Recovery Housing for Pregnant Women

描述：（申请人提供） 怀孕期间滥用非法药物，包括海洛因和可卡因，被认为是一个重大的公共卫生问题。虽然已经制定了专门的多学科治疗方案，以解决“护理障碍”和预防产前药物滥用的不良后果，但以前的研究表明，许多药物依赖孕妇过早离开治疗，重新吸毒，增加了临床结果不佳的风险。因此，必须确定减少或消除接受治疗的药物依赖孕妇使用非法药物的有效方法。本项目建议修改并扩大到药物依赖妇女的特殊人群，成功地用于治疗来自类似的内城巴尔的摩集水区的海洛因依赖脱毒男子和妇女的治疗。所有妇女都将在一个专门为怀孕药物依赖妇女设立的中心，即成瘾和怀孕中心（CAP）接受标准护理。使用2组随机设计（每组N = 64），我们将使用改良的社区强化方法加双盲模型测试标准与增强CAP治疗的疗效。在这种模式中，强化治疗包括禁欲-应急恢复房子生活结合积极的，以目标为导向的个人治疗的基础上，社区强化方法。女性将入组研究6个月。将在1、3、6和12个月随访时检查治疗保留、非法药物使用和其他心理社会结局。还将对各组的出生结果进行比较。据推测，加强护理干预措施将导致更好的治疗保留和依从性，减少药物使用和改善出生结果，干预措施将具有成本效益。该项目将大大有助于理解社区强化方法加上以住宅无毒品住房形式提供的代金券及其对孕产妇和儿童成果的影响。

DESCRIPTION: (provided by applicant) Misuse of illicit drugs including heroin and cocaine during pregnancy, is considered a significant public health problem. Although specialized multidisciplinary treatment programs have been developed to address the "barriers to care" and prevent the adverse consequences of prenatal drug abuse, previous research has shown that many drug dependent pregnant women leave treatment prematurely and relapse to drug use increasing the risks for poor clinical outcomes. Thus, identifying effective methods for reducing or eliminating illicit drug use in pregnant drug dependent women in treatment is imperative. The present project proposes to modify and extend to the special population of drug dependent women, a treatment used successfully to treat detoxified heroin dependent men and women drawn from similar inner city Baltimore catchment area. All women will receive standard care in a specialized center for pregnant drug dependent women, the Center for Addiction and Pregnancy (CAP). Using a 2 group randomized design (N = 64 per group), we will test the efficacy of standard versus enhanced CAP treatment using a modified Community Reinforcement Approach plus Vouchers model. In this model, enhanced therapy consists of abstinence-contingent recovery house living combined with an active, goal-oriented individual therapy based on the Community Reinforcement Approach. Women will be enrolled in the study for 6 months. Treatment retention, illicit drug use, and other psychosocial outcomes will be examined at 1, 3, 6 and 12-month follow-ups. Birth outcomes will also be compared across groups. It is hypothesized that the enhanced care intervention will result in better treatment retention and compliance, less drug use and improved birth outcomes and that the intervention will be cost-effective. This project will make substantial contributions to the understanding of the Community Reinforcement Approach plus vouchers in the form of residential drug free housing and it's impact on maternal and child outcomes.