Intensity of Case Management Services

Abstract

Specialized programs for pregnant, drug dependent women have assisted many in achieving abstinence during pregnancy. Following delivery, however, such women often resume drug use and drop out of treatment, placing their children at even greater risk for subsequent medical and developmental problems. Standard outreach services, while generally effective as a public health measure for high-risk populations of women and children, are often insufficient for chronic and severely drug dependent women. The present study was a randomized clinical trial comparing maternal and infant outcomes for drug dependent women assigned to either routine or intensified case management services for the first 4 months following delivery. Women randomly assigned to intensified case management showed better treatment retention, accessed a greater variety of services, were more likely to be abstinent from cocaine at 4-month follow-up, and felt their children received greater benefit from the services than women assigned to routine case management. The number of case management visits was positively correlated with total time in treatment across both intervention groups. Study findings support the efficacy of intensified case management services for drug dependent women and their children.