Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 9/2012

01-12-2012

Barriers to Receiving Substance Abuse Treatment Among Rural Pregnant Women in Kentucky

Authors: Afton Jackson, Lisa Shannon

Published in: Maternal and Child Health Journal | Issue 9/2012

Login to get access

Abstract

Research presenting outcomes for women who enter substance abuse treatment during pregnancy consistently shows benefits. While treatment has nearly universal benefits, there are many barriers to seeking substance abuse treatment for pregnant women. The purpose of this study is to explore barriers for rural pregnant women seeking substance abuse treatment. There were three eligibility criteria for study participation: (1) aged 18 and older, (2) pregnant, and (3) undergoing short-term inpatient detoxification at the University of Kentucky Chandler Medical Center. Eighty-five rural women (N = 85) were included in the analysis. Substance use history and previous treatment were assessed with measures adapted from the Addiction Severity Index. Treatment barriers were measured with three qualitative questions and were coded into four overarching categories: availability, accessibility, affordability, and acceptability barriers. This sample had an extensive substance use history. Almost all participants had used alcohol (98%), marijuana (98%), illicit opiates (99%), and cigarettes (97%). On average, participants reported about two barriers to receiving treatment (Mean = 1.8; SD = 1.3), with over 80% of the sample reporting having experienced any barrier to treatment. The majority experienced acceptability (51%) and accessibility (49%) barriers. Twenty-six percent (26%) of the sample reported availability barriers. A smaller percentage of participants reported affordability barriers (13%). Rural pregnant women seeking substance abuse treatment face many obstacles to receiving needed treatment. More studies on barriers to substance abuse treatment among rural pregnant women are needed. Identifying these barriers can help in improving treatment access and services.
Literature
1.
2.
Finkelstein, N. (1993). Treatment programming for alcohol and drug-dependent pregnant women. The International Journal of Addictions, 28(13), 1275–1309.
3.
Weisdore, T., Parran, T. V., Jr., Graham, A., & Synder, C. (1999). Comparison of pregnancy-specific interventions to a traditional treatment program for cocaine-addicted pregnant women. Journal of Substance Abuse Treatment, 16(1), 39–45.CrossRef
4.
Booth, B. M., & McLaughlin, Y. S. (2000). Barriers to and need for alcohol services for women in rural populations. Alcoholism, Clinical and Experimental Research, 24(8), 1267–1275.PubMedCrossRef
5.
Wright, A., & Walker, J. (2001). Drugs of abuse in pregnancy. Best Practice & Research Clinical Obstetrics and Gynaecology, 15(6), 987–998.CrossRef
6.
Hofhuis, W., deJongste, J. C., & Merkus, P. J. F. M. (2003). Adverse health effects of prenatal and postnatal tobacco smoke exposure on children. Archives of Disease in Childhood, 88, 1086–1090.PubMedCrossRef
7.
Blume, S. B., & Zilberman, M. L. (2005). Alcohol and women. In J. H. Lowinson, P. Ruiz, R. B. Millman, & J. G. Langrod (Eds.), Substance abuse: A comprehensive textbook (4th ed., pp. 1049–1063). Baltimore, MD: Williams & Wilkins.
8.
Kuczkowski, K. M. (2007). The effects of drug abuse in pregnancy. Current Opinion in Obstetrics and Gynecology, 19(6), 578–585.PubMedCrossRef
9.
Finnegan, L. P. (1991). Treatment issues for opioid-dependent women during the perinatal period. Journal of Psychoactive Drugs, 23, 191–201.PubMedCrossRef
10.
Fischer, G., Bitschnau, M., Peternell, A., Eder, H., & Topitz, A. (1999). Pregnancy and substance abuse. Archives of Women’s Mental Health, 2, 57–65.CrossRef
11.
Kaltenbach, K., Berghella, V., & Finnegan, L. (1998). Opioid dependence during pregnancy: Effects and management. Obstetrics and Gynecology Clinics of North America, 25(1), 139–151.PubMedCrossRef
12.
Jarvis, A. E., & Schnoll, S. H. (1995). Methadone use during pregnancy. In C. N. Chiang, & L. P. Finnegan (Eds.), National institute on drug abuse research monograph Series, 149, (pp. 58–77). Rockville, MD: NIDA.
13.
American Academy of Pediatrics. (1998). Neonatal drug withdrawal. Pediatrics, 101, 1079–1088.
14.
Zuckerman, B., Frank, D., & Brown, E. (1995). Overview of the effects of abuse and drugs on pregnancy and offspring. In C. N. Chiang, & L. P. Finnegan (Eds.), National institute on drug abuse research monograph series, 149, (pp. 16–38). Rockville, MD: NIDA.
15.
Havens, J., Simmons, L., Shannon, L., & Hansen, W. (2009). Factors associated with substance abuse during pregnancy: Results from a national sample. Drug and Alcohol Dependence, 99, 89–95.PubMedCrossRef
16.
Shannon, L., Havens, J. R., & Hays, L. (2010). Examining differences in substance use among rural and urban pregnant women. The American Journal on Addictions, 19, 467–473.PubMedCrossRef
17.
Armstrong, M. A., Osejo, V. G., Lieberman, L., Carpenter, D. M., Pantoja, P. M., & Escobar, G. J. (2003). Perinatal substance abuse intervention in obstetric clinics decreases adverse neonatal outcomes. Journal of Perinatology, 23, 3–9.PubMedCrossRef
18.
Svikis, D. S., Golden, A. S., Huggins, G. R., Pickens, R. W., McCaul, M. E., Velez, M. L., et al. (1997). Cost-effectiveness of treatment for drug-abusing pregnant women. Drug and Alcohol Dependence, 45, 105–113.PubMedCrossRef
19.
Sweeney, P. J., Schwartz, R. M., Mattis, N. G., & Vohr, B. (2000). The effect of integrating substance abuse treatment with prenatal care on birth outcomes. Journal of Perinatology, 4, 219–224.CrossRef
20.
Steverson, J. W., & Rieckmann, T. (2009). Legislating for the provision of comprehensive substance abuse treatment programs for pregnant and mothering women. Duke Journal of Gender Law and Policy, 16(315), 315–346.
21.
Tuchman, E. (2010). Women and addiction: The importance of gender issues in substance abuse research. Journal of Addictive Diseases, 29(2), 127–138.PubMedCrossRef
22.
Beckman, L. J. (1994). Barriers to alcoholism treatment for women. Alcohol Health and Research World, 18(3), 208–210.
23.
Shannon, L. M., & Walker, R. (2008). Increasing the recognition of barriers for pregnant substance users seeking treatment. Substance Use and Misuse, 43(8/9), 1266–1267.PubMedCrossRef
24.
Kumpfer, K. L. (1991). Treatment programs for drug-abusing women. The Future of Children, 1(1), 50–60.CrossRef
25.
Jessup, M. A., Humphreys, J. C., Brindis, C. D., & Lee, K. A. (2003). Extrinsic barriers to substance abuse treatment among pregnant drug dependent women. Journal of Drug Issues, 33(2), 285–304.CrossRef
26.
Breitbart, V., Chavkin, W., & Wise, P. H. (1994). The accessibility of drug treatment for pregnant women: A survey of programs in five cities. American Journal of Public Health, 84(10), 1658–1661.PubMedCrossRef
27.
28.
Clark, J. J., Leukefeld, C., Godlaski, T., Brown, C., Garrity, J., & Hays, L. (2002). Developing, implementing, and evaluating a treatment protocol for rural substance abusers. Journal of Rural Health, 18(3), 396–406.PubMedCrossRef
29.
Schoeneberger, M. L., Leukefeld, C. G., Hiller, M. L., & Godlaski, T. (2006). Substance abuse among rural and very rural drug users at treatment entry. The American Journal of Drug and Alcohol Abuse, 32, 87–110.PubMedCrossRef
30.
Hays, L. R. (2004). A profile of OxyContin addiction. Journal of Addictive Disorders, 23(4), 1–9.CrossRef
31.
Fortney, J., & Booth, B. M. (2001). Access to substance abuse services in rural areas. Recent Developments in Alcoholism, 15, 177–197.PubMedCrossRef
32.
Chitwood, D., McBride, D., Metsch, L., Comerford, M., & McCoy, C. (1998). A comparison of the need for health care and use of health care by injection-drug users, other chronic drug users, and nondrug users. American Behavioral Scientist, 41(8), 1107–1122.CrossRef
33.
McLellan, A., Luborsky, L., O’Brien, C., & Woody, G. (1980). An improved diagnostic instrument for substance abuse patients: The addiction severity index. Journal of Nervous and Mental Diseases, 168, 26–33.CrossRef
34.
Leonhard, C., Mulvey, K., Gastfriend, D. R., & Schwartz, M. (2000). The addiction severity index: A field study of internal consistency and validity. Journal of Substance Abuse Treatment, 18, 129–135.PubMedCrossRef
35.
36.
37.
Centers for Disease Control, Prevention. (2010). Vital signs: Current smoking among adults aged ≥18 years-United States, 2009. Morbidity and Mortality Weekly Report, 59(35), 1135–1140.
38.
United States Department of Agriculture. (2006). Crop production, 2005 summary. Cr Pr 2-1 (06). Washington, DC: National Agricultural Statistics Service.
39.
40.
Hankin, J., McCaul, M. E., & Heussner, J. (2000). Pregnant, alcohol-abusing women. Alcoholism, Clinical and Experimental Research, 24(8), 1276–1286.PubMedCrossRef
41.
Sexton, R. L., Carlson, R. G., Luekefeld, C. G., & Booth, B. M. (2008). Barriers to formal drug abuse treatment in the rural south: A preliminary ethnographic assessment. Journal of Psychoactive Drugs, 40(2), 121–129.PubMedCrossRef
42.
Small, J., Curran, G. M., & Booth, B. (2010). Barriers and facilitators for alcohol treatment for women: Are there more or less for rural women? Journal of Substance Abuse Treatment, 39, 1–13.PubMedCrossRef
43.
Finkelstein, N. (1994). Treatment issues for alcohol- and drug-dependent pregnant and parenting women. Health and Social Work, 19(1), 7–15.PubMed
44.
Lewis, R. A., Haller, D. L., Branch D., & Ingersoll, K. S. (1996). Retention issues involving drug-abusing women in treatment research. In E. Radhert (Ed.), Perinatal 20 projects: Treatment research in progress. National Institute on Drug Abuse Research Monograph 166 (pp. 110–122), Bethesda, MD.
45.
Allen, K. (1995). Barriers to treatment for addicted African-American women. Journal of the National Medical Association, 87(10), 751–756.PubMed
46.
Coletti, S. D. (1998). Service providers and treatment access issues. In C. L. Wetherington, & A. B. Roman (Eds.), Drug addiction research and the health of women. (NIH publication no. 98-4290, pp. 237–244). Rockville, MD: National Institute on Drug Abuse.
47.
Jansson, L. M., Svikis, D., Lee, J., Paluzzi, P., Rutigliano, P., & Hackerman, F. (1996). Pregnancy and addiction: A comprehensive care model. Journal of Substance Abuse and Treatment, 13(4), 321–329.CrossRef
48.
Tanney, M. R., & Lowenstein, V. (1997). One-stop shopping: Description of a model program to provide primary care to substance-abusing women and their children. Journal of Pediatric Health Care, 11, 20–25.PubMedCrossRef
49.
50.
United States Census Bureau. (2010). Kentucky (rural): 2005–2009 American community survey 5-year estimates. Retrieved August 3, 2011 from http://​factfinder.​gov.
51.
Shannon, L. M., Havens, J. R., Mateyoke-Scrivner, A., & Walker, R. (2009). Contextual differences in substance use for rural Appalachian treatment-seeking women. The American Journal of Drug and Alcohol Abuse, 35(2), 59–62.PubMedCrossRef
52.
Shannon, L. M., Havens, J. R., Oser, C., Crosby, R., & Leukfeld, C. (2011). Examining gender differences in substance use and age of first use among rural, Appalachian drug users in Kentucky. The American Journal of Drug and Alcohol Abuse, 37(2), 98–104.PubMedCrossRef
Metadata
Title
Barriers to Receiving Substance Abuse Treatment Among Rural Pregnant Women in Kentucky
Authors
Afton Jackson
Lisa Shannon
Publication date
01-12-2012
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 9/2012
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-011-0923-5

Other articles of this Issue 9/2012

Maternal and Child Health Journal 9/2012 Go to the issue

OriginalPaper

Early Predictors of Obesity and Cardiovascular Risk Among American Indian Children

Brief Report

Missed Opportunities: A National Survey of Obstetricians About Attitudes on Maternal and Infant Immunization

OriginalPaper

Factors Associated with a Medical Home Among Children with Attention-Deficit Hyperactivity Disorder

OriginalPaper

Female Perceptions of Male Versus Female Intendedness at the Time of Teenage Pregnancy

OriginalPaper

Factors Affecting Tobacco Use Among Middle School Students in Saudi Arabia

OriginalPaper

Parental Weight (Mis)Perceptions: Factors Influencing Parents’ Ability to Correctly Categorise Their Child’s Weight Status