An In-Depth Analysis of Structural Barriers to Recovery and Rehabilitation for Drug Use Among Black Mothers

Drug use (DU) during pregnancy and postpartum is a pressing public health issue among black mothers. A CDC report found that non-Hispanic (NH) blacks had the highest prevalence of prescription opioid use (OU) during pregnancy compared to other racial and ethnic groups. There is mounting evidence of the adverse effects of undiagnosed DU. While DU is treatable, the lack of access to treatment and other social determinants of health (SDH) creates a reinforcing loop that hinders black mothers from seeking care, fearing the removal of their children and criminalization. The need for theory-driven research to understand the complexities of DU among black mothers cannot be overstated. In this review, we use Bronfenbrenner's socioecological systems theory as a framework (SEM), integrating an intersectionality lens and SDH to show how race-based societal norms breed discriminatory practices and policies, making it extremely challenging for black mothers to recover and rehabilitate.