Treatment of Substance Abuse During Pregnancy

Barry M Lester; Jean E Twomey


Women's Health. 2008;4(1):67-77. 

In This Article


We no longer have to ask if treatment works for women who use drugs during pregnancy. As shown in this review, there is evidence-based research that documents the effectiveness of a number of approaches, some that have a history of success (prenatal care, length of treatment, comprehensive and home-based approaches) and others that are more recent (motivational interviewing, contingency management, FTDC, mother-infant interaction and pharmacotherapy). The recognition of the importance of relationships, with increased focus on mother-child relationships and the need to include partners, not only to address problems such as domestic violence but also as an important component of family life, reflects a more nuanced understanding of the complexity of this problem. However, this enthusiasm is somewhat diminished by the methodological limitations of the current literature. Large, randomized trials in multiple settings with long-term follow-up are critical. Even so, with the scientific basis we have for addiction as a brain disease and the efficacy of treatment programs, it is ironic that policy has still not caught up with all that we have learned.


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