HELPING CRACK-USING MOMS TALK TO KIDS

DURHAM -- Like parents in television commercials demanding to know
where their teens are and who they're with, as many as 150 black
crack-using mothers in Durham are learning how to open and maintain
potentially lifesaving conversations with their preadolescent
children. The three-year, federally funded program, developed by
scientists at RTI International, is designed to measure its potential
for keeping the children from using drugs and lowering their risk for
developing HIV infection. If proven effective, it may become a
national model for helping struggling families. "We're trying to build
their relationships," said K.K. Lam, RTI's principal investigator for
the study, which is being paid for by the National Institute on Drug
Abuse. "Substance abuse and HIV infection rates within this population
of mothers and youths in North Carolina is a significant concern." As
drug users, most of the women involved in the program have several
health issues that detract from their parenting -- and from the rest
of their lives, Lam said.

"A lot of people want to just write these women off and say we can't
do anything with them until they kick their drug habit," she said.
"Maybe that's the case in a few extreme circumstances, but many of
these women are doing somewhat OK, and still have a lot of skills to
offer." Mothers may be eligible for the program if they're living with
their children and if they've used crack cocaine on about 13 of the
past 180 days -- approximately once a week.

"People in the community say that's about the point at which the drugs
are affecting their lives," Lam said "They're said to be 'in a fog,'
enough that their drug use would be affecting their parenting at some
level." So far, according to Lam, 62 women have been enrolled in the
program. And they're already saying it's helpful, according to the
researcher. She said the children often served as the motivators for
their mothers to attend the six weekly two-hour sessions and to
complete the homework assignments. The latter generally include
discussions between the mothers and their children about such
sensitive topics as sex and drug use. Though addiction increasingly is
understood as a chronic illness, with physiological components as real
as hypertension or diabetes, as many as 87 percent of adult drug users
who need treatment are not getting it. Researchers estimate that
between 6 million and 12 million children are living with a parent
with a substance abuse problem. Research suggests that more than half
of children living with substance-abusing mothers have been suspended
from school and three-fourths of that population have witnessed a drug
deal. The family intervention program, held at the First United
Antioch Baptist Church at 1415 Holloway St., recruits participants
mainly through a unique "street outreach" system, Lam said.

"We have workers who are trusted in the community, often some of whom
are in recovery themselves," she said.

Recruiters are paid a few dollars for each eligible participant they
bring into the program. Other women are recruited through
word-of-mouth peer advocate programs.

Women responding to the invitation undergo an intake interview, then
are randomized into an intervention group or a control, so Lam and her
colleagues will be able to measure any differences made by the
interventions.

All participants ultimately are offered referrals to community
providers that can help them with their addiction illnesses and other
problems, Lam said. "We stay in contact with them if they need help,"
she said. During the first hour of the intervention session, the
children and their mothers meet with counselors separately. In the
second hour they have a family session and light meal together,
practicing some of the skills they've learned.

The sessions include locally relevant examples, stories, language and
graphics, as well as HIV education and goal setting. At the end of the
program, participants return for a one-month follow-up interview and a
graduation observance, Lam said.

"Our goal with the family intervention sessions is to empower these
mothers and remind them that they still can have a lot of positive
influence over their kids, despite their own drug use," Lam said.