Many times throughout the semester when we have been discussing how to allocate money and other resources for health services, the issue of being less willing to pay for another individual’s health care if that person’s health issues are the result of unhealthy personal behaviors. An often used example is substance abuse, which is why I thought it would be interesting to examine this article in light of some of the things our readings on liberation theology led me to consider. This article is about some of the issues facing the unborn and newborn children of women who are addicted to opiates. Many of us are aware that abusing substances can cause serious harm to an unborn child. However, as was the case with a mother who took OxyContin for the first 12 weeks of her pregnancy, quitting can also be dangerous for the unborn child, as it can cause seizures in utero and can even cause a miscarriage. As a result, doctors choose to keep these women on methadone, a drug that keeps low levels of opiates in the body in order to prevent a withdrawal reaction, which can seriously harm the baby. However, these babies are often then born addicted to the opiate and must be weaned off of the methadone, which is also painful and dangerous.
It would be easy for us to place full blame on the mother for her decision to abuse drugs in the first place, let alone to do so when that decision so heavily impacted another person’s life. However, we cannot forget the social and environmental factors that may have led to initial drug use. Poverty, level of education obtained, and access to jobs are all factors, as are exposure to trauma or abuse, and other situations that have an impact on a person’s mental health and ability to cope. As one woman in the article said about taking pills, ” It was a lot easier to get through life and have energy.” Certainly personal responsibility is at play here, but we cannot solely blame these women and forget the way that certain social structures have attempted to dis-empower them and limit the agency they have over their own lives.
We can of course design and implement interventions that aim to prevent these women from ever beginning to use drugs, not only so that they are healthier, but also so their children will never have to undergo methadone treatments and also be healthier. We can work for structural changes that will leave less people vulnerable to substance abuse. But how can we move beyond technical interventions and an impersonal redistribution of resources to truly “suffering with,” to build relationships and enter into praxis with those that have been disadvantaged by our current system, to bring about a true community? Can we really say we are “suffering with” if we are still unwilling to give up fully on our privilege?