Substance Abuse

Substance Abuse Evaluated Among Women With Children

Highlights of Recently Published NIDA-Supported Studies

SUBSTANCE ABUSE EVALUATED AMONG WOMEN WITH CHILDREN

In two nationally representative surveys, about 2 percent of mothers with at-home children under the age of 18 reported symptoms meeting the clinical criteria for abuse of or dependence on illicit drugs or prescription drugs that are being misused.

Dr. Leigh Ann Simmons, currently of Duke University, and former colleagues at the University of Kentucky found that 1.1 percent of the 19,300 mothers in this category who responded to the 2002 and 2003 National Survey on Drug Use and Health had a substance use disorder involving prescription painkillers, tranquilizers, sedatives, or stimulants; 0.9 percent involving marijuana; 0.4 percent, cocaine; 0.1 percent, heroin; and 0.2 percent, multiple drugs. The overall rates of drug abuse were not higher among these women compared with other women who participated in the survey. Compared with non-drug-using mothers, however, mothers who used drugs were, on average, younger, less educated, more stressed, less healthy, and more likely to be unmarried or divorced, unemployed, receiving public assistance, victims of interpersonal violence, and affected by serious mental illness.

Parental substance abuse increases a child’s risk for neglect, abuse, and health and behavioral problems, including poor socialization, attention deficit hyperactivity disorder, depression, and substance use disorders. Dr. Simmons and colleagues urge increased attention to detecting and responding to parental drug abuse in primary care, pediatric, and emergency settings and support for research to better understand the impact of parental drug abuse and related factors on children’s development.
Annals of Epidemiology 19(3):187–193, 2009. [Full Text]

DEEP BRAIN STIMULATION REDUCES RATS’ COCAINE SEEKING

A stream of electrical pulses delivered to the brain’s reward center curbs the power of a cocaine injection to spur rats to drug seeking.

Dr. R. Christopher Pierce of Boston University School of Medicine and colleagues trained rats to press a lever to self-administer the drug, then weaned the rats off that behavior by withholding the drug. Normally, after rats exposed to this protocol receive a priming injection of cocaine, they resume lever pressing, a response that mimics human relapse to drug abuse. In the Boston experiment, rats that received 2 hours of deep brain stimulation to the shell area of the nucleus accumbens (NAc) immediately following the priming injection pressed the lever about half as much as control animals.

Dr. Pierce says his team’s findings suggest that deep brain stimulation of the NAc shell holds promise as a therapy for severe cocaine addiction. Deep brain stimulation of a different brain region has benefited patients with Parkinson’s disease, and the technique is also being tested as a potential therapy for severe depression that does not improve with medication.
Journal of Neuroscience 28(35):8735–8739, 2008. [Full Text]

INTERVENTION IMPROVES ABSTINENCE, EMPLOYMENT AMONG WELFARE RECIPIENTS

Intensive case management (ICM) can help substance-abusing women who receive welfare benefits stay off drugs and make strides in employment, report Dr. Jon Morgenstern and colleagues at Columbia University. In a study of 302 applicants for Temporary Assistance for Needy Families in New Jersey, the researchers assigned roughly half to an ICM intervention that included weekly visits from a case manager, help in overcoming treatment barriers, assistance in identifying and meeting other patient service needs, and voucher incentives for remaining in treatment. The rest of the trial participants received the care welfare agencies typically provide to substance-abusing clients, which consists of screening and referral for treatment.

When interviewed after 24 months, 47 percent of the women receiving ICM had been abstinent from drugs for the past 30 days, compared with 24 percent of those in the usual care group. At that same time, 22 percent of the women in the ICM group—but only 9 percent of those in the usual care group—were employed full-time. For comparison, the full-time employment rate was 34 percent among 150 female welfare recipients who did not abuse drugs.

The researchers are now conducting a cost-benefit analysis of ICM. If their promising results are replicated in future evaluations, welfare agencies may have an effective tool to help some of their most vulnerable clients.
American Journal of Public Health 28(53):14372–14378, 2008. [Abstract]

U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse, NIDA InfoFacts:from the NIDA Web site, http://www.nida.nih.gov/NIDA_notes/NNvol23N3/RIB.html.