Women In Substance Abuse Treatment Research Articles

Maternal and paternal warmth impact recovery support and social network composition for substance dependent African American and non-African American women

Background: Poor early relationship experiences during the first 16 years of life may negatively impact adults’ capacity to establish and utilize social support (Suchman et al. 2005). This is especially of concern for women with substance use disorders (SUD) for whom social support is associated with recovery maintenance and treatment retention (Gregoire and Snively 2001). The purpose of this study was to examine the influence of early relationship experiences, specifically paternal and maternal warmth, on recovery related social support and personal network characteristics among African American (AA) and non-AA women in treatment for SUD.Methods: Data were collected from 254 women in substance abuse treatment, 146 AA and 108 non-AA. Ordinal logistic, Poisson or multiple linear regressions were fitted to predict the impact of maternal and paternal warmth during childhood on adult social network composition and recovery support.Results: Greater maternal warmth was associated with greater recovery-specific social support for both AA (β = 0.12) and non-AA (β = 0.15) women. Paternal, but not maternal, warmth significantly predicted the number of social network members who supported recovery for non-AA women (AOR = 1.04), and number of network members who used drugs and alcohol for AA women (IRR = 0.99).Conclusion: Developmental experiences associated with fathers appear to affect different domains of adult functioning than those associated with mothers, and those effects are different for AA versus non-AA women. Attention to these differences may inform culturally relevant substance abuse prevention and treatment efforts.

2094 Validation of a set of “healthcare trust” scales for women seeking substance abuse treatment in community-based settings

OBJECTIVES/SPECIFIC AIMS: To validate previously published psychometric scales capturing interpersonal or healthcare-related trust in a target population of women with a history of substance use disorder seeking substance abuse treatment in a community-based setting. METHODS/STUDY POPULATION: Participants are enrolled at The Next Door, Inc. (TND) and Renewal House (RH), 2 community agencies in metropolitan Nashville that provide substance abuse treatment and post-incarceration re-entry services for women with a history of substance use disorder. We will enroll 300 participants to provide sufficient power for statistical psychometric validation. Inclusion criteria include adult women with self-identified history of substance use disorder seeking substance abuse treatment within seven days of initiation of inpatient residential or intensive outpatient treatment at TND or RH. Participants complete a one-time online survey comprising a demographics questionnaire, Rotter Interpersonal Trust Scale, Wake Forest Trust in Physician Scale, Revised Health Care System Distrust Scale, 5-item RAND Social Desirability Scale, and Adverse Childhood Events Survey. Participants then individually participate in a modified protocol of the “Trust Game.” Predictor variables for multivariate analysis collected include age, race/ethnicity, gender identification, number of days in current treatment, number of prior substance abuse treatment programs, and number of adverse childhood events. RESULTS/ANTICIPATED RESULTS: Each individual scale will be assessed for item analysis, factor analysis, construct validity, content validity, and reliability and compared with general population sample values published in the literature. We will use multivariate analysis to determine the impact of potential predictor variables on specific types of interpersonal or healthcare-related trust. We anticipate having preliminary results to present in April. DISCUSSION/SIGNIFICANCE OF IMPACT: Women who seek substance abuse treatment in the community face unique challenges compared to their male counterparts, including higher rates of prior interpersonal trauma, co-occurring psychiatric diagnoses, and more serious physical health problems. Characteristics such as these highlight the need for regular healthcare engagement in the setting of an increased risk of decreased interpersonal or healthcare-related trust. Prior qualitative research demonstrates that trust building is seen as an essential component of care in ongoing substance abuse treatment for women in this population. Validation of psychometric healthcare-related trust scales in a population of women seeking substance abuse treatment in a community based setting will provide a framework for future quantitative inquiry into the impact of healthcare-related trust on health outcomes, healthcare engagement, and treatment retention for this target population. Similarly, it will also facilitate inquiry into the effectiveness of specific treatment programs or interventions on improving therapeutic trust building.

Perceptions of child protective services among pregnant or recently pregnant, opioid-using women in substance abuse treatment

Pregnant, opioid-using women represent a challenge to healthcare providers attempting to engage them in prenatal and substance abuse services. Limited, primarily international research suggests that child welfare clients have mixed feelings about Child Protective Services (CPS) and that fear of CPS may present a barrier to care. Understanding how pregnant opioid-using women in substance abuse treatment perceive CPS may be useful in encouraging substance abuse treatment initiation. Participants were currently or recently (within past 12 months) pregnant women with current or recent (within past 12 months) abuse/dependence of pharmaceutical opioids at a drug treatment facility. Participants were recruited by treatment staff to participate in a comprehensive study across multiple domains. Data for this analysis were collected using semi-structured qualitative interviews. Transcribed data were thematically analyzed using in vivo and interpretive coding by three coders for purposes of inter-rater reliability. Following 2, two-hour meetings, consensus was reached on primary themes and sub-themes. Two major themes and several sub-themes were identified: 1) Participants’ feelings and attitudes about CPS (positive and negative); 2) Interaction-based perceptions of CPS’ function and performance. Participants’ feelings toward CPS were often conditioned by their experiences with individual caseworkers. While many pregnant, opioid-using women identify legitimate, and even useful features of CPS, fear of CPS can be a barrier to care. Making substance abuse treatment accessible to this population requires recognition of their complex feelings toward CPS, and coordination among CPS case workers and substance abuse treatment providers.

Parenting contributors to early emerging problem behaviour in children of mothers in methadone maintenance treatment

AbstractThis study explored whether variations in parenting provided by mothers with substance‐abuse disorders are related to behaviour problems in their young children and whether specific parenting practices are associated with specific types of behaviour problems. Mother‐reported and observational assessments were used to examine contributions of parenting behaviour and home environment to internalizing and externalizing behaviour problems in 150 preschool children of mothers receiving methadone‐maintenance treatment for heroin addiction. In multivariate analyses, mother‐reported child externalizing behaviour was related to greater maternal harshness and to mother history of illicit drug use during pregnancy but not other features of substance use and treatment history. Observer‐coded child internalizing behaviour was related to less maternal sensitivity and less provision of learning activities in the home. Additionally, mother report of her own psychopathology symptoms was related to mother‐reported, but not observer‐coded, child internalizing and externalizing problems. Findings suggest that women in substance abuse treatment should receive parenting interventions and that interventions should focus on increasing maternal sensitivity, reducing harshness, and providing children with cognitively stimulating environments. Findings also suggest that the need for attention to ongoing mental health problems of women in substance abuse treatment—both for their own well‐being and the well‐being of their children.Highlights This study explored whether variations in parenting provided by mothers with substance‐abuse disorders are related to behavior problems in their young children. Maternal harshness was related to child externalizing behavior, low sensitivity, and low provision of learning opportunities to child internalizing problems. Findings suggest that women in substance abuse treatment should be provided access to parenting interventions.

Formal and Informal Concrete Support and Discharge Disposition among Women in Substance Abuse Treatment in the U.S.

The purpose of this study is to examine the relative contribution and the relationships between formal (treatment related members) • informal (family members) concrete support and discharge disposition. A total of 172 women interviewed upon intake in one of 3 counties funded substance abuse treatment programs in Cleveland, Ohio. Hierarchical logistic regression was performed to assess the impact of formal concrete support and informal concrete support on the likelihood of a discharge disposition of completed treatment. Formal concrete support showed a statistically significant contribution to discharge disposition, while informal concrete support did not. Findings of this study highlight the importance of formal concrete support. Future research should continue to expand our knowledge of how support from formal treatment services interacts with support from informal (family) networks.

Double whammy: Adverse childhood events and pain reflect symptomology and quality of life in women in substance abuse treatment

ABSTRACTBackground. This study examined the profiles of symptoms and health-related quality of life (QOL) of women in substance abuse treatment, comparing those with higher versus lower histories of adverse childhood events (ACE), and those with versus without current pain. Methods. Adult women in outpatient substance abuse treatment (n = 30) completed questionnaires (cross-sectional study) on topics including drug use, adverse childhood events (ACE), QOL, functional ability, current pain, and depression. Results. Women with pain indicated significant differences in emotional (p < 0.05), and functional ability (p < 0.01); but no significant differences were found between women with high versus low levels of ACE. Yet, radar plots of women with both current pain and high levels of ACE, versus those without, portrayed a distinctive profile indicating high levels of anxiety and depression. Conclusions. Rather than a checklist, visual composites of symptoms experienced by women in substance abuse treatment illustrates areas of concern in the overall status of women in substance abuse treatment.

Recovery support mediates the relationship between parental warmth and quality of life among women with substance use disorders.

Historically, recovery from substance use disorders (SUD) has focused exclusively on the use or non-use of the addictive substance(s). More recently, SAMSHA [1] has defined recovery in a more holistic way, using quality of life (QoL) as a measure of recovery for individuals with substance use and mental health disorders. However, little is known about the myriad experiences that inform and affect QoL for individuals with substance use disorders. Using an attachment informed stress-buffering framework, the purpose of this study was to examine the contribution of parental warmth and recovery support to QoL among women in substance abuse treatment. Linear regression and bootstrapping were used to examine direct and mediated effects of parental warmth and recovery support on QoL among 318 women recruited from three inner-city women-only addiction treatment programs. Relationships were assessed across three domains of quality of life: physical, psychological, and social. Parental warmth and recovery support were directly associated with psychological and social QoL, when controlling for the influence of trauma symptoms. Recovery support mediated the relationship between parental warmth and QoL across psychological and social QoL domains. Findings suggest that interventions that focus on attachment-related constructs to enhance recovery support may improve quality of life among women with SUD.

Mother-Child Relational Quality of Women in Substance Abuse Treatment.

Mothers who abuse substances are more likely to have impaired parenting and lose custody of their young children. The pilot study described mother-child relational quality of women in substance abuse treatment. The identification of mothers' perceptions of being parented, current level of depression, discrete and potentially modifiable mothering behaviors, and self-appraisals of their role. The descriptive study implemented audio-video-recorded mother-child interactions for coding. Twenty-nine dyads participated with children age 4 weeks to 5 years. Mothers had lower levels of caring from their parents and moderate depression that was correlated with many of the relational quality behaviors. Eleven of 29 maternal behaviors were coded as concerning. Reflections by mothers revealed modest, yet confident self-appraisals of their maternal role. Women who experienced higher depression demonstrated lower maternal quality. Some maternal behaviors were identified as less optimal although many were strengths.

Abstract B69: Cervical and anal HPV serotype-specific prevalence among high-risk indigent women in substance abuse recovery

Abstract Background: A high priority area identified by the President's Cancer Panel is increasing the uptake of human papillomavirus (HPV) vaccinations. One group at highest risk of HPV-related cancers is a hard to reach, underserved, and marginalized population – indigent women who use sex for drug money. Illicit drug users are characteristically at high risk for acquiring HPV due to risky sexual behaviors and a greater likelihood of exposure to social networks with high prevalence of sexually transmitted infections. International studies suggest these populations may have a different HPV profile. In one of the largest studies of female sex workers, cervical lesions were commonly negative for HPV 16/18, suggesting a role for other high risk HPV (hr-HPV) types or multiple co-infections. Yet there is little known about the HPV profile of street sex workers in the United States. Building on a non-traditional partnership with law enforcement and over 36 community organizations (the Dallas Prostitute Diversion Initiative, Texas), we are providing cancer prevention screening services with HPV co-testing targeting those women diverted to substance abuse treatment centers. We report here on the prevalence of HPV serotypes across cervical and anal sites and across age groups that could inform future HPV vaccination efforts in this vulnerable population. Methods: We partnered with AIDS Arms Clinic to create a point of access for cancer screenings among women in substance abuse treatment at Nexus Recovery, the largest female-only substance abuse recovery center in North Texas. Screenings provided include cervical and anal PAP screens with HPV co-testing (16, 18, or other hr-HPV). Other high risk types included 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, or 68 and were reported in aggregate. Also included were screenings for breast, hepatitis, and HIV/sexually transmitted infections. A follow-up clinic visit was provided 7 days from the initial screen as a second opportunity to educate, explain screen findings, and navigate positives to diagnostic care. This prevention services project is ongoing through August 2016 with the goal to screen 1220 women. Results: A total of 538 women were screened for cervical and anal HPV. The average age was 33 years, 33% were non-white, and over 80% were smokers without health insurance. One-quarter reported 50+ lifetime sex partners. Twenty-nine percent were cervical hr-HPV positive, with 87% classified as other hr-HPV serotype and 13% as HPV 16/18+. Similarly, 32% of women were positive for anal hr-HPV, with the majority being other hr-HPV (88.4%). Unexpected was the bimodal age distribution of HPV prevalence, peaking at 22 years and 48 years. Conclusion: The HPV serotypes observed in this study provide baseline HPV prevalence rates for monitoring future HPV vaccination efforts in this and similar underserved populations. This is significant since one of the fastest growing segments of the criminal population are women offenders serving time on probation for low level offenses related to drug activity and prostitution. HPV vaccination programs in this target population may need to be broadened to include mid-adult women and other serotypes in addition to HPV 16/18. Citation Format: Martha J. Felini, Oluwatosin Igenoza, Saritha Bangara, Kelechi Ukpaka, Opeyemi Jegede, Shuchika Gupta, Gene W. Voskuhl, Timothy Kremer, Ralph Anderson, Raquel Qualls-Hampton. Cervical and anal HPV serotype-specific prevalence among high-risk indigent women in substance abuse recovery. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B69.

Mothers in Substance Abuse Recovery: Perspectives on Motivators, Challenges and Family Involvement.

Background:Most women in substance abuse treatment are of childbearing age, and many of them have children who both are affected by and influence the mother’s substance abuse and treatment behaviors.Objectives:This qualitative study (n = 13) was conducted in two drug treatment centers in southern Florida and explored the perspectives of mothers currently or recently in substance abuse treatment regarding their recovery motivators and challenges, as well as their attitudes and preferences regarding family involvement in their treatment.Patients and Methods:We used a qualitative descriptive approach. In-depth interviews were conducted with the participants and centered on 3 major themes: (a) motivators for recovery, (b) challenges for recovery, and (c) attitudes and preferences for family involvement in recovery.Results:Findings revealed that family plays an important role in the recovery of these mothers, and that mothers are willing to incorporate their families in their recovery process. Women expressed a positive attitude towards family therapy, and they believed that it could benefit their recovery, and their relationship with their children and families.Conclusions:The findings of this study can contribute to the development of a family-based substance abuse treatment aftercare intervention that might benefit women in substance abuse treatment.

Heterosexual Anal Sex Among Men and Women in Substance Abuse Treatment: Secondary Analysis of Two Gender-Specific HIV-Prevention Trials

Receptive anal sex has high human immunodeficiency virus (HIV) transmission risk, and heterosexual substance-abusing individuals report higher anal sex rates compared to their counterparts in the general population. This secondary analysis evaluated the effectiveness of two gender-specific, evidence-based HIV-prevention interventions (Real Men Are Safe, or REMAS, for men; Safer Sex Skill Building, or SSSB, for women) against an HIV education (HIV-Ed) control condition on decreasing unprotected heterosexual anal sex (HAS) among substance abuse treatment-seeking men (n = 171) and women (n = 105). Two variables, engagement in any HAS and engagement in unprotected HAS, were assessed at baseline and three months postintervention. Compared to the control group, women in the gender-specific intervention did not differ on rates of any HAS at follow-up but significantly decreased their rates of unprotected HAS. Men in both the gender-specific and the control interventions reported less HAS and unprotected HAS at three-month follow-up compared to baseline, with no treatment condition effect. The mechanism of action for SSSB compared to REMAS in decreasing unprotected HAS is unclear. More attention to HAS in HIV-prevention interventions for heterosexual men and women in substance abuse treatment is warranted.

Continuing Care and Trauma in Women Offenders’ Substance Use, Psychiatric Status, and Self-Efficacy Outcomes

Using secondary data analysis of 3 separate trauma-informed treatment programs for women offenders, we examine outcomes between those who received both prison and community-based substance abuse treatment (i.e., continuing care; n = 85) and those who received either prison or community aftercare treatment (n = 108). We further account for differences in trauma exposure to examine whether continuing care moderates this effect on substance use, psychiatric severity, and self-efficacy outcomes at follow-up. The main effect models of continuing care showed a significant association with high psychiatric status and did not yield significant associations with substance use or self-efficacy. However, the interaction between trauma history and continuing care showed significant effects on all 3 outcomes. Findings support the importance of a continuing care treatment model for women offenders exposed to multiple forms of traumatic events, and provide evidence of the effectiveness of integrating trauma-informed treatment into women's substance abuse treatment.

Abstract PR05: Cancer screening uptake among women in substance abuse treatment

Abstract Purpose: Women in residential and out-patient substance abuse treatment programs represent a broad range of criminally affected indigent women and vulnerable street sex workers at highest risk of cervical cancer. This population is underrepresented in research, but through a nontraditional partnership with law enforcement this project capitalized on reaching a previously hard to reach population that is at high risk for cervical cancer and more likely to not have participated in recommended cervical screens. Scientific studies describe female jail populations receptive to cervical screenings with approximately 70-90% reporting a Pap screen in the last three years; however, knowledge of screening for cancer was poor. Preliminary findings from focus groups conducted among the target population suggest that self-administered HPV testing would not be well accepted or trusted among this population. Thus, the purpose of this study was to evaluate the uptake rate of cervical cancer screening from female nurse practitioners. Methods: Using findings from preliminary focus groups conducted among the target population, investigators adapted and integrated an evidence-based, culturally appropriate, and trauma sensitive women's health education into the largest female substance abuse center in Dallas, Texas, to prepare women for the opportunity to participate in a cervical exam the following day. Cervical screenings were provided at the AIDS Arms outpatient clinic which specializes in providing medical care to extremely poor and vulnerable populations. Other screenings provided included anal, breast, HIV/ sexually transmitted infections, and Hepatitis B and C. Screening positives are navigated by care coordinators for diagnostic screening. Results: Over a five month period, 214 women in residential substance abuse treatment have completed the education seminar on cancer prevention and screening. One third of those participating were African American, Hispanic, or American Indian. Over 98% of women completing education seminar signed up for the cancer screening opportunity and completed the screening the next day. Approximately 5% of cervical pap smear results received thus far were abnormal (ASCUS or LSIL). Nearly 15% reported last pap smear 5 - 10 years ago. One out of every four tested positive for anal high risk HPV. Conclusion: The uptake rate observed in this population exceeded what was anticipated based on the few studies of jail populations available. Thus, women in substance abuse treatment present an exceptional window of opportunity to engage them in cancer screening programs. We hypothesize that trauma-based education prior to offering a cervical exam is a critical factor in increasing screening uptake among this population. Three year project funded by Cancer Prevention Research Institute of Texas. Screening is ongoing through 2016. This abstract was also presented as Poster B71. Citation Format: Martha J. Felini, Raquel Qualls-Hampton, Saritha Bangara, Darius Taylor, Gene W. Voskuhl. Cancer screening uptake among women in substance abuse treatment. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr PR05.

Depression, Abuse, Relationship Power and Condom Use by Pregnant and Postpartum Women with Substance Abuse History.

Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9%) evidenced current depression. Less social support (-0.17, p<0.05) and relationship power (-0.48, p<0.001), and greater depression (-0.16, p<0.05) predicted more condom-use barriers. History of mental health problems predicted condom-use barriers, mediated by recent depression and relationship power (0.15, p<0.001). These findings suggest depression and diminished relationship power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.

Comorbid Alcohol Disorder Intensifies Patterns of Psychological Symptoms Among Women

This secondary analysis describes the additional psychological symptoms experienced by women in substance abuse treatment who have an alcohol use disorder (AUD) in addition to a drug use disorder (DUD). Results show high levels of certain patterns of psychological symptoms, which include Paranoid Ideation, Phobic Anxiety, Anxiety, and Psychoticism, on the Brief Symptom Inventory (BSI) subscales. Also, age had an adverse effect, with Depression and Psychoticism scores higher with increasing age. Nurse practitioners are ideally situated to assess and screen for patterns of co-occurring psychological symptoms in women with an AUD, which can complicate treatment and lead to practice implications.

Stigma management for women in recovery

Aims: This study examines the lives of women in substance abuse treatment by exploring the stigmas they perceive as they reintegrate into their communities Methods: Semi-structured interviews and observations were conducted over 9 months with 34 women in treatment. Data was collected and analyzed using a grounded theory approach of comparing emergent themes to develop theoretical conceptualizations. NVivowasused for initial, and theoretical codingprocesses in order to analyze women’s stigma and coping mechanisms. Results: Study participants perceived stigmas from family and intimate partners based on views of the permanence of the “addict identity”. Moreover, stigmas were undergirded by norms of proper womanhood violated bywomen’s experiences with addiction, survival sex, mothering and incarceration. Additionally, the Latina and Caucasian sample population reported perceptions of stigma embedded in racialized stereotypes of proper behavior for their ethnic community. Moreover, women also perceived stigma from treatment peers also managing psychological threats. As a result study participants employed strategies to reduce stigma and preserve their burgeoning identities. Conclusions: This study increases knowledge available to social justice researchers and advocates working with women managing stigmas. It gives insights into how stigmas shape processes of support seeking and community reintegration. Research findings can also inform programming for their families who are also managing anger, loss and stigma. This study has implications for both trauma andstigma informed initiatives that respond to theneedsofwomen and families with complex illness-related struggles. Financial support: I do not have any financial support to participate in the CPDD conference.

Trajectories of drug use frequency after substance abuse treatment among a sample of homeless youth

Aims: This study examines the lives of women in substance abuse treatment by exploring the stigmas they perceive as they reintegrate into their communities Methods: Semi-structured interviews and observations were conducted over 9 months with 34 women in treatment. Data was collected and analyzed using a grounded theory approach of comparing emergent themes to develop theoretical conceptualizations. NVivowasused for initial, and theoretical codingprocesses in order to analyze women’s stigma and coping mechanisms. Results: Study participants perceived stigmas from family and intimate partners based on views of the permanence of the “addict identity”. Moreover, stigmas were undergirded by norms of proper womanhood violated bywomen’s experiences with addiction, survival sex, mothering and incarceration. Additionally, the Latina and Caucasian sample population reported perceptions of stigma embedded in racialized stereotypes of proper behavior for their ethnic community. Moreover, women also perceived stigma from treatment peers also managing psychological threats. As a result study participants employed strategies to reduce stigma and preserve their burgeoning identities. Conclusions: This study increases knowledge available to social justice researchers and advocates working with women managing stigmas. It gives insights into how stigmas shape processes of support seeking and community reintegration. Research findings can also inform programming for their families who are also managing anger, loss and stigma. This study has implications for both trauma andstigma informed initiatives that respond to theneedsofwomen and families with complex illness-related struggles. Financial support: I do not have any financial support to participate in the CPDD conference.

Trauma Symptoms for Men and Women in Substance Abuse Treatment: A Latent Transition Analysis

Differences in trauma symptoms among men and women in two court-involved substance abuse treatment programs were examined using latent transition analysis (LTA). It was hypothesized that women would be more likely to report clinical-level trauma symptoms than would men, but that both groups would show reductions in symptoms over time. Symptom classifications were determined by the LTA. Scores on the Trauma Symptom Inventory (TSI) were obtained on 381 program participants, 112 men and 269 women, at intake and after 6months in treatment. Three ordered classes were obtained for men and women at each time point: non-clinical (no TSI scales elevated), moderate symptoms (1 or 2 scales elevated) and severe symptoms (all scales elevated). Men were more likely to be represented in the non-clinical class at intake, while women had higher representation in the severe symptoms classification. There was a reduction of trauma symptoms for most men and women, but some groupings had symptoms that remained the same or became worse over time. Using gender and trauma-symptoms to help determine interventions is discussed.

Effects of walking on cigarette craving, nicotine withdrawal symptoms and affect in smokers with schizophrenia

Aims: Sexual risk behavior is common among substance abusers. To effectively target sexual risk behaviors for intervention in treatment programs, it is important to have a rapid and accurate measure of sexual risk. This study compares two dichotomous ratings of unprotected sex (Y/N) among women in outpatient substance abuse treatment who participated in a NIDA Clinical Trials Network HIV sexual risk reduction intervention: (1) any unprotected sex during vaginal or anal sex occasions in the past 3months versus and (2) unprotected sex at last sexual occasion. Methods: 363 sexually active women with a main or non-main male partner(s) from 12 methadone maintenance or psychosocial outpatient treatment programs were included. Unprotected sex in the last 3 months (dichotomized as yes/no) and unprotected sex at last occasion (yes/no), combined across 3 time points (baseline, 3-month and 6-month follow up), were compared for congruence. Results: Considering sexual occasions with main male partners (n=787occasions), 87.8%of the sample reportedunprotected sex in the past 3 months compared to 93.1% reporting unprotected sex at last occasion. Only 1.3% (n=10)were incongruent (reported unprotected sex at last sexual occasion but consistent protection during the last 3 months). Considering sexual occasions with non-main partners (n=182), 68.1% of the sample reported unprotected sex at last occasion, compared to 61.5% reporting unprotected sex in the past 3 months. 8 results (6.5%) were incongruent. Conclusions: Dichotomous ratings of unprotected sex at last sexual occasion and unprotected sex in the past 3 months similarly categorized the vast majority of women in substance abuse treatment programs. In busy substance abuse treatment programs, a single question about last sexual occasion could efficiently identify the presence of sexual risk behavior, and provide a basis for selected sexual risk reduction intervention. Financial support: This study was supported by National Institute on Drug Abuse (NIDA) Clinical Trials Network grants: U10 DA13035 (Edward Nunes, PI).

Characteristics of perinatal women seeking treatment for marijuana abuse in a community-based clinic

In the US, marijuana continues to be the most frequently used illicit drug among women of childbearing age, including pregnant and postpartum women. Given the critical window for treatment during the perinatal period, more information is needed about the characteristics of women who abuse marijuana and about their unique needs with the goal of improving clinical services and outcomes for both women and their infants. Objectives: To (1) identify a profile of perinatal women seeking treatment for primarily marijuana abuse and (2) report birth outcomes in a subset of pregnant women with marijuana abuse. Methods: This retrospective clinical chart review study examined 67 adult perinatal women patients (54 % ethnic minority) who attended an inner-city, hospital-affiliated outpatient program specializing in substance abuse treatment for women. Of all pregnant women, 26 % reported positive urine screens during the first trimester, 41 % during the second trimester, and 27 % during the third trimester. While the subset of pregnant women was small, exploratory results suggest that infants whose mothers continued to use marijuana during their pregnancies were born at a lower gestational age than mothers who abstained; t(29) = 2.04, p <0.05. Conclusion: Identifying potential barriers to treatment could help improve retention in community-based treatment programs during pregnancy and the postpartum period.