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

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 28days 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 4week active study phase and at 1 and 3month follow-ups.

RESULTS

Significant treatment-by-time interaction effects were found for illicit-drug use days during the active (X2=6.89, df=1, p<0.01) and follow-up (X2=8.26, df=1, p<0.01) phases and for alcohol use during the follow-up phase (X2=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.