TREATMENT OF PERINATAL COCAINE ADDICTION - USE OF THE MODIFIED THERAPEUTIC-COMMUNITY

Treatment outcome was evaluated for perinatal cocaine addicts admitted to a hospital-based day treatment clinic, organized as a modified the rapeutic community (TC) modality. The perinatal program consisted of a specialized track for women embedded within this larger coed day trea tment clinic. A total of 87 perinatal women (28 pregnant at intake, th e remaining 59 postpartum) were compared with cohorts of nonperinatal women (N = 63) and men (N = 158) admitted during the period of evaluat ion (September 1989 through December 1993). In logistic regression ana lysis, successful discharge urine status (last three urines prior to d ischarge drug-free) was associated with current child custody involvem ent (odds ratio = 2.80, 95% C.I. = 1.16-6.72), entering treatment when not postpartum (odds ratio = 0.15, 95% C.I. = 0.05-0.42), and taking psychiatric medication (odds ratio = 2.04, 95% C.I. = 1.11-3.72). Both pregnant and postpartum perinatal women showed a similar pattern of s horter treatment as compared with nonperinatal women and male clients, averaging 2 months of treatment as compared with 4 months for nonperi natal clients. Factoring out pregnancy and postpartum status, the wome n in treatment fared as well as men with respect to both retention and discharge urine standings. This finding indicates that programmatic m odifications need to address specific perinatal issues and not gender issues per se. Also, a differential pattern in discharge urine status of women who enter treatment while pregnant vs. those who enter when p ostpartum suggests that outreach and recruitment be targeted, but not limited, to pregnant women.