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Substance Abuse and Mental Health Services Administration
Comprehensive Treatment Program for Pregnant Substance Users in a Family Medicine Clinic
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Problem being addressed: Substance use during pregnancy is a substantial public health problem and a risk factor for poor neonatal outcomes. Prenatal care is often provided in high-risk pregnancy units, separate from addiction treatment. (Authors)
Objective of program: To provide comprehensive prenatal care and addiction treatment in a family medicine setting.

Description of program:The Toronto Centre for Substance Use in Pregnancy (T-CUP) is a family medicine–based program in a large urban city in Ontario. The T-CUP program comprises an interdisciplinary team using a one-stop access model to provide comprehensive services for pregnant women with a history of alcohol or drug abuse, including prenatal and postnatal medical care, addiction counseling, and assistance with complex psychosocial needs.

Evaluation: A retrospective chart review was performed, including charts for 121 women who received care at T-CUP from August 2000 to January 2006. Women demonstrated a high compliance rate with prenatal care attendance. Most women reported reduction in a variety of drug use categories. Significant differences were found especially among women who presented earlier in their pregnancies (P < .05). As a result, neonatal outcomes were satisfactory and approximately 75% of newborns were discharged home in the care of their mothers.

Conclusion: Pregnant substance-using women have positive maternal and infant health outcomes when they receive comprehensive care in a family medicine setting. (Authors)
November 2011
Ontario, Canada
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