Deja Gilbert, Ph.D., MPA, MS, is Chief Executive Officer of Gaudenzia, Inc., a leading nonprofit provider of substance use disorder treatment services across the Mid-Atlantic region.
For most expectant mothers, pregnancy marks a time of anticipation, care, and new beginnings. But for others—particularly those struggling with alcohol use disorder (AUD)—this chapter can be shadowed by stigma, fear, and uncertainty.
This Alcohol Awareness Month, I write not only as Chief Executive Officer of Gaudenzia, one of the Mid-Atlantic’s largest treatment providers, but as an advocate for compassionate, accessible care—especially for mothers facing the unimaginable intersection of addiction and parenthood.
One of the most widely used drugs in the world, alcohol affects the brain in complex and damaging ways, and its long-term misuse can lead to serious physical and emotional consequences. Alcohol is neurotoxic with direct effects on nerve cells.
Unfortunately, we all know someone who’s been affected by alcohol abuse. The results can have damaging emotional and physical effects on any of us. Chronic alcohol use can result in brain damage, depression, liver damage, cancer, high blood pressure, and physical and psychological dependence.
Moderate drinking, too, has been called into question in recent years.
“Some past studies had suggested that moderate drinking might be good for your health,” the CDC website now acknowledges. “But scientists highly debate these findings. More studies now show that there aren’t health benefits of moderate drinking compared to not drinking.”
In many parts of the Mid-Atlantic region, alcohol is known as the “primary drug of choice.” Individuals with severe alcohol dependence may require monitoring during withdrawal due to the heightened risk of seizures and hallucinations.
Here is a snapshot of alcohol’s grave impact today: 487 individuals die from excessive alcohol use per day in the US, on average. Each year, an estimated 4,000 people under 21 in the US die from an alcohol-related death.
While more widely known for treating opioid use disorder, medication-assisted treatment can also have important benefits for clinical outcomes related to alcohol use disorder, especially among adults with serious mental illness.
Gaudenzia provides specialized programming to meet the needs of pregnant and parenting women, individuals with co-occurring diagnoses, and individuals involved in the criminal justice system.
A population group of particular interest to Gaudenzia is expectant mothers. In today’s complex world, more serious considerations face pregnant women than planning a baby shower—especially for those living in poverty.
For many expectant mothers, this otherwise hopeful time can collide with substance and alcohol use disorders that present serious risks to their baby’s health. A 2018 study from the Journal of the American Medical Association estimated between one and five percent of US children in first grade suffer from fetal alcohol spectrum disorder (FASD). Individuals with FASD experience cognitive and behavioral impairments throughout their life.
Unfortunately, medical advice hasn’t always steered expectant mothers in the right direction. In 2023, CDC researchers found that only 16 percent of pregnant women who self-reported drinking within the past 30 days were advised to quit or reduce their use.
These findings highlight missed opportunities to integrate alcohol screening and deploy strategies to address known barriers—such as low reimbursement for alcohol screening or lack of consistent protocols in prenatal care.
In light of this, Gaudenzia has sought to innovate its care to reach pregnant and parenting women through specialized facilities. Gaudenzia now offers nine residential and specialized programs for women and women with children—which allow women to bring children with them into treatment, without fear of losing custody.
There is hope, however, for those struggling with alcohol abuse. Our recovery facilities at Gaudenzia, for example, served nearly 16,000 admissions across 120 programs in 50 facilities in our 2024 fiscal year, with alcohol use disorder the primary disorder for 31% of our clients.
“With alcohol, my life was unmanageable, unhealthy, and dangerous,” wrote a client in recovery at Gaudenzia’s Claymont Center for Women and Women with Children in Delaware. “My advice to someone struggling with alcohol abuse is to admit you are struggling. You are not alone, and recovery is an everyday, ongoing, long journey.”
Every woman deserves the chance to heal without fear of losing her child or being turned away from care. Every baby deserves the healthiest possible start.
This Alcohol Awareness Month, may we expand not only our awareness, but also our empathy—and work toward a future where recovery is always within reach. At Gaudenzia, we remain committed to ensuring no mother has to face that journey alone.