Brief interventions for illicit drug use among peripartum women

Abstract

We review the evidence and identify limitations of the current literature on the effectiveness of brief interventions (≤5 intervention sessions) on illicit drug use, treatment enrollment/retention, and pregnancy outcomes among pregnant and postpartum women; and consider this evidence in the context of the broader brief intervention literature. Among 4 published studies identified via systematic review and meeting a priori quality criteria, we found limited, yet promising evidence of the benefit of brief interventions to reduce illicit drug use among postpartum women. Two of the 4 randomized controlled trials tested similar computer-delivered single-session interventions; both demonstrate effects on postpartum drug use. Neither of the 2 randomized controlled trials that assessed treatment use found differences between intervention and control groups. Studies examining brief interventions for smoking and alcohol use among pregnant women, and for illicit drug use in the general adult population, have shown small but statistically significant results of the effectiveness of such interventions. Larger studies, those that examine the effect of assessment alone on illicit drug use, and those that use technology-delivered brief interventions are needed to assess the effectiveness of brief interventions for drug use in the peripartum period.

A Pilot Randomized Controlled Trial of a Computer-Delivered Brief Intervention for Substance Use and Risky Sex During Pregnancy

“…30,31 The majority of existing interventions have had a single focus either on reducing alcohol/drug use or improving sexual health, and very few of these have targeted pregnant women exclusively. 20,[32][33][34] A single session brief intervention targeting sexual risk reduction in a sample of men and women patients at a STI clinic found that a Results of clustered logistic regression using data from both time points. b Results of logistic regression on follow-up engagement only, time and time • group terms not applicable.…”

Medicaid Accountable Care Organizations and Childbirth Outcomes

“…Studies have shown the efficacy of SBIRT for pregnant women, especially for decreasing alcohol use and tobacco use (Bowden, Oag, Smith, & Miller, 2010; Chang et al, 2005; Chang, Wilkins-Haug, Berman, & Goetz, 1999; Ferreira-Borges, 2005; O’Connor & Whaley, 2007). In addition, a recent systematic literature review of randomized clinical trials on the efficacy of brief interventions for illicit drug use in pregnancy found limited but promising results (Farr, Hutchings, Ondersma, & Creanga, 2014).…”

Obstetrician–gynecologists’ practice patterns related to opioid use during pregnancy and postpartum—United States, 2017

“…Taking patient histories and using verbal screening tools provide the opportunity for the prenatal care clinician to offer brief intervention or motivational interviewing (6,20). Brief behavioral counseling interventions have been shown to be effective in reducing drinking (21,22), smoking (23,24), and illicit drug use (25) during pregnancy and to improve pregnancy outcomes (26). However, more than half of respondents in our study reported a low frequency of conducting brief intervention or performing motivational interviewing or cognitive behavioral therapy, potentially due to the time-consuming nature of these activities or referral to treatment centers or addiction specialists.…”