Sustained abstinence after a methamphetamine-specific treatment program for pregnant and parenting women

The treatment of methamphetamine use disorder (MUD) poses a significant challenge due to high rates of treatment discontinuation, substance use recurrence, and socioeconomic adversity. 'Mummy, think of me' (MAMADAM, an acronym from the German "Mama, denk an mich"), a treatment program specifically designed for pregnant women and young mothers with substance use disorders, has shown positive results regarding treatment efficacy and retention of child custody. This study aimed to evaluate the long-term sustainability of the MAMADAM intervention, which has not yet been examined. For this retrospective follow-up study, former patients with MUD who were pregnant and/or parenting women at the time of MAMADAM treatment were contacted by telephone. We analyzed whether self-reported abstinence after discharge from MAMADAM was associated with patient characteristics at admission to MAMADAM. Of the 114 eligible women, 39 participated in the follow-up interview, on average, 4.5 years after completing MAMADAM. Of these, 16 (41%) reported sustained abstinence from all addictive substances, excluding tobacco. At 12 and 18 months after discharge from MAMADAM, 9/39 (23%) and 11/39 (28%) women, respectively, reported at least one instance of substance use, including alcohol but excluding tobacco. Women who reported recurrences of substance use were significantly more likely to have more underage children, live apart from at least one minor, and consume methamphetamine for longer before MAMADAM than women with sustained abstinence. Cox regression, controlling for the duration of MAMADAM treatment, indicated that a longer history of methamphetamine use at admission to MAMADAM was associated with a shorter period of abstinence from all addictive substances (excluding tobacco) following discharge. The MAMADAM program is effective and sustainable in supporting long-term abstinence among pregnant and parenting women with MUD, indicating that pregnancy and parenthood can serve as turning points for promoting the necessary behavioral changes for recovery from addiction. Some women remain at elevated risk of relapse due to the vulnerabilities identified in this study. Future research should investigate whether stronger collaborations with government and community agencies can help these women maintain long-term abstinence.