Altering Unjust Policies and Practices to Mitigate the Sociostructural Drivers of Harm for Perinatal People who Use Drugs

Abstract: Pregnancy and early parenting is a period of unique health needs and a time when people are highly motivated to create positive changes in their health and lives. For perinatal people who use drugs, this period also comes with heightened regulation of bodies and rights in ways that produce, rather than mitigate, harms like overdose. This is thus a missed opportunity to support families and advance health and rights. Here, I present mixed methods data on perinatal substance use and how policies and clinical practices, including provider stigma, play a role in producing harm, but could be altered to better serve this population.

Brooke S. West is an Assistant Professor at the Columbia School of Social Work and Faculty Affiliate of the Social Intervention Group (SIG). As a medical sociologist, Dr. West’s research focuses on the social, economic, physical and policy factors underlying inequities in health among marginalized and criminalized populations, both globally and domestically. Drawing on both social science and public health approaches, her work centers primarily on the social and structural determinants of substance use and HIV/STI, with newer work examining violence exposure and reproductive health. Dr. West is the principal investigator on a NIDA-funded study that examines the intersection of venue-based risk and networks for substance-using women in Tijuana, Mexico, with the goal of capturing the dynamic and overlapping nature of risk environments and how connections to and movement between places can confer health risks. The integration of place-based and network methods, both of which have wide applicability for addressing health inequities in diverse settings, will inform the development of novel intervention approaches that seek to reshape environments and create safer spaces. Dr. West also works on projects related to overdose among women and the health of women more broadly, including the evaluation and development of sexual and reproductive health programs in Kenya, South Africa, Zambia, and the United States.         Before joining the School of Social Work, Dr. West was an Assistant Professor in the Division of Infectious Diseases and Global Public Health at the University of California San Diego (UCSD) with a dual appointment in the Department of Sociology. Prior to her appointment as an Assistant Professor at UCSD she was a Postdoctoral Fellow on a T32 focused on substance use and infectious diseases. Dr. West received her Ph.D. in Sociomedical Sciences from Columbia University’s Mailman School of Public Health and her M.A. in Sociology from Cornell University.