Comorbidity and Related Factors Among Ethnically Diverse Substance Using Pregnant Women

Abstract

Studies have established that comorbidity needs to be considered when assessing and treating substance-using clients. This study explores course of treatment, risk factors, and drug-related issues among 192 ethnically diverse pregnant women who were actively using drugs at admission to a residential treatment program. Findings revealed that course of treatment is more difficult for comorbid clients who perceived more treatment barriers than noncomorbid clients. Comorbid clients were more likely to have a history of attempting suicide but no more likely to have been reported for child abuse or charged with a crime. Comorbid clients reported greater severity of alcohol use but did not differ from noncomorbid clients regarding drug of choice. Comorbid clients were no more likely to leave against treatment advice, and noncomorbid clients were no more likely to complete treatment. Findings suggest that sensitivity to comorbidity issues is crucial to retaining comorbid clients in treatment.

Recent Sex Trade and Injection Drug Use Among Opiate and Cocaine-dependent Pregnant Women in Treatment

“…Psychiatric comorbidity in the present study sample (59.3%) was comparable to other studies examining lifetime prevalence of comorbid psychiatric disorders in national samples 41%–65%17, opioid abusers entering methadone 44%20, and substance dependent pregnant women in treatment 51% 19. Therefore, the prevalence of comorbid non-substance related lifetime psychiatric comorbidity reported here is consistent with other studies, which together highlight that approximately half of all adults presenting to drug treatment have a history of other mental health problems to consider in addition to substance abuse, with some estimates suggesting 70% of pregnant women in drug treatment have a current, comorbid Axis I disorder 16…”

“…Pregnant women with psychiatric comorbidity are more likely to report treatment barriers,19 post-treatment relapse,16 have a history of abuse30 and suicide attempts,19, 30 and as evidenced by this study, engage in risk behaviors that may result in the transmission of HIV or other infectious diseases that further compromise the health of mothers and their unborn fetuses.…”

“…This study adds to a growing body of literature on psychiatric comorbidity among pregnant women in drug treatment16, 19, 30 suggesting that (1) more than half of the pregnant women in drug treatment have a comorbid, non-substance related lifetime diagnosis and (2) pregnant women in drug treatment with psychiatric comorbidity have greater psychosocial problems and risk behaviors that compromise their health and functioning when compared to pregnant women without a comorbid disorder 16, 19, 30. Pregnant women with psychiatric comorbidity are more likely to report treatment barriers,19 post-treatment relapse,16 have a history of abuse30 and suicide attempts,19, 30 and as evidenced by this study, engage in risk behaviors that may result in the transmission of HIV or other infectious diseases that further compromise the health of mothers and their unborn fetuses.…”

“…Almost half (44%) of opioid abusers entering a methadone treatment program were found to have a lifetime non-substance use Axis I or Axis II diagnosis 20. In a study of pregnant, substance abusing women from a residential treatment program, 51% were identified as having a history of comorbid psychiatric diagnoses 19. These findings suggest that nearly half of drug dependent populations, including pregnant women in drug treatment, suffer from a comorbid psychiatric disorder during their lifetime.…”

Ethnic Differences in Substance Use Patterns in a Sample of Pregnant Substance‐Using Women in Treatment

“…A few additional items (none of interest to the present study) are obtained not through interview but through review of prior treatment records received by the residential facility (e.g., psychiatric diagnosis; cf. Brems & Namyniuk, 1999). Regarding drug use history (the interview section most relevant to this study), information is solicited about drug of choice, types of drugs used in a lifetime, frequency of use, recency of use, and severity of use as measured by number of previous drug treatments and presence of blackouts.…”