierre, 2019). Relatedly, Brown and Wincup (2020) have noted the importance of ‘vulnerability’ as a political currency and policy concern. Using Bacchi’s WPR approach, they examine the 2017 UK drug strategy, observing how vulnerability is problematised in ways that underplay the role of material inequalities in the distribution of drug-related harms. Some social work scholarship has also reflected on the ways in which notions of risk, individual responsibility, and blame play out within discourse on child protection, reducing social and material inequalities to matters of personal responsibility. Social services and family courts in England and Wales are under considerable strain following more than a decade of austerity (Gupta, 2017; Robins & Newman, 2021). Despite rising poverty levels and huge cuts to welfare budgets, Gupta (2017) argues that discussions tend to ignore such factors and instead blame both families and social workers for failing to prevent and address child harm. According to Bywaters et al. (2018, p. 54), practice has also become increasingly ‘risk averse,’ with the “model being promoted centred on the identification of and elimination of risk to individual children with little concept of the relationship to safeguarding to the economic or community context.”

These reflections on governing rationalities, which emphasise self-regulation, control, and self-motivation (Rose, 1999), correlate with the second part of the discussion of the data, which addresses enactments of parental responsibility and risk. Without wishing to ignore or silence the harms experienced by children in disadvantaged households, the growth in concern about PSU reflects deepening anxiety in late modernity about the nature of parenting itself. It coheres, for example, with a more scrutinising approach to parenting practices, particularly the expectation that parents raise their offspring in ever more intensive and child-focused ways. The tropes of the ‘intensive mother’ and the ‘vulnerable and at-risk child,’ drawing on late modern rationalities of risk and responsibilisation (Beck, 1992), are familiar in the fields of childhood and parenting studies. Scholars have focused on the discipline of developmental psychology, in particular, as the dominant explanatory model for childhood, particularly the notion that lives are formed indelibly in infancy. Parenting is now understood as a ‘task’ necessitating expert supervision, especially in respect of ‘problem’ families (Burman, 2017; Gillies, 2005, 2011; Macvarish, 2016). As part of an emphasis on self-management, “‘good’ parents (mothers) are child-centred, reflexive, informed consumers, able to ‘account’ for their parenting strategies to minimise any sort of risk to their children” (Faircloth, 2013, p. 11). Mothers who use drugs are, in particular, subject to the construct of “good mothering,” or hegemonic motherhood, which serves as an important cultural norm supporting social stigma and affecting service provision (Nichols et al., 2021). As “one of the last bastions of essentialism” in much social science research (Rosen & Faircloth, 2020, p. 8), it is perhaps no surprise that ‘the child’ has become the quintessential locus of the ‘drug problem’ in many contemporary societies (Flacks, 2021). With the risky parent as the obverse of the naturally vulnerable child (Lee et al., 2014), correcting or addressing one’s own traumatic childhood experiences has become a prerequisite for ‘safe’ or ‘good enough’ parenting.

These observations about risk and responsibility continue to have resonance for the final part of the analysis, which focuses on accounts of ‘recovery’. The question of self-improvement or correction is important in the context of drug policy, and particularly for dominant recovery discourses which tend to venerate abstinence, and individual responsibility for it, above all else (Race, 2009; Wincup, 2016). Focusing on the ‘politics of identity’ in an Australian context, Fomiatti et al. (2017, p. 174) argue that the ‘recovering addict’ is a socially produced category, and that treatment subjects—according to their data—tend to be materialised as both disordered and in control, as requiring surveillance as well as support, and as “entirely individually responsible for extinguishing drug use.” Constructing individuals as responsible for their own problems may stigmatise minority groups, rendering them as deviant or incapable, while limiting what they believe they should expect from the government (Lancaster, Duke, et al., 2015, p. 620). This makes it even more important that we better understand how enactments of addiction, recovery, and parental capacity underpin child protection interventions.

Approach

The discussion in this paper is informed by Carol Bacchi and colleagues’ approach to social problems and their representation and constitution. A ‘problematisation’ approach, with its origins in the thinking of Foucault (1988), is key to this mode of interrogation. This perspective does not consider social problems to be ‘out there’ and in need of solutions from policymakers or perhaps lawmakers. Rather, it suggests that such problems are made and shaped by the ways in which we think about them. The aim is to make the politics of problematising visible (see also Mol, 2002). The discursive practices that are the object of investigation can thus be understood as a historically specific set of routines through which social knowledges are continually formed (Bacchi and Bonham 2016). For example, departments of health, treatment providers, NHS bodies, parliamentary reports, case law transcripts, social work files, publications and reports are sites formed through spatio-temporal routines. It is in these sites and through the routines which form them that knowledges about various topics, for example, drugs, families, and parenting, with varying degrees of authority, are produced. It is important to investigate how the parental substance user (PSU) is produced and remade through discursive practices because problematisations are a powerful means of governance. They have consequences for how people are treated and subjectified (Bacchi, 2009). As Butler (1990) argues, the subject of law does not exist prior to the law but is produced within juridical processes. The repetition of such processes serves to naturalize the subject along with the qualities, capacities, and statuses that constitute it (Butler, 1990, p. 2).

Bonham and Bacchi’s work has been deployed to great effect in the critical assessment of drug policy and legal discourses, particularly in Australia but also in the UK (Brown & Wincup, 2020; Fomiatti, 2020; Fraser & Moore, 2011; Lancaster & Ritter, 2014; Lancaster, Seear, et al., 2015; Pienaar & Savic, 2016; Seear & Fraser, 2014). This work has demonstrated that, rather than simply responding to pre-existing ‘AOD problems,’ the law and other texts produce AOD as particular kinds of things and problems. Such perspectives have, for the most part, been applied to policy discourses, and to a lesser extent, legal ones, rather than interview data. However, Bacchi and Bonham (2016) devote an appendix to interview analysis in their book Poststructural Policy Analysis: A Guide to Practice, and subsequently apply the method to the subject of cycling (Bonham & Bacchi, 2017; see also Fomiatti, 2020).

The methodology, which the authors call Poststructural Interview Analysis (PIA), is based on the premise that interviews are just like other knowledge practices, including law and policy discourses, and are thus inherently political. The point is that “reality” is made in and through discursive practices and that, given the multiplicity and mutability of those practices, it can be unmade. By understanding “subjects” as “in process”, interview transcripts may be treated as texts, leading to the politicization of “personhood” (Bacchi & Bonham, 2016, p. 113). The aim is not to understand why the interviewee says what they say, but to “map the kinds of ‘subject’ it is possible to become” (ibid. p. 115), and thus how subject status can be questioned and disrupted. The authors cite seven processes, briefly outlined here, on which such an analysis can be based:

Noting what is said. This is not about motives or intentions, but moments of excision and attribution, measurement, and other formation.

Producing genealogies of “what is said.” This means examining how certain things are sayable, for example, understanding the various practices that make an object intelligible within different fields of knowledge.

Highlighting key discursive practices, such as ‘health’ or ‘law,’ and the subject positions within such practices

Analysing “what is said”: “Things said” must be studied in terms of what they produce, or constitute, rather than in terms of what they ‘mean.’

Interrogating the production of “subjects.” Interviewees discuss their, or other’s, conduct in terms of certain norms, thus associating themselves or others with specific subject positions.

Exploring transformative potential. According to the authors, discursive practices are plural and perhaps contradictory “opening up spaces for disruption” (ibid., p.119)

Questioning the politics of distribution. The political uses of interview material and decisions about what will be reported, largely depend on the interviewers themselves, the distinctions they make, and where the material will be distributed, and so require interrogation.

Whereas Bacchi and Bonham (2016) focus on the ways in which interviewees speak of themselves as particular kinds of subjects, my interest is in how the study participants spoke of others, namely parental substance users with whom they had interacted either in court settings or social service practice. It is through these routine relations involving materials, movements, documents, words, symbols, and so forth that objects (drugs), subjects (parents and children), concepts (addiction), and strategies (interactions between lawyers, judges, and social workers as they make parenting assessments) are formed, re-formed, and transformed (see also Seear, 2023). Interviews are also part of these routines of relations, so that researchers and the participants contribute to the formation, re-formation, and transformation of objects, subjects, concepts, and strategies (Bonham & Bacchi, 2017).

Method

The study was funded by a small grant from the Socio-Legal Studies Association. Thirty-five interviews were conducted, ranging from 45 to 75 minutes in length. They were semi-structured in nature, giving a framework for the interviews while allowing participants the opportunity to explore particular issues or questions in more depth, as they saw fit. Participants included 15 social workers, seven barristers, six solicitors, six District Judges, four magistrates, and two psychiatrists. All had experience working in family courts, including in some cases Family Drug and Alcohol Courts. The sample included a mix of ages, ethnicities and genders, and participants were based in a variety of English regions (London and the South East, the Midlands and the North West). Recruitment took place mainly through existing networks and contacts, although some participants were also found as a result of call-outs on Twitter. My intention was to gather the perspectives of a range of actors involved in Family Court cases, at different levels of decision-making, including district judges, magistrates, solicitors, barristers, psychiatrists who provide expert evidence in court, and social workers. The aim was not to produce a generalisable data set, or to make representative claims about any or all of these cohorts, but to explore the interviews as sites for the making of truths about the relationship between parental AOD use and child protection (Bonham & Bacchi, 2017).

The interviews were conducted, online via video software, between September 2020 and May 2022. Permission was sought and granted by the President of the Family Division, via the Judicial Office at the Royal Courts of Justice, to interview members of the judiciary. The audio recordings were transcribed and coded according to the seven processes identified by Bacchi and Bonham (2016), as described above. The questions in the interview schedule addressed the relationship between parenting, substance use, ‘addiction,’ and child welfare. They included, for example, how does parental substance use impact on children’s welfare, if at all? Are some substances more problematic than others? If so, which ones and why? What do you understand ‘addiction’/’problem’ use to be? It should be restated that the process of analysing interview data, by researchers, is political. This is because interviews, like any research method, ‘are not a way of opening a window on the world, but a way of interfering with it’ (Mol, 2002, p. 154). Bonham and Bacchi thus urge some reflexivity on the part of the researcher, keeping in mind the politics of distribution (P7) and the role of the researcher in making realities. For example, participants understood that my study was concerned with the question of parental substance use. This may have had an influence on the ways in which they answered the questions.

The interviews were transcribed using a secure and data-compliant transcription service. I first developed a list of provisional codes from my reading of Bacchi and Bonham’s (2016) method, using Nvivo, and then read and re-read the texts according to these codes. This involved, for example, noting the discursive practices drawn upon by the interviewees (Process 3 (hereafter P3)), moments of excision and attribution, measurement and other-formation P1), and so on. I then returned to the transcripts to compare these codes with the transcripts and identify any further points of relevance. This resulted in an iterative, back-and-forth process to the point of saturation. It should be emphasised that the purpose of the interview analysis method pioneered by Bonham and Bacchi is to analyse truth discourses and avoid normative conclusions, analysing interviews ‘according to their content of “possibilities,” liberty or creativity, without any appeal to transcendental values.’ At the same time, I have highlighted the possible effects of truth claims while attempting to avoid making normative judgements about the ‘nature’ or ‘value’ of parental substance use (assuming it is ever possible to be completely ‘value-free’ when interpreting data). Ethics approval was granted by the University of Westminster.

Trauma, Drugs, and Child Protection

In a number of participants’ accounts, trauma was situated at the root of parents’ substance-using experiences. They said that PSUs used in order to cope with difficult feelings or to deal with painful or abusive incidents from childhood. For social worker Carly ² ,

All of [the parents] have a history of childhood trauma, definitely. I don’t think I assessed any alcohol or drug users who didn’t eventually start disclosing childhood trauma.

As a moment of measurement, the claim that ‘all’ of them experienced trauma is significant (P1). In moments of ‘attribution,’ some participants felt that these experiences of past trauma meant parents could not exercise full volition in respect of their substance-using behaviours. Social worker Amelia said

…it’s not always an active decision [to use alcohol or other drugs]… it’s like a coping mechanism, usually, for the kind of pain or trauma that they themselves have experienced.

‘Coping’ is enacted here in opposition to ‘active’ agency, suggesting that the use of substances to ameliorate difficult feelings, in particular, is not an active choice. Judge Smith went further, framing addiction within the discursive practice of disability (P3). She said

I think that almost always, it’s as a result of some reaction to some sort of trauma. I’ve heard other people say, “Oh well, people make a choice.” Nobody chooses to become an addict, you know, nobody chooses to have their children taken away…you have to accept that addiction is a disability as opposed to a choice.

Autonomy is excised here from the (traumatised) parental ‘addict.’ In questioning whether they may have ‘chosen’ their situation, parents are positioned as not entirely responsible for it. In one sense, placing the question of addiction and substance use within the field of disability adds to the transformative potential of what is being said by disrupting moralistic interpretations of substance use rooted in personal (and parental) failure (P6). The trauma—or perhaps the person or thing that caused it—is thus responsible, rather than the parents themselves.

On the other hand, the idea that addiction cannot be (entirely) volitional, perhaps even rendering the user disabled, binds addiction to a disordered mode of subjectivity in which a person’s agency has been compromised or even excised (P4,5). As Fraser et al. (2014) have suggested, well-meaning explanations of addiction as a ‘disability’ may also inadvertently perpetuate stigma and exclusion. Moreover, the urge to accept addiction “as a disability as opposed to a choice” enacts ‘disability,’ as much as ‘addiction,’ as a condition or state that is defined by an absence of choice (P2,3) (see Flacks, 2012).

While Judge Smith argued that addicts cannot choose, for social worker Kate, substance use was incompatible with desire:

…every parent that I've worked with there has been some level of trauma and I really link their substance misuse to that. I think it's rare to find a parent that wants to be using substances. Most of them want to be abstinent and don't want social workers in their lives.

As for Carly, the assertion that all parents have experienced trauma positions substance use as largely irreconcilable with the active pursuit of, say, pleasure or experience. In this sense, the inability to be abstinent, despite the apparent desire to be, places continuing substance use as ‘the other’ of autonomy. This was expressed more explicitly by the psychiatrist James, who, as might be expected, located addiction within the discursive practice of medical pathology:

the reason why you can’t just stop is because addiction is not actually about the pleasure of getting off on the substance. If you and I, I’m pretty certain, were locked in a room and given heroin for a week, I don’t think we’ll be addicted to it. We’ll have some physical withdrawal but… addiction is specifically using substances, strong substances to suppress and contain unbearable memories and emotions that one would otherwise perceive as untenable. So, it’s actually really about the chronic post-traumatic stress symptom.

For James, the risks of addiction lie not only in the substance itself but also in the person consuming it, and more specifically their need or desire to ‘suppress’ or ‘contain’ traumatic experiences. The subject is pathologised not only through the excision of pleasure from addiction but also through the diagnosis of post-traumatic stress. The incompatibility of substance use with the pursuit of desire or pleasure again places parents in a specific mode of subjectivity; their choice to consume is not an active or perhaps rational one, but rather a consequence of damaging emotional experiences. The distinctions made here between ‘you and I’, and between pleasure and pathology, operate as ‘dividing practices’, which Bacchi and Goodwin define as ‘dynamic practices of differentiation and subordination’ (2016, p. 51; see also Fomiatti, 2020). Addiction is not something that ‘we’ would suffer (P1,5), and nor are ‘we’ subject to those “unbearable memories and emotions” that structure addict subjectivity.

For other participants, it was not trauma, specifically, but mental health problems which lay behind parental substance use. Desiree, a barrister, said

I think what I would say is that oftentimes when I've had clients who are using drugs; it's been an underlying mental health issue. Like with cannabis it's depression or anxiety and they find that it helps them be calm so they just use the drugs. Then it's either in a drugs and alcohol and DV, it's a toxic trio, all of them altogether. I think they’re just kind of, they’re always together. It's mental health and drugs, or drugs and alcohol.

The use of cannabis to ‘calm’ symptoms of depression or anxiety, and to address an ‘underlying’ or hidden mental health issue, is slightly different from framing substance use as a means of coping with past trauma. Nevertheless, this formulation also suggests that consumption is a response to an exceptional or pathological state/symptom.

Sarah, a social worker, drew on the connections between substance use, mental health, and violence (elaborated further below) in more detail. She said

very often the actual problem isn’t just drugs in and of itself, if you've got a parent with poor mental health, that makes them more likely to use drugs. If they’re using drugs, that makes them more likely vulnerable to poor mental health.

In contrast to the account above, Sarah argued that causality worked in both directions. Drug use was both a consequence and a cause of mental health problems. In addition to trauma, several participants suggested that problematic substance use resulted from poverty. Judge Rowland said

I think poverty is behind a lot of substance abuse. Poverty of expectation and absolute poverty. We’ve got a lot of people living in absolute poverty, literally, no hot water

Like trauma, poverty serves as a dividing practice by differentiating those who ‘abuse’ substances from ‘other’ parents (like you and I). As explanations, the attribution of either trauma and/or poverty to parents involved in care proceedings has both transformative and limiting potential, offering a more empathetic reading of parental substance use (beyond moralistic accounts) but at the same time imposing possible limits on agency. For example, such enactments have potential implications for a parent who claims not to have been traumatised, or who is not poor, with consequences for how actors conceptualise child harm. Is it more or less likely that such individuals will be subject to the scrutinising power of social service institutions and family court professionals? How might they be subjectified within family justice proceedings? Might such a parent be held more responsible for their behaviours and any related family harm? Similarly, if a parent cannot or does not wish to provide evidence of past trauma or abuse (see also Seear & Fraser, 2014), is space made for alternative explanations of drug use and will courts look less favourably on such accounts? This is not to suggest that traumatic experiences, or other forms of disadvantage or inequality, are not correlated with the problems associated with substance use. However, it also important to attend to the ways in which drug problematisations produce specific kinds of subjects, and understandings of substance use, which may influence assessments of any risks posed to children.

The understanding that parents do not normally “want” to be using substances, according to Kate, or that addiction is incompatible with pleasure, according to James, may also influence perceptions of parental capacity and decisions about child protection. As discussed above, parenting has become a site of ever-more intensive focus, with parents—especially mothers—expected to submit their own needs to those of their children. If a parent suggests that they do elicit pleasure from the use of substances, how might this affect judgements about their ability to protect their children from harm? On the one hand, according to James’ formulation, it could mean that they are not deemed ‘addicted’ and therefore pose less risk to their children. On the other hand, could they also be afforded less sympathy or understanding when assessments of parenting capacity are underway? Since pleasure is a subugated knowledge when it comes to discourse on drugs, it seems possible that parents’ experiences could be silenced or deemed inauthentic. This has potential consequences for the instigation and resolution of child protection proceedings, given that the performance of honesty is integral to decision-making (Flacks, 2023a). Troubling such distinctions, for example, between addiction/pleasure and desire/need, is therefore an important critical endeavour.

Risk and Gender

As indicated above, characterisations of agency have potentially significant consequences for how risk and harm are conceived in a child protection context. In this section, I pay closer attention to what, precisely, constituted ‘risk’ in participant accounts, and especially how this coheres with gendered accounts of agency and capacity. As might be expected, given that the framing of risks posed to children by PSUs is not a politically neutral exercise, there was variation in what behaviours were considered most problematic and how potential harms might be mitigated. However, there was also some consistency in the enactment of risky substance use as rooted in individual pathology or subjectivity, rather than the drug itself. This raises questions about how parental AOD users might be expected to better safeguard their children.

Social worker Deli thus argued that:

it’s not so much about the substance per se, it’s about the risks and harms associated with that person who is using that substance. Something called drug, set and setting, it’s the drug that’s taken, the mindset and psychology that person’s bringing and, also, the setting where they’re using…look at the parent, Mum or Dad’s presentation, how they actually physically looked, signs of withdrawal, signs of intoxication, self-care, hygiene, cognitive ability, etc.

Here, although Deli indicated that context and environment were important (‘setting’, the ‘drug that’s taken’), the risks posed by the individual and their suspect body, manifested through visual cues and the parent’s ‘mindset’ (P1), were important. The discursive practices of ‘hygiene’ and ‘self-care’ (P3) worked to produce problematic/addict PSUs as potentially unhygienic and lacking the ability or inclination to look after themselves. Deli attributed less significance to the substance (‘not so much’) or the setting, compared with the ‘psychology’ of parents (for example, ‘cognitive ability’) (P5).

In this way, the risks were inherent to, and embodied by, the addicted personality as much as the substance itself. Another reading was offered by the psychiatrist Felicity, who linked the risks posed by parents more directly to the intermittent harms of intoxication as well as addiction. She said

You get psychological harm because the mother or father isn't psychologically available when they're intoxicated. That was the emotional type of harm, then I suppose neglect. If the person is really addicted to whatever substance it is and all that they're interested in is just to get enough money to get hold of that substance and the house is neglected.

Intoxication here is equated with psychological or emotional absence (P1,4), and addiction with neglect of the home and, by implication, the children. The question of whether it is the consumption of a given substance, and related behaviours, or a person’s personality that is at issue is important for decision-making in a child protection context, particularly in considering how the risks posed to children can be mitigated. As discussed further in the final section, below, if AOD testing and abstinence are the primary means by which a court seeks to effect change, this might address some risks but presumably not the complexity of social, individual, and environmental deficits described by Deli.

The question of ‘psychological’ harm or emotional availability was a recurring one, with consequences for the constitution of the relationship between substance use and child harm. Emily, a social worker, said

The question is whether you are available for the child either emotionally or physically because of the substance misuse. And also, obviously, are you able to control your reaction time, for example, if you’re on cocaine, responding to the needs of the child? That is the sort of focus…The children’s welfare should be able to be provided with emotionally attuned parenting, you know, it affects functioning.

According to this account, substance misuse can render a user emotionally or physically unavailable. As with Felicity, the question of emotional attunement or availability was a binary one—parents either were, or were not, emotionally (as well as physically) ‘present’ for their children. Some interviewees similarly argued that ‘problem use’ was characterised by a parent’s decision to choose substances over their children’s welfare. Sarah said

I think it is about the financial side of things, whether the parent or carer is putting their child's needs above their own needs of those substances. The home conditions, so that daily functioning, children going to school, attending appointments. That's the areas when it becomes problematic, when it has an impact onto the daily functioning or health and wellbeing of their children.

This complicates the question of agency since a parent’s choices are constrained by their ‘need’ for AOD, but they retain a degree of autonomy in choosing to prioritise the needs of their children (P4,5). Whether parents are understood to retain agency or not when using substances is important, not only for how they are positioned as subjects, and therefore citizens (P5), but also for subsequent interventions, as discussed in the final section.

Assessments of parenting capacity could depend on specific enactments of gender. Women were produced as inherently vulnerable in some accounts, which in turn meant they could pose greater threats to their children. For James, gender was central to his claim that children were potentially less safe with substance-using mothers (P4,5). He said

A mum who has people coming to her house can be a problem. Or who is leaving her children with people, and there’s a risk of someone seeing that this mum is not managing and thinking of grooming the children. Or using their house as a crack house. Or getting involved with theft…Not so much as the use itself but, who your friends are, basically.

For the barrister Pat, a woman’s drug use is implicated in her vulnerability to domestic violence, which in turn poses risks to children. She said

So, if you’ve got a woman who is constantly taking back a man who’s battering her and there’s always screaming and shouting that’s happening in front of the children, and they also find out during the course of that that you’re drinking or taking speed, they’ll say, “You can’t address one problem without addressing the other.” it’s that whole lifestyle that is making you meet the wrong people, getting rid of your self-esteem, making you so needy that you’ll stay with a man that abuses you…

The use of substances is represented here as intricately bound up with being violently victimised (“you can’t address one without addressing the other”; “making you so needy”), attributing responsibility to the drugs and, to some extent, the mother (p1,5). The use of the word ‘lifestyle’ seems here to refer to a ‘substance-using lifestyle’, evoking agency and choice, as well as moral misgivings. This again points to a tension between attributions of vulnerability and agency in participant accounts.

Mothers also carried more risks simply because of the amount of time they spent with their children, as explained by Julia, a social worker:

Do you know what, I would maybe take gender out of it and think about who is the primary carer, if that makes sense? A case I’ve got in court now, Mum and Dad both have substance misuse issues, but Dad has never been primary carer for the child, so the impact of it is less because he can use at the weekend when he’s not got him. Then that’s mitigating the risk isn’t it? Whereas if Mum cares for the child seven days a week, when is she going to use and it not impact the child, if that makes sense?

Julia thus suggests that primary caregivers—normally mothers—pose greater risks, but that this is a function of unequal caregiving, rather than ‘gender’. In reflecting the circumstances of her practice in this example, she highlights a wider problem of potentially subjecting mothers to greater surveillance due to gender-based inequalities. Concerns about child protection require pragmatic assessments of risk, and consequent interventions, but this can efface broader societal disparities that require structural changes to resolve.

In addition to varying understandings of the potential harm posed to children by PSUs, there were also different approaches to how such risks might be prevented or mitigated. This latter concern is taken up in the final section, which concerns how participants understood the routes towards recovery for parents, whether in terms of resolving their substance use issues or recovering/retaining care of their children.

Recovery and Responsible Parenthood

As discussed above, the question of ‘recovery’ from substance use is a contentious and complex one. In the UK, recovery has often been framed as synonymous with abstinence in policy discourses, and harm reduction as the antithesis of recovery (Wincup, 2016). For most participants, the decision to abstain and the mobilisation of strategies of self-responsibilisation were the most important route towards retaining or regaining the care of their children. Des, a social worker, said

the contract at the beginning would be what I want is abstinence. What I think you need is abstinence, what your children need is abstinence and to think otherwise is just thinking like an addict really. It’s trying to find a way, how can I use, how can I take back control? That’s the thing about it. Abstinence…that’s your key to a different life.

As a dividing practice, the claim that it is possible to ‘think like an addict’ stabilises addiction as a unique form of personhood (P1,4). Addicts, lacking control, think differently from non-addicts, and abstinence is the only viable solution—the ‘key to a different life’, namely, one like ‘ours’ (P3). Thinking otherwise is, it is intimated, deluding oneself. This is emphasised by his use of the word ‘contract,’ locating his work with substance users within the discursive practice of law. This adds conditionality to the treatment process, in part due to child protection concerns, but also because the commitment to abstinence, and to reforming one’s will (‘taking back control’), appears necessary for Des’s own engagement in the process. The ‘addict identity’ invoked by Des potentially frames substance use as the defining feature of a person’s identity—their ‘master identity’ (Dahl, 2015). This risks both limiting the richness and complexities of substance-using experiences and also eliding the social and material dimensions influencing the will for change (Lancaster, Duke, et al., 2015; Neale et al., 2011). It potentially limits parents’ ability to adopt behaviours, besides total abstinence, that could mitigate any risks to children and puts the individual’s control of their will above the importance of social and relational capital—as well as the availability of treatment—for improved outcomes for families.

Similarly, Judge Dewar saw abstinence and a greater acceptance of personal responsibility as the only means by which a parent could retain care of their children. She said “recovery means abstinence. Their willingness to change, I think is a huge, huge part.” Other means of recovery, including reductions in use, or safe consumption away from children or at specific times/locations, were thus excised from formulations of ‘recovery.’

The drug test was for a number of participants an essential technology at the court’s disposal. Indeed, for the psychiatrist James, it was the only means of determining whether an addict parent had taken sufficient steps to retain care of their child(ren). He said

You can’t do anything without those tests. They’re fundamental. All addicts lie, there we are. Or they are in denial…I simply cannot give a meaningful judgement without a hair test. I can’t do it.

As a process of other-formation (P1), deceit and/or denial are enacted here as an intrinsic characteristic of ‘the addict’ (see Flacks, 2023b; Keane, 2002). The test is therefore the means by which an addict’s lies are disproved. The fetishization of the test result is a logical corollary of an abstinence-based understanding of recovery although, once again, it potentially provides a narrow assessment of parental capacity and a limited understanding of how to protect children from possible risks posed by AOD use. It should be added that testing has been subject to some critical scrutiny, including in court, because of concerns about reliability and accuracy. ³

There were however alternative accounts of recovery that did not pivot on either abstinence or the drugs test in such straightforward terms. For a social worker in West London, recovery was measured by improvements in the welfare of children rather than an assessment of a parent’s substance use. She said

We might want abstinence. But there is a question as to whether that is realistic. The most important thing is to see an improvement in the child’s living conditions, and that might mean reducing use or using in safer environments. People can get fixated on the results of a drug test.

This variation in accounts points to the political (and politicised) nature of recovery discourses, but also to possible disparities in experiences across courts and locations. It also points to the differences, tensions, and inconsistences in attempts to stabilise objects such as ‘addiction’ and ‘recovery.’ Although addiction could be framed in terms of passive victimhood, participants acknowledged the agency of parents in recovering or retaining care of their children by making active decisions to abstain. Abstinence and recovery were framed in some accounts in binary terms—one either recovers, through abstaining, or does not, removing other means of risk-reduction from conceptions of ‘recovery.’ As some participants acceded, there is a tension in representations of parents who are not responsible for their traumatic experiences, and consequent addiction, yet who must subsequently be responsible for ‘turning their life around’ within a short space of time, and with limited support due to weak social service provision following more than a decade of cuts to the public sector. Drug testing did a lot of work in both indicating a failure of parenting—not just to abstain but to demonstrate a commitment to their children—and providing evidence of the ‘fact’ of an addict’s deceit (both their self-deception and dishonesty towards others). This should prompt reflection on what the focus on AOD use, and the test, might occlude in terms of other vulnerabilities, disadvantages and challenges experienced by parents who are subject to child protection proceedings. The privileging of the test was also in tension with some participants’ own approaches to assessing parenting and child wellbeing. They spoke, for example, about the importance of the overall environment (Deli), emotional availability (Felicity), responding to a child’s needs (Emily), and attending to a routine (Sarah). Given that the drug test has a limited role in providing information about these practices, its potential centrality to social work practice and court proceedings should be questioned.

Conclusion

The PIA method allowed for some important insights to emerge from the data, with consequences for the relationship between enactments of parental AOD use, risk assessments, and care proceedings. I suggested first that trauma operated as a ‘dividing practice’ to explain parents’ AOD use. The discursive practice of disability was in some cases used to explain how trauma led to a disordered mode of subjectivity in which a person’s agency had been compromised. Whereas such practices are potentially transformative, by disrupting moralistic interpretations of substance use rooted in personal (and parental) failure, there are other possible consequences. I suggested, for example, that in the child protection context, a parent’s engagement with—or denial of—discourses of trauma and/or disability, or perhaps an acknowledgement of the pleasurable nature of AOD use, could affect the ways in which family court actors make assessments about the potential risks posed to children. It is thus important to critically engage with, and trouble, understandings of AOD use among professionals, particularly where they tend towards binary assessments of, for example, trauma, pleasure, and agency.

I also considered how risk was characterised in participant accounts, including its relationship with agency and gender. In line with other work on the subject of gender and AOD use, I found that female caregivers could be identified as posing exceptional risks to children. Although this was acknowledged by some professionals, the politics of gender could be de-emphasised or de-positioned as participants sought to explain this focus on mothers as almost a natural and perhaps unavoidable consequence of unequal caregiving practices. While this may be the understandable consequence of a concern for prioritising the protection of children, if left critically unchallenged it risks reproducing the historically-embedded and disproportionate scrutiny of mothering practices, notably among those who are poorer and disadvantaged (Gillies, 2005). Women’s perceived vulnerability, as much as the amount of time they spend with their children, was also perceived to pose risks and thus appeared to invite greater surveillance.

Finally, I considered how ‘recovery’ was stabilised in the data. It is well established in critical drugs scholarship that the dynamics of everyday life are “not always readily amenable to the individualised management of risk or ‘responsible’ behaviour,” particularly for people experiencing intersectional forms of disadvantage such as poverty, stigmatisation, and inequality (Fomiatti et al., 2017, p. 181). Nevertheless, treatment and recovery policy remain largely focused on responsibilising individuals to overcome addiction through the power of their own will. The representation of parental substance use in ways that either limit agency or require abstinence may foreclose the possibilities for both using substances and practising ‘safe’ or ‘good enough’ parenting (valentine et al., 2018). Given the importance placed on keeping families together where possible, any prioritising of abstinence in law, policy, and practice, particularly when evidenced through the use of a drug test, must be subject to ongoing critical attention.