Linking substance-abusing pregnant women to drug treatment services: a pilot program

To conduct a pilot study to assist pregnant substance abusers to enter drug treatment.

A nonexperimental design provided eligible women with outreach/home visits from a team led by a public health nurse.

All services for the women were provided in homes in the northeastern United States.

Ten pregnant substance-abusing women who were not in drug treatment upon entry into prenatal care enrolled in the project.

Home visits by a public health nurse were provided to the women to jointly develop a plan of care targeted to each woman's needs. A substance abuse counselor was available as a consultant and for home visits. An interdisciplinary team met monthly to coordinate services, discuss therapeutic approaches and treatment strategies, and address needed changes in the health services system.

Rates of entry into substance abuse treatment, retention of custody of the index child, and scores on the Addiction Severity Index (ASI).

Although the expected rate of entry into treatment was 10%, 90% of the women (n = 9) entered treatment. All had full-term newborns. Eighty percent (n = 8) retained custody of the index child. Upon the participants' enrollment, ASI scores indicated a moderate to extreme problem with alcohol and drug use for all women, and moderate to extreme psychiatric problems for 89% of the women. Subsequent ASI scores demonstrated marked improvement in all three subscales.

This project provides strategies that nurses can use to assist substance-abusing pregnant women to enter drug treatment.