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Wayne State leads first-ever study focused on effects of threat of legal action on pregnant women abusing drugs or alcohol

March 22, 2010

Studies show that 25 percent to 50 percent of people receiving treatment for substance abuse report some formal pressure to do so. The use of coercion to promote substance abuse treatment is controversial, particularly in the case of pregnant women.

To date, no one has analyzed the use of external pressure on pregnant women who abuse drugs or alcohol. The study, External Pressure, Motivation, and Treatment Outcomes among Pregnant Substance-Using Women, was recently published in Drug and Alcohol Dependence by a Wayne State University researcher in collaboration with the University of Cincinnati. The study has revealed new findings among this group.

“Among pregnant women receiving treatment for substance use, those who report external pressure in the form of threat of legal action, loss of child custody or loss of housing, attend treatment more regularly, and use drugs less often than those who do not,” said Steven Ondersma, Ph.D., lead author of the study and associate professor of psychiatry and behavioral neurosciences in the School of Medicine, and the Merrill Palmer Skillman Institute for Child & Family Development at WSU.

Ondersma and his collaborators studied 200 pregnant women who were receiving substance abuse treatment. They found that those who said they were formally notified that they would go to jail, have a child removed from custody, or would lose housing if they did not enter a drug treatment program, showed a significantly higher rate of drug treatment compliance than the non-coerced group. All differences were not attributable to other factors such as education, legal history, employment, motivation, or the presence or absence of a substance use disorder.

“Women reporting external pressure attended more scheduled treatment hours, stayed in treatment longer, and used drugs or alcohol less often than similar women who were not coerced,” said Ondersma. While further studies are needed, particularly to address complex ethical issues, these results suggest external pressure to attend treatment can result in significantly greater treatment retention and lower drug use, thereby improving maternal and child outcomes.

In addition to Ondersma, Theresa Winhusen, Ph.D., and Daniel F. Lewis from the University of Cincinnati also participated in this study, which utilized data from a study directed by Dr. Winhusen. The study was funded by the National Institutes of Drug Abuse and the Joe Young, Sr. funds from the State of Michigan.

To view the complete study, visit http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T63-4XPXT58-4-1&_cdi=5019&_user=147018&_pii=S0376871609003925&_orig=search&_coverDate=03%2F01%2F2010&_sk=998929997&view=c&wchp=dGLzVzz-zSkzk&_valck=1&md5=992320b395f9629a8ed50f33bf90b63d&ie=/sdarticle.pdf.

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Wayne State University is one of the nation’s pre-eminent public research universities in an urban setting. Through its multidisciplinary approach to research and education, and its ongoing collaboration with government, industry and other institutions, the university seeks to enhance economic growth and improve the quality of life in the city of Detroit, state of Michigan and throughout the world. For more information about research at Wayne State University, visit http://www.research.wayne.edu

For more information, contact Julie O'Connor at julie.oconnor@wayne.edu or 313-577-8845.