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Traditionally, alcohol and other drug treatment programs served adult males, and few women received the treatment they needed. The scarcity of treatment services for women continues today. It is imperative that programs include services designed specifically for women, particularly pregnant women.
Many alcohol and other drug treatment programs do not accept pregnant women because of liability issues or a lack of knowledge about pregnancy. Furthermore, programs have not had access to standardized guidelines for treatment, case management, and followup services. The information that follows offers such guidance and is intended to encourage programs to broaden and strengthen their services to pregnant, substance-using women.
Reliable national estimates of the prevalence of alcohol and other drug use by pregnant women are not available. Several factors limit the accuracy and usefulness of current estimates, including differences in the populations studied, the lack of representativeness of samples used, and differences in the methods employed to determine drug use. Results of specific studies, such as those reported below, illustrate to some degree the nature and extent of the problem.
To meet the need for estimates of the prevalence of alcohol and other drug use by pregnant women that are generalizable to the Nation, the National Institute on Drug Abuse has recently sponsored a national, hospital-based study known as the National Pregnancy and Health Survey. Until these and other data become available, service providers should be alert to patterns of alcohol and other drug use occurring locally among women of all socioeconomic and ethnic groups.
Those with clinical experience in treating substance-using women have found that the therapeutic needs of women, especially those with children, are markedly different from the needs of men. Substance-using women come from every ethnic and socioeconomic group and have a multitude of needs. Moreover, a substantial portion of the women who seek publicly supported treatment for their addictions share a core group of problems that reflect problems of the communities in which they live. Unless these core problems are addressed, women will be unable to take full advantage of the therapeutic process.
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