"I'm home!" Penny shouted as she opened the door to her house in Palmer.
"How was school?" her mother, Tabitha Mattie, asked.
Mattie doesn't take any of these ordinary domestic scenes for granted. Back when she was addicted to methamphetamine, she said she dreamed of that simplicity.
"I would look at these houses around here, and I would just think, 'I hope someday I can be normal like them,'" she said. "'They were a family or they're together, and they don't have this demon with them all the time of addiction.'"
But it was an uphill climb. Mattie knew she could not quit drugs on her own, but she felt like she had to choose between mothering Penny, who was almost 3, and getting treatment.
"We'd never been apart," Mattie said. "She's very, like, just my shadow."
Mattie had other kids who she knew could stay with family, but she didn't have a safe place for Penny and didn't want to be apart from her.
A cry for help
Experts note only a few treatment programs in Alaska allow mothers to bring their kids. Mattie desperately wanted to stay with Penny during treatment, so she wrote a message to a woman on Facebook who worked for a mom-friendly program, Valley Oaks, in Wasilla.
"The message that I sent to her, it's just like, 'Hey, you don't know me, but I need this more than air,'" Mattie said, her voice cracking. "I got this little girl. Like, I don't want to lose her, but I need help.'"
There are many barriers to getting treatment for addiction in the state, but Moms like Mattie face extra hurdles. Experts recommend that programs accommodate more parents by allowing moms to stay with their kids or providing childcare, but in the seven years since Mattie went to rehab, not much has changed in Alaska.
A big part of the equation is shame and stigma, according to addiction medicine specialist Dr. Sarah Spencer, who works on the Kenai Peninsula.
"Having a substance use disorder is already the most stigmatized medical condition when you look at studies, and among that, the population that is the most stigmatized among all the subpopulations are pregnant and parenting people," Spencer said.
She says that stigma and shame can mean women don't reach out even when they know they need help.
Access during pregnancy
Pregnancy can motivate women to stop using, Spencer said, and pregnant women have the highest priority for treatment beds in Alaska. But she said some medical providers feel uncomfortable treating pregnant women, even though the treatment often doesn't differ.
"Pregnant women are scary, right?" Spencer said. "We don't want to mess anything up so we think, 'Oh, it's better not to do anything at all.' But that can mean that people have no access to care."
Some pregnant women mistakenly think it's safer for them to quit on their own, Spencer said, but it's much safer to get treatment.
"I've experienced mothers who have lost their lives because they couldn't access treatment, and also bad fetal outcomes or bad outcomes for babies because moms weren't able to access the care that was needed," she said.
Another huge barrier
Anna Stafford Min'garalria, clinical supervisor at Dena A Coy, Southcentral Foundation's program serving pregnant women and moms who can bring their children aged 3 and under, said there's another massive barrier facing mothers.
"They also are afraid that their custody of the kids are going to be taken, if they should identify themselves as having (a) substance use problem," Stafford said.
In Alaska, almost two thirds of removal cases with the Office of Children’s Services involved parental alcohol or drug abuse from 2020 to 2025, much higher than the national average of 38%. If a mother is seeking treatment, providers don't necessarily have to report her to the Office of Children's Services, but some do. Spencer said patients typically find supportive programs by word of mouth, through harm reduction programs or by reaching out anonymously on social media.
Trauma and addiction
The program at Dena A Coy, Stafford says, includes parenting education, therapy, and trauma work. She says sometimes women identify how they've used substances to cope with trauma.
"It's a hard program to go through, but it's also a very gratifying experience for a lot of our women," she said. "They leave here awakened, awakened with newfound knowledge about themselves and their families."
Typically mothers in the Dena A Coy program have to spend some time first without kids no matter what, to detox and get stable, but Stafford said watching moms reunite with their kids is heartwarming.
"When you see the vacant look in a child's eye because they haven't been with their mother, it's one of the saddest things I could see," Stafford said. "And then in the next few weeks, they come to life. It's amazing. I have seen that."
Reunifying
Tabitha Mattie said she was separated from her daughter Penny for about two months. Penny stayed with a foster family until Mattie was ready for Penny to join her.
"Having her, I could finally breathe and listen," she said.
Penny was only three years old. She may not remember much from that time, but she knows that her mom did drugs and got treatment.
"For doing them she got a punishment, which was getting me taken away," Penny said. "And then she got me back because she got better, and that was a reward."
Mattie reminded Penny she'd never do drugs again.
