Use of drugs during pregnancy, especially illicit drugs like heroin and cocaine, is prevalent in certain segments of society and is considered a significant public health problem. Although there are a plethora of physiological, psychological and environmental factors that contribute to a woman's illicit drug use, one factor of significant impact is drug use by her male partner. It has been shown that pregnant women who have a drug using partner are 5 times more likely to use drugs themselves compared with women whose partner did not use drugs or alcohol. Since drug-using partners can be a compelling barrier to successful drug treatment, new interventions are needed to address this problem. The present Stage I Behavioral Therapies Development proposal will develop, implement and test a novel therapy package targeted to the drug-using partners of drug dependent pregnant women enrolled in treatment at the Center for Addiction and Pregnancy (CAP). The three elements of the therapy to be developed for the male substance using partners include a modified version of Motivational Enhancement Therapy (MET), abstinence incentives in the form of monetary valued vouchers and education about pregnancy, child development and parenting with tailored information about the impact drug use has on each of these areas. Since these drug using partners are active treatment seekers, MET will be used to foster motivation and movement towards behavior change. Contingency management in the form of vouchers will be used to improve treatment retention and reduce illicit drug use in the drug-using partners. Finally, the specialized education groups will provide the men with basic knowledge about pregnancy, pre- and post-natal child development and parenting skills and the impact of drug abuse has on each topic. It is hypothesized that this therapy package will decrease the drug use by the partner and increase his pro-social support of the drug dependent woman. This hypothesis will be tested in a pilot study in which 40 drug using partners of drug dependent women enrolled at CAP will be randomly assigned to a either standard care control or intervention group. The partners and CAP women will be followed for 22 weeks. Objective (urine and breath samples) and subjective (e.g., self-reported drug use, perceived support) measures will be collected from both the male partners and the women . In summary, the new therapy will utilize the goals, philosophy, and methods of MET to increase the men's motivation for behavioral change, sustain the change in drug use with a contingency management program and provide these men with necessary, information and skills to become positive models in his new family's life.
