Florida is one of several states that have sought to protect newborns by requiring that mothers known to have used alcohol or illicit drugs during pregnancy be reported to health authorities. To estimate the prevalence of substance abuse by pregnant women, we collected urine samples from all pregnant women who enrolled for prenatal care at any of the five public health clinics in Pinellas County, Florida (n = 380), or at any of 12 private obstetrical offices in the county (n = 335); each center was studied for a one-month period during the first half of 1989. Toxicologic screening for alcohol, opiates, cocaine and its metabolites, and cannabinoids was performed blindly with the use of an enzyme-multiplied immunoassay technique; all positive results were confirmed. Among the 715 pregnant women we screened, the overall prevalence of a positive result on the toxicologic tests of urine was 14.8 percent; there was little difference in prevalence between the women seen at the public clinics (16.3 percent) and those seen at the private offices (13.1 percent). The frequency of a positive result was also similar among white women (15.4 percent) and black women (14.1 percent). Black women more frequently had evidence of cocaine use (7.5 percent vs. 1.8 percent for white women), whereas white women more frequently had evidence of the use of cannabinoids (14.4 percent vs. 6.0 percent for black women). During the six-month period in which we collected the urine samples, 133 women in Pinellas County were reported to health authorities after delivery for substance abuse during pregnancy. Despite the similar rates of substance abuse among black and white women in our study, black women were reported at approximately 10 times the rate for white women (P less than 0.0001), and poor women were more likely than others to be reported. We conclude that the use of illicit drugs is common among pregnant women regardless of race and socio-economic status. If legally mandated reporting is to be free of racial or economic bias, it must be based on objective medical criteria.

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The relationship of acculturation and cultural influences to inhalant use was studied in a sample of 110 Mexican American adolescents and their mothers. The analyses examined both the direct relationship of acculturation with outcomes, including inhalant use, as well as the possible indirect relationship of acculturation through socialization, socioeconomic, and psychological variables, with outcome measures. Little support was found for the direct relationship of acculturation with outcomes, but there was limited support for the indirect relationship of acculturation with outcomes through socialization and psychologicalfactors. While the homogeneity of the sample may limit generalization of results, the relationships of drug use with perceived racial discrimination, association with deviant peers, involvement in religion and family, and psychological status are important for future study.

There is a need to design separate condom-promotion programs for foreign Asian and local clients of sex workers in Singapore.

A survey of 481 homeless persons in Cook County, Illinois, was conducted to assess the prevalence of alcohol and illicit drug use in this population, and potential treatment needs. Respondents were sampled at random in emergency and transitional shelters, soup kitchens, drop-in centers, and single room occupancy (SRO) hotels. Approximately 30% were characterized as having alcohol-related treatment needs. A slightly smaller proportion (26.7%) were estimated to have treatment needs associated with drug use behavior, and 13.5% were found to have both alcohol and drug-related, or dual, treatment needs. Those with alcohol user treatment needs were mostly male, age 35 and older, White, and living in SRO hotels. In contrast, persons with drug user treatment needs found in shelter settings. Implications for the treatment of homeless persons with substance misuse problems are discussed.