Drug use among American women is a major social and health problem. This is especially evident in poor, minority communities in the major cities which are also epicenters for HIV-related illness. Cocaine/crack has become the """"""""drug of choice"""""""" among women. The synergism of these epidemics has created a human catastrophe. Most substance abusing women are not in any treatment program. The magnitude of the problem suggests the need for new, effective drug abuse, medical, and psychosocial services and treatment approaches that are seen as low barrier by these women so as to attract and retain them and their children in continuous substance abuse treatment and health care services in the postpartum period. The Rawson MATRIX Center neurobehavioral approach, developed with NIDA funds, has shown potential in helping clients attain and maintain a drug free state. The present project will test the generalizability of this model to postpartum women. St. Luke's-Rooselvelt Hospital Center (SLRHC), which delivers more than 400 babies a year to drug addicted women, proposes to establish a COMPREHENSIVE CARE CENTER with a focus on accessible, one-stop care in a multiservice model to test the relative effect of: 1) comprehensive care with the Rawson MTATRIX neurobehavioral approach, 2) comprehensive care with referrals for other appropriate treatment, and 3) standard hospital care.
Specific aims are to: 1) attain and maintain drug free status, 2) increase maternal mental, physical, and social wellbeing, and 3) improve child development outcomes. The project will draw upon a pool of over 900 postpartum women with evidence of cocaine/crack use at the time of delivery at SLRHC over the 30 months of enrollment. The randomized experimental pretest-repeated posttest design will result in at least 100 women with complete data in each of the three groups. Research will determine which approach is more effective, whether the effectiveness of each approach varies among different subgroups of women, and for which outcomes the greatest gains are produced. Process data and qualitative data will supplement and enrich the quantitative research design.
