California's Approach to Perinatal Substance Abuse: Toward a Model of Comprehensive Care

Abstract

In the late 1980s and early 1990s there was a growing awareness of the many health, social, psychological, treatment, and recovery needs of pregnant and parenting women and their drug-exposed children. This awareness sensitized policymakers and service providers to the necessity for women-centered programs. Many points of intervention, from primary prevention to treatment of drug dependence, are required to adequately respond to the various needs of this heterogeneous population; a comprehensive women-centered model of care is required that includes health, social, and personal support services. In addition, programs are needed that are aimed at the prevention and treatment of use, abuse, and addiction to alcohol and tobacco, which are dangerous to women's health and birth outcomes and responsible for more costs to society than are associated with use of illicit drugs. The existing system of social services and health care has been fragmented and uncoordinated in responding to substance-abusing women generally, and especially to those who are pregnant and/or parenting. A panel of experts and policymakers in California delineated the appropriate components of a model of service delivery for pregnant and parenting women. This article assesses the implementation of California programs that were informed by the model.

A Unique Drug Treatment Program for Pregnant and Postpartum Substance-Using Women in New York City: Results of a Pilot Project, 1990–1995

“…PACE was set up to provide comprehensive, woman-centered, and familyoriented services, an approach that was, and still is, recommended by drug treatment proponents (2)(3)(4)(5). Provision of comprehensive services for women and their families is cost effective compared to incarceration, foster care, and tertiary medical care (6,7).…”

The Effects of State Alcohol and Pregnancy Policies on Women’s Health and Healthy Pregnancies

“…For similar findings see Brindis et al (1997), Werner (2005), California FASD Task Force (2006), Chasnoff et al (2008), Grella (2003), Drabble (2007), Lester et al (2004), and Young et al (2008).…”

Permanency planning and social service systems: A comparison of two families with prenatally substance exposed infants

“…Two-dimensional approaches to the multifaceted needs of families affected by substance use are being increasingly replaced by treatment programs that have the depth to integrate the process of recovery with the undertaking of parental responsibilities (Brindis, Berkowitz, Clayson, & Lamb, 1997;Chavkin, Paone, Friedmann, & Wilets, 1993;Clayson, Berkowitz, & Brindis, 1995;Howell, Heiser, & Harrington, 1999;Lester, Freier, Boukydis, Affleck, & Boris, 1996;Luthar & Walsh, 1995;Magura, Laudet, Kang, & Whitney, 1999;Marsh, D'Aunno, & Smith, 2000;Wobie, Eyler, Conlon, Clarke, & Behnke, 1997). Comprehensive and integrated services are the most effective strategies to address lifestyle changes that will promote parental abstinence from drug use and optimize possibilities for nurturing children.…”