Treatment of Substance Abuse During Pregnancy

Barry M Lester; Jean E Twomey

Women's Health. 2008;4(1):67-77.

Future Perspective

Continued advances in drug-abuse research show that drug addiction is a chronic brain disease that can be treated. The stigma of drug abuse during pregnancy is reduced. Programs are expanded to treat the whole family, including infants, older children and partners. Treatment goals should include child developmental and psychological needs. Large, randomized trials in multiple settings that include long-term follow-up are conducted to support traditional programs as well as new approaches. Pharmacotherapy approaches are developed in conjunction with behavioral treatments. Reimbursement for substance use and mental health services are bundled to make treatment more affordable and accessible, including carve outs for special populations. New approaches that await empirical validation include better use of the media and other technology and more attention to relationships, including the mother-infant relationships and the role of partners, and a broader understanding of the other forces that affect these women's lives, such as domestic violence.

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Reprint Address

Barry M Lester, Warren Alpert Medical School of Brown University, Brown Center for the Study of Children at Risk, Women and Infants Hospital, 101 Dudley Street, Providence, RI 02905. E-mail: Barry_Lester@brown.edu .

Cite this: Treatment of Substance Abuse During Pregnancy - Medscape - Jan 01, 2008.

Model Programs and Key Indicators for Success
Name	Type of program	Key components related to outcome	Ref.
Camp and Finkelstein (1995) Nurturing Program for Families in Substance Abuse Treatment and Recovery	Residential	Parenting component After-care services Measured self-esteem Evaluated birth outcomes	72
Szuster et al. (1996) Salvation Army Treatment Program	Residential	Children included Family groups Parenting component Parent-child interaction therapy Therapeutic nursery Psychiatric day treatment for children	73
Stevens et al. (1989) Amity, Inc.	Residential	Children included Increased female:male client ratio Supportive environment for females	74
Hughes et al. (1995)	Residential	Children included Parenting component Parent-child interaction therapy Therapeutic nursery	75
Haller et al. (1993)	Outpatient	Time-limited program	76
Strantz and Welch (1995)	Outpatient	Intensive day treatment Cognitive-behavioral plan Parenting component Parent-child interaction therapy Therapeutic nursery Relapse/lapse considered part of treatment Female staff Lower staff caseload	77
Suffet and Brotman (1984) PAAM	Outpatient	Prenatal care Parenting component Therapeutic nursery Infant developmental assessment	36
Brindis et al. (1997) Options for Recovery	Outpatient and residential	Intensive day treatment Comprehensive case management Foster parent recruitment Biological and foster parenting component Respite care for infants Multimethod approach to evaluation Developmental assessment of infant	78

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Treatment of Substance Abuse During Pregnancy

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