Identifying pregnant women at risk for early attrition from substance abuse treatment

Effect of waiting time on substance abuse treatment completion in pregnant women

“…A high school education could be a proxy for socioeconomic level, which, along with employment, may engender greater access to child care, transportation, or a support network. Our results are consistent with previous studies in pregnant women and mixed-gender populations that have identified a high school education, employment, and criminal justice referral as predictors of treatment completion (Brady & Ashley, 2005;Greenfield et al, 2007;Howell et al, 1999;Kissin et al, 2004). Prior research in pregnant women on the role of race in predicting treatment completion was inconclusive (Redko, Rapp, & Carlson, 2006).…”

“…Pregnant women may be at increased risk of attrition from substance abuse treatment despite the clear benefits of treatment (Bell et al, 1997;Arndt et al, 2010;Grella et al, 1999;Kissin et al, 2004;Scott-Lennox et al, 2000). We have identified waiting time for treatment as a predictor of completion, and its effects are dependent upon treatment setting.…”

“…Substance abuse treatment during pregnancy is associated with successful maternal outcomes, such as increased abstinence and improved social functioning (Kissin, Svikis, Moylan, Haug, & Stitzer, 2004), and improved neonatal outcomes, such as a reduced incidence of preterm births and higher birth weight (Howell, Heiser, & Harrington, 1999;Lester et al, 2004). Although pregnancy can be a motivating factor for entering substance abuse treatment, pregnant women face barriers both to treatment initiation and completion (Grella, Polinsky, Hser, & Perry, 1999;Grella, Joshi, & Hser, 2000).…”

“…Pregnant women may be less likely to enter substance abuse treatment due to fear of losing custody of their children, prosecution, alienation from society or lack of child care, insurance, transportation, or economic means (Bell, CramerBenjamin, & Anastas, 1997;Grella et al, 1999;Howell et al, 1999). Similarly, despite the benefits of treatment during pregnancy, pregnant women may be at a higher risk of attrition compared with the general population (Arndt, 2010;Bell et al, 1997;Grella et al, 2000;Kissin et al, 2004). Among pregnant women, certain factors have been associated with an even lower likelihood of treatment completion, including age (Bell et al, 1997;Scott-Lennox et al, 2000) and race (Kissin et al, 2004;Scott-Lennox et al, 2000), as well as high peer deviance, self-referral to treatment, lack of employment, education level, being unmarried, and having had experiences with child protection services (Bell et al, 1997;Howell et al, 1999;Kissin et al, 2004).…”

Mental health problems: Are they or are they not a risk factor for dropout from drug treatment? A systematic review of the evidence

“…Eight studies found that the severity of a client's psychological symptoms was unrelated to retention (Epstein et al 1994;Ryan et al 1995;Saxon et al 1996;Ross et al 1997;Tidey et al 1998;McCaul et al 2001;Sayre et al 2002;Wallace and Weeks 2004). However, there is also a considerable amount of evidence that clients with more severe symptoms were more likely to leave treatment (Carroll et al 1993;Petry and Bickel 1999;Lang and Belenko 2000;Haller et al 2002;Haller and Miles 2004;Kissin et al 2004;Van Stelle and Moberg 2004). Moreover, three further studies reported gender differences: two studies found that symptom severity was related to early drop out in women but not men (Mertens and Weisner 2000;Siqueland et al 2002), but another associated severe symptoms with drop out in men only (Green et al 2002).…”