Efficacy of motivational enhancement therapy to decrease alcohol and illicit-drug use in pregnant substance users reporting baseline alcohol use

摘要

Abstract Background Approximately 35% of pregnant substance users in treatment report alcohol abuse, which increases the risk of fetal alcohol spectrum disorders (FASD) in their offspring. The present study was a preliminary evaluation of the efficacy of motivational enhancement therapy (MET) in decreasing alcohol use in pregnant women attending substance use treatment. Methods Secondary analysis of a trial evaluating the efficacy of MET, relative to treatment as usual (TAU), in improving treatment outcomes in 200 pregnant substance users. The present study included the 41 women (n = 27 MET and n = 14 TAU) who reported alcohol use in the 28 days prior to randomization. Alcohol and illicit-drug use days were assessed with self-report; illicit drug use was assessed with urine drug screens. All measures were obtained weekly for the 4 week active study phase and at 1 and 3 month follow-ups. Results Significant treatment-by-time interaction effects were found for illicit-drug use days during the active ( X 2 = 6.89, df = 1, p 0.01) and follow-up ( X 2 = 8.26, df = 1, p 0.01) phases and for alcohol use during the follow-up phase ( X 2 = 13.07, df = 1, p 0.001), all reflecting a beneficial effect for MET, relative to TAU. All other treatment effects were non-significant. Conclusions These findings suggest that MET may be effective in decreasing alcohol and illicit-drug use in pregnant substance users reporting alcohol use. With 2–5% of US births affected by FASD, future research to replicate these findings seems warranted. Trial registration ClinicalTrials.gov http://www.clinicaltrials.gov; Identifier: NCT00078143 . Highlights ? Motivational enhancement therapy (MET) was provided to pregnant substance users. ? Treatment outcomes were analyzed in a subgroup of women with baseline alcohol use. ? MET resulted in decreased alcohol use over time in this subgroup of women. ? MET resulted in decreased illicit-drug use in this subgroup over time. ? MET may decrease alcohol and drug use in pregnant substance users more than TAU.