4246.0: Tuesday, October 23, 2001 - 5:42 PM

Abstract #25235

Policy implications of perinatal substance abuse treatment in community settings

Mary Anne Armstrong, MA1, Gabriel J. Escobar, MD1, Veronica M. Gonzales, BS1, and Leslie Lieberman, MSW2. (1) Division of Research, Kaiser Permanente, 3505 Broadway, Oakland, CA 94611-5714, (510) 450-2226, Maryanne.Armstrong@kp.org, (2) Patient Care Services, Kaiser Permanente, 1950 Franklin, Oakland, CA 94612

We have found that providing confidential substance abuse treatment to pregnant women is associated with improved neonatal outcomes, including decreased need for assisted ventilation. These outcome improvements are of sufficient magnitude to affect how a large managed care organization, such as the Kaiser Permanente Medical Care Program's Northern California Region, with 3 million members and 32,000 deliveries, chooses to provide prenatal care. Our experience suggests that a number of issues involving substance abuse treatment for pregnant women need to be reconsidered. These include: 1) reassessing the ethical implications of routine toxicology screening during prenatal care; 2) evaluating the status of insurance coverage for substance abuse treatment during pregnancy; and 3) evaluating what services are being provided by managed care organizations, including the degree to which "carve out" strategies are employed. In view of the enormous direct and indirect costs related to substance abuse, an overview of national and international policies regarding substance abuse prevention and treatment vs. prosecution of substance abusing pregnant women will be provided. Policy recommendations based on research results will also be outlined.

Learning Objectives: At the conclusion of this presentation, the participant will be able to assess the policy implications of substance abuse treatment for pregnant women.

Keywords: Substance Abuse Treatment, Policy/Policy Development

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA