This study reports the results of a comprehensive care program for pregnant addicts, one that provides medical, counseling, and child development services. Findings include the following. Women who enroll while pregnant generally stay through childbirth, and most deliveries are free of complication. Most newborns are of normal gestational age and birthweight, and these outcomes are directly related to length and amount of prenatal care. Neonatal withdrawal is directly related to prenatal maternal methadone dose. Child development, as measured by the Bayley Scales, is usually in the normal range, although mean scores for cognitive development decrease through age 2. Female babies generally have higher cognitive and motor scores than males, and their cognitive scores decline less sharply than those of the males. Developmental scores are directly related to neonatal maturity, especially birthweight. Prenatal maternal methadone dose tends to be negatively related to developmental scores for boys but not for girls.
Management of 50 experimental newborn infants ill with narcotic withdrawal has been carried out with the aid of an instrument developed for measuring its severity, the Neonatal Narcotic Withdrawal Index (NNWI). With its use, infants exposed to methadone in utero have been successfully cared for with detoxification needed in less than 25% of cases and for durations of less than 2 weeks. The percentage of cases and the length of treatment is much less than is customary for infants who have been prenatally exposed to similar doses of methadone. Validity of the NNWI is shown by the statistically significant difference between the mean scores for experimental and control subjects, a high significant correlation between simultaneously measured scores by separate examiners, statistically significant correlations between subscores and total withdrawal scores for the narcotic-exposed experimental cases, and for this group, a statistically significant correlation between scores of withdrawal and the maternal dose of methadone. The simplicity of the NNWI should help to make it acceptable for use by physicians.
This paper, based on a review of recent social science drug research, summarizes the main findings on female drug use and speculates on its future direction. The findings include the following: women are usually initiated into illicit drug use by men; rates of illicit drug use are lower among females than males (which may reflect the greater personal freedom traditionally granted to males), although the difference narrows among younger persons and among those who subscribe to more liberal values and life styles; women are more likely than men to use psychotherapeutic drugs (which may reflect strains resulting from their unequal status vis-à-vis men); and female opiate addicts, although they tend to hold conventional values, are often involved in such deviant activity as prostitution. To the extent that women gain social equality with men and subscribe to greater personal lifestyle freedom, they may be expected to show a higher rate of illicit drug use, particularly of a recreational kind. On the other hand, the rate of psychotherapeutic drug use may decrease, although if the tensions of the workplace eventually substitute for the tensions of status inequality, the resultant changes in rates and patterns of substance use are problematic.
This study examines the relationship between employment and social disability. It is based on admission data for 296 opiate addicts who enrolled in New York Medical College's Multitrack Abstinence Program during 1974. Social disability is defined here as an attribute of the patient which may count against him or her in the job market. Employment rates are examined in the light of an index comprised of three specific disabilities: minority group status, lack of a high school degree, and presence of an arrest record. It is found that the proportion of addicts employed upon admission to the program varies inversely with the number of disabilities. Furthermore, it is found that the proportion of addicts who rely on illegal acts for their main source of income varies directly with the number of disabilities.
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