Family discord is associated with increased substance use for pregnant substance users.

Childhood abuse and partner violence are associated with prenatal substance abuse, but the potential impact of current family discord, which reflects broader family relationships and encompasses problems less severe than violence, has had little evaluation in pregnant substance users. Using data from 196 pregnant substance users participating in the National Drug Abuse Treatment Clinical Trials Network study CTN-0013 (Motivational Enhancement Therapy to Improve Treatment Utilization and Outcome in Pregnant Substance Users), the authors examined the relationship of baseline family discord to substance use and treatment session attendance. Family discord was assessed using items from the family composite of the Addiction Severity Index. Substance use was assessed by the Substance Use Calendar and urine drug screens (UDS). Assessments were weekly for four weeks and at two- and four-month post-randomization. Women with family discord were more likely to report living with a problematic substance user, reported a higher percentage of substance use days throughout each study phase, had a greater proportion of positive UDS over the four-month study period, and attended more weeks of treatment during the first month.

Conclusions: As hypothesized, women with family discord reported more days of substance use relative to women without family discord during each study phase. This is the first demonstration that family discord is associated with greater substance use for women who are both pregnant and have a substance use disorder. Specific treatment interventions targeting pregnant women experiencing family discord may be warranted.

Related protocols: CTN-0013