Research Director: Hendree Jones, Ph.D.
Research Director: Michelle Tuten, LCSW-C
Program Director: Vickie Walters, LCSW-C
TREATMENT PROGRAM BACKGROUND
The Center for Addiction and Pregnancy (CAP) is a community-based treatment center located on the campus of The Johns Hopkins Bayview Medical Center. CAP offers multidisciplinary, comprehensive treatment to pregnant substance abusing women and their children including psychiatric care, obstetrical/gynecological care, family planning services, pediatric health care, and developmental assessment, developmental play (child care) program and 24-hour nursing care. Efforts are continually made to match staff to the cultural, ethnic and socioeconomic characteristics of patients being treated. CAP has 16 residential beds and 100 outpatient treatment slots and typically offers care to over 365 women and 140 children per year. All services are provided on two floors of one hospital wing thereby centralizing care to reduce the barrier of fractionalized services that often prevents women from completing many aspects of needed multidisciplinary care. The population enrolled in CAP is approximately 60% African American and 40% Caucasian, 80% single, with a mean education level of 11 years and an average of 1.5 living children.
Click here for more information about the CLINICAL SERVICES offered by the Center for Addiction and Pregnancy.
OVERVIEW OF RESEARCH INTERESTS
Since its inception in 1991, CAP has been committed to generating evidence-based research and applying these findings to improve the treatment provided. Given the various disciplines involved in the program (obstetrics, pediatrics and psychiatry), this is an ideal setting for patients to receive comprehensive care. Research projects conducted at CAP have examined a wide variety of questions including optimal medication and counseling services for pregnant women with substance use disorders, the role of partners in the treatment process for women at the program, the cost and benefit of the services provided, and novel behavioral treatments for pregnant women with active substance use disorders.
CAP research has several IRB-approved National Institute of Health, National Institute on Drug Abuse studies that focus on learning about the most effective treatments for pregnant women with a drug addiction.
ROSE (Reduction of Smoke Exposure)
This study is looking at ways to help women with smoking reduction and cessation during pregnancy. Participants are randomly assigned to one of three groups: (1) tobacco-abstinence-contingent gift certificates; (2) gift certificates that are not contingent on smoking status; or (3) a control group that does not receive gift certificates. This study involves a baseline interview and then participants provide urine and breath samples three times a week. Participants also have follow-up interviews scheduled at one month, three months, and at six weeks post-partum.HOPE (Helping Other Partners Excel)
This 22-week study is looking at ways to help CAP patients improve their outcomes by helping their partners stay drug-free. The intervention is focused on the male partner. Participants are randomly assigned to one of two groups: (1) Standard Care Group that provides a weekly men’s support group; or (2) Intervention Group that provides help with getting drug treatment, rewards for being drug free and attending individual counseling. CAP patients and their partners provide urine samples twice a week. All participants are asked to provide baseline and follow-up interviews that are scheduled at four, eight, 20 and 28 weeks following signing informed consent.HOME (Housing Opportunities for Mothers Expecting)
This 6-month study is looking at ways to help pregnant, non-methadone-treated patients remain drug free. Participants are randomly assigned to one of two groups: (1) Enhanced Care Group that provides individual counseling and free recovery housing contingent on abstinence; or (2) Usual Care Treatment that provides referrals for housing. All subjects provide baseline interviews and follow-up assessments at one, three, six and 12 months from signing informed consent.MOTHER (Maternal Opioid Treatment: Human Experimental Research)
This 8-site randomized, double-blind (neither staff nor patient knows what medication is taken), double-dummy (two forms of medication are given with only one being active) study compares the maternal, fetal, and neonatal safety and efficacy of methadone and buprenorphine. During screening, interviews, blood tests, urine tests, and a sonogram are done. CAP patients taking methadone five days or less are placed on morphine during screening. Those already stable on methadone are screened on methadone. Once medically cleared, women are inducted onto the study medication. For those screened on methadone, they receive morphine for several days before induction onto study medication to wash the methadone from their system. Patients receive medication onsite daily. They get seven tablets under their tongue (buprenorphine or placebo) and liquid to drink (methadone or placebo). They give urine and breath samples three times a week to test for drug use, fill out questionnaires each week, give blood samples monthly, and have fetal monitoring at week 32. Participants will stay inpatient starting a week before delivery and then inpatient ten days after the baby is born. Women receive study medication for 28 days post-delivery and then are returned to methadone unless other treatment is requested.Fetal Testing
Participants receiving medication will undergo fetal testing before and after medication at various times during their pregnancy in order to better understand how the medication impacts maternal and fetal physiology and fetal and infant behavior.HIV Prevention
This 16-week intervention looks at ways to prevent HIV by reducing risk behavior. Participants are randomly assigned to either (1) psycho-education or (2) cognitive-behavioral/family intervention. Participants are interviewed and give blood samples at baseline, and then at three, six and 12 months.
For more information about CAP research, please call Pamela Addis at 410-550-7680.
