Recovery Housing for Pregnant Women

描述：(申请人提供) 怀孕期间滥用包括海洛因和可卡因在内的非法药物被认为是一个重大的公共卫生问题。尽管已经制定了专门的多学科治疗计划，以解决“护理障碍”和预防产前药物滥用的不良后果，但先前的研究表明，许多药物依赖孕妇过早离开治疗并再次使用药物，增加了不良临床结果的风险。因此，确定减少或消除怀孕药物依赖妇女在治疗中使用非法药物的有效方法势在必行。本项目提议对毒品依赖妇女这一特殊人群加以改进和推广，这一治疗方法成功地用于治疗来自巴尔的摩类似市中心集水区的戒毒海洛因依赖男子和妇女。所有妇女都将在专门的怀孕药物依赖妇女中心接受标准护理，该中心名为成瘾和怀孕中心(CAP)。采用2组随机设计(每组N=)，我们将使用改良的社区强化方法加代金券模式来测试标准与强化CAP治疗的疗效。在这一模式中，强化治疗包括戒酒康复室生活和基于社区强化方法的积极的、以目标为导向的个人治疗。女性将参加为期6个月的研究。治疗保留、非法药物使用和其他心理社会结果将在1、3、6和12个月的随访中进行检查。出生结果也将在不同的群体中进行比较。据推测，加强护理干预将导致更好的治疗保留和依从性，更少的药物使用和改善分娩结果，而且干预将具有成本效益。该项目将对了解社区强化办法和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结果的影响作出重大贡献。

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.