Abstract
In a grounded theory study with 19 perinatal women in treatment for cocaine crack use, their main problem was found to be staying clean, a goal achieved by some through a process the authors called creating a new life. Treatment facilities used an addiction-as-illness model and emphasized the importance of the women achieving an addict identity. The pregnant women, going through the developmental process of achieving a maternal identity, found the treatment center philosophy conflictual to their psychological and biological needs. The women's ability for staying clean or temperant included 4 dimensions, holding on to the lifeline, messin' up, goin' it alone, and dancin' with the devil. Resolution of this conflict, as well as a growing confidence in their ability to recover from cocaine addiction and to commit to a "normal" life as mothers were central to the new life created as the women. Implications of the theory for practice are suggested.
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