Literature and clinical practice have extensively dealt with the topic of addictions. However, there are still few studies that have systematically investigated parenting and the use or abuse of narcotics. Most focused mainly on the consequences and safety of the children involved. Aware of the need for a rigorous knowledge of the challenges, expectations and difficulties faced by the user in responding adequately to the parental role, the aim of this work is to retrace and integrate, with a critical approach, the main theoretical contributions of the last decade with a specific focus on the maternal role. We therefore argued the need for systemic care of the user starting from pregnancy, which arises as a highly stressful event that puts a strain on a woman’s therapeutic path. The most recent contributions will then be explored in order to understand and explain the variability of parental responses in addictive behavior according to the neurobiological approach to the mother-infant relationship. Finally, we will mention the environmental and social correlates related to the use of substances and how these can selectively affect particular parenting skills, such as the ability to provide consistent and constant caregiving over time. The path traced up to now pushes us to the awareness of the need for a deep knowledge of the complexity of the phenomenon and a careful analysis of the needs prior to the conception of a therapeutic path. The main predictor of treatment failure in this target user is, in fact, the lack of specific intervention programs, which consider individual differences.
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