The extent of substance abuse of the traditional """"""""hard"""""""" as well as the """"""""recreational"""""""" drugs in American society is unparalleled with any other time in the history of this country. No socioeconomic level of society or racial or ethnic group has been spared, and the number of addicted pregnant women who have come to medical facilities for delivery in the last decade has risen substantially. This study is designed to monitor the prevalence of drug abuse in pregnant women and subsequent neonatal drug exposure. The implications for neonatal and infant morbidity are worrisome, especially given the established growth of cocaine use. The cost of care as well as the quality of life of infants affected are key policy concerns of NIDA; however, to better formulate policy and actively pursue solutions, the extent of the problem, its costs and who is affected need to be documented. The objectives of the proposed research can be summarized as follows: (1) identify and monitor the prevalence of drug-addicted mothers and drug-exposed infants in a sample of urban hospitals; (2) develop and implement an educational program for physicians that will enhance their ability to recognize drug abuse and will allow appropriate treatment and more accurate monitoring of drug use in pregnant women and drug exposure in neonates; (3) analyze the morbidity and mortality associated with drug abuse in mothers and exposure in neonates and assess particular subgroups of women (by age and zip code) to identify differences in prevalence and (4) assess the cost of care for drug-affected mothers and neonates compared to an age- and race-adjusted comparison group.
