Substance abuse treatment for pregnant women: a window of opportunity?

The use of substance abuse treatment services by pregnant and nonpregnant women was compared to explore the effects of pregnancy on treatment utilization and outcomes. Treatment service records for 227 pregnant drug- and alcohol-dependent women and a matched comparison group of 277 nonpregnant women were retrieved from the Massachusetts Bureau of Substance Abuse Services Management Information System. Treatment services received by the two groups of women during a 6-month period following an index detoxification were tabulated and compared. Treatment services for pregnant women differed quantitatively and qualitatively from the services received by nonpregnant women over the 6-month time period. After controlling for background characteristics and substance abuse history, pregnant women were 1.7 times more likely to be readmitted to detoxification, 2.8 times more likely to enter residential facilities, and 5.4 times more likely to enter methadone programs. For both groups, the use of outpatient and/or residential treatment services following discharge from detoxification significantly reduced the risk of subsequent detoxification admissions. The increased likelihood of admission to detoxification, residential, and methadone services suggests that treatment programs have improved access to care for pregnant women. Multiple detoxification admissions suggest, however, that some pregnant women have difficulty entering stable recovery. Given the brevity of the gestational period and the detrimental effects of drug and alcohol use on fetal outcomes, the use of continuing treatment services for pregnant women is strongly recommended.