Specialized programs for pregnant, drug dependent women have assisted many in achieving abstinence during pregnancy. Following delivery, however, such women often resume drug use and drop out of treatment, placing their children at even greater risk for subsequent medical and developmental problems. Standard outreach services, while generally effective as a public health measure for high-risk populations of women and children, are often insufficient for chronic and severely drug dependent women. The present study was a randomized clinical trial comparing maternal and infant outcomes for drug dependent women assigned to either routine or intensified case management services for the first 4 months following delivery. Women randomly assigned to intensified case management showed better treatment retention, accessed a greater variety of services, were more likely to L. M. Jansson, MD, is affiliated with Johns