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 II Behavioral Therapies Development proposal will fully test a novel therapy package that was developed, implemented and tested on 32 male partners of pregnant drug dependent women enrolled in treatment at the Center for Addiction and Pregnancy (CAP). The three elements of the therapy package for the male substance using partners include (1) research supported methadone/detoxification treatment, (2) abstinence incentives in the form of monetary valued vouchers and (3) tailored Motivational Interviewing (MI) for the couple. The research supported methadone/detoxification treatment will help the partner imitate and maintain drug abstinence that will then allow him to focus on relationship and family issues. Contingency management in the form of vouchers is used to improve treatment retention and reduce illicit drug use in the drug-using partners. Finally, the couples MI is used to foster motivation and movement towards drug behavior change and improved social support of the woman. The hypothesis that this therapy package will decrease the drug use by the partner and increase his pro-social support of the drug dependent woman will be tested in a full clinical trial by comparing both the partners' and the women's outcomes of partners randomly assigned to either a 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 MI/MET to increase the men's motivation for behavioral change, sustain the change in drug use or maintain a positive behavior change toward the woman.
