Substance Abuse Treatment by Sylvia Mignon MSW PhD

Author:Sylvia Mignon MSW, PhD
Language: eng
Format: epub
Publisher: Springer Publishing Company, Inc.
Published: 2014-06-14T16:00:00+00:00

Pregnant Women

Little attention was paid to the substance abuse problems of pregnant women until the 1990s, after years of concern in the 1980s about “crack babies.” The stigma attached to drug-addicted pregnant women was severe and resulted in legislation in some states to charge women with child abuse crimes if they tested positive for drugs at delivery. In response, the National Institute of Drug Abuse, the Center for Substance Abuse Treatment, and other federal agencies provided significant funding, resulting in a 250% increase in funding for the treatment of pregnant women in Massachusetts alone (Daley, Shephard, & Bury-Maynard, 2005).

It later became clear that the concern over an epidemic of crack babies was overblown and sensationalized in the media. That does not mean that cocaine use during pregnancy is not without risk—cocaine use during pregnancy is associated with low birth weight (Daley et al., 2005). Babies born to opioid-dependent mothers can experience a type of withdrawal, known as neonatal abstinence syndrome, that includes greater risk of low birth weight, respiratory and feeding problems, and seizures (National Institute on Drug Abuse, 2012b). Women who drink during pregnancy can have children with fetal alcohol spectrum disorders who sustain lifelong cognitive problems, including low IQ.

On average, 5.9% of pregnant American women used illicit drugs in 2012; 8.5% drank alcohol, 2.7% were binge drinkers, and 0.3% were heavy drinkers (SAMHSA, 2013b). Research shows that women who received substance abuse treatment while pregnant are less likely to deliver prematurely and their babies are more likely to have a healthier birth weight (Daley et al., 2000). Although residential treatment is more expensive, it provides continuity for women who are homeless and come from abusive environments; it also provides the necessary stability for pregnant women (Daley et al., 2005). In a study comparing 739 women who delivered their babies while in residential treatment, there were lower rates of morbidity (illness) and mortality (death), even compared with women in the general U.S. population (Burgdorf, Dowell, Chen, Roberts, & Herrell, 2004). For pregnant women who are opioid dependent, methadone and buprenorphine can be safely used (Jones et al., 2008).

There is a long running debate about whether women should be in the same treatment programs as men or in women-only programs known as “gender-specific” treatment programs (Walton et al., 2001). One factor is that male dominance in society can be associated with male dominance in treatment (Greenfield et al., 2007). This can result in staff members and even female clients giving more attention to the needs of male clients.

No clear picture emerges for the best treatment types for women. In a review of the research, gender-specific treatment was not more effective than mixed-gender treatment groups (Green, 2006). Yet a personal history of trauma can make women more comfortable with gender-specific treatment than with mixed-group treatment (Greenfield et al., 2007). In a literature review of women’s treatment options, Greenfield et al. (2007) concluded that for programs that are gender specific, “the effects of these changes on treatment outcomes remain unclear” (p. 13).

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