African American Women's Caregiving Experience in the Opioid Epidemic

Background

Non-medical illicit drug use has a negative effect on parenting and results in intergenerational caregiving disproportionately by Black women relatives to vulnerable young children. A synthesis of the research on African Americans caregiving regarding health disparities, child welfare, and grandparent caregiving due to drug involvement showed that the opioid epidemic has a deleterious effect on family members. Despite the paucity of studies on female caregivers’ experiences with opioid, related studies with grandparent caregiving due to crack/cocaine found a host of unidentified, underfunded, and under-resourced social service needs. Sensitized by the Black feminist theory to address power dynamics of identity, persistent social inequalities (Collins, 2000; Jones, 2015) this qualitative study with a phenomenological perspective approach asks: What are the experiences of African American women caring for their young relatives whose parents are opioids-involved?

Methods

African American women who were primary caregivers of young relatives under 18 years due to the parents’ involvement in opioids, were recruited using flyers mailed by a local social service agency. A total of nine women, grandmothers (5), great-aunts (2) and aunts (2) were screened and volunteered to participate in a telephone interview. The majority of the women, ages 28-68, self-reported their income as low. They were caring for young relatives (21) between the ages of 1-18 years (M= 6 years) in private (5), kinship foster care (3), and adoption (1). The majority of the young relatives had sporadic contact with their parents and entered care due to maltreatment (13), fetal alcohol syndrome (3), unmet mental health needs (1), and other traumatic experiences (4). Interviews lasting 60-120 minutes were audiotaped and transcribed verbatim. Emic codes were induced through repeated readings of each transcript by three independent coders. Disagreements were resolved through discussion. Peer debriefing and member checking further enhanced the credibility of our interpretations.

Results

Our preliminary results suggest that besides the plethora of social services needed by them; caregivers and the children in their care experienced grief and fear of an opioid overdose and death of the children’s parents. In addition, a negative stigma due to the complex intersection of having a family member who used opioids and racism plagued both groups. Racism influenced caregivers’ hesitation to discuss opioid use, the condition of the parents and seeking needed social services. Caregivers reportedly perceived the children’s behavior problems and special educational needs as linked to their parents’ drug use. Both caregivers and children seemed to be frozen in time as they anticipated receiving news that the parent’s situation has worsened. Caregivers described resources for coping as religion/spirituality, community members, support groups, therapy, and maintaining family connections.

Conclusions and implications

Our research with African American women caregivers demonstrates that they experience persistent disparities that obstructs adequate services and supports to meet their specific needs due to the stigma of parental opioid-involvement and racism. Despite having resources to cope with stigma and racism, caregivers and their service providers would benefit from an exploration of racism in family caregiving especially regarding stigma, racism and grief for opioid involved families.