Comprehensive treatment program for pregnant substance users in a family medicine clinic.

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.

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.