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- Title
Comprehensive Treatment for Pregnant and Parenting Women with Substance Use Disorders and Their Children: The UNC Horizons Story.
- Authors
Jones, Hendrée E.; Andringa, Kim; Carroll, Senga; Johnson, Elisabeth; Horton, Evette; O'Grady, Kevin; Stanford, Deborah; Renz, Connie; Thorp, John
- Abstract
Objectives: To describe how the UNC Horizons program, a comprehensive women-centered program for pregnant and parenting women with substance use disorders, and its patient population have changed over time and summarize basic neonatal outcomes for infants born to women in treatment at Horizons. Methods: Yearly Annual Reports from fiscal years of 1994 to 2017 were abstracted. Patient characteristics and infant outcomes compared to normative North Carolina data were examined. Results: Highlights of findings include: The percentage of women for whom opioids were the primary substance of use increased from 0% in 1995–1996 to 62% in 2016–17, while cocaine decreased from 66 to 12%. Intravenous substance use history increased from 7% in 1994–1995 to 41% in 2016–2017. The number of women reporting a history of incarceration rose from 10–20% in the early years to 40%-50% beginning in 2007–2008. The proportion of women reporting a desire to hurt themselves rose from 20% in 2004–2005 to 40% in 2016–2017. Self-reported suicide attempt history remained consistent at 32% across years. While reporting of childhood physical abuse remained at 38% across years, reporting of sexual abuse and domestic violence trended upward. Horizons did not differ from North Carolina in the likelihood of patients giving birth prematurely [χ2(13) = 20.6,p =.082], or the likelihood of a patient giving birth to a low birthweight infant [χ2(13) = 14.7,p =.333]. Conclusions for Practice: Breaking the cycle of addiction for women and children must focus on helping women with substance use problems develop a sense of hope that their lives can improve, and a sense of feeling safe and nurtured. Significance: Systematic examinations of programs that provide treatment services to pregnant and parenting women with substance use disorders have typically been focused on a limited set of outcomes and have been cross-sectional in nature. The current paper presents a detailed examination of the patient populations over a 23-year period, with particular attention to the changes over time in the women served. The birth weight and prematurity of infants born to the women in this program were likewise examined over time, and in comparison to state-level data.
- Subjects
NORTH Carolina; SUBSTANCE abuse treatment; MOTHERS; NARCOTICS; TREATMENT programs; EVALUATION of human services programs; PREMATURE infants; SOCIAL determinants of health; INTRAVENOUS drug abuse; PRISONERS; CHILD abuse; CROSS-sectional method; PREGNANT women; SELF-injurious behavior; DOMESTIC violence; REGRESSION analysis; PARENTING; PREGNANCY outcomes; SUICIDAL behavior; LOW birth weight; COCAINE; SEX crimes; DESCRIPTIVE statistics; CHILD health services; PSYCHOSOCIAL factors; EMPLOYMENT; RESEARCH funding; WOUNDS &; injuries; CRIMINAL justice system; EDUCATIONAL attainment
- Publication
Maternal & Child Health Journal, 2024, Vol 28, Issue 3, p409
- ISSN
1092-7875
- Publication type
Article
- DOI
10.1007/s10995-023-03870-7