National Institute on Drug Abuse Services Research Recommendations from NIDA's Conference on Drug Addiction and the Health of Women

Broad Scope

1. Studies are needed that examine a variety of health care models as well as integrated approaches linking health care, drug treatment, and HIV services.
2. The health services research agenda must be broadened to include prevention as well as treatment, and treatment should include not just drug abuse treatment but also AIDS treatment and primary care treatment.
3. More research is needed to determine the types of services women are being offered or receiving when they enter drug treatment. For which women are comprehensive programs most cost-effective? What are the treatment outcomes in different types of programs?
4. How does the provision of child care, medical care counseling, family planning services, HIV screening, parenting education, housing assistance, and transportation relate to longterm treatment outcome?
5. Research shows that women drug abusers, particularly those who are pregnant, want and need health care services, but they will end contact with health care providers who appear to judge, blame, or humiliate them because of their drug use. How can drug treatment services be designed to ease the problem of women avoiding or dropping out of drug treatment programs?

HIV/AIDS

1. Research is needed on how best to identify women who are at high risk of HIV infection, particularly women drug users. Services and effective treatment should be made available to these women and they should be consulted with regard to azidothymidine (AZT) intervention before and during their pregnancy.
2. More research is need on eliminating barriers to health care for HIV-infected women and developing new models of care that integrate approaches from the biologic and social sciences.
3. What are the most effective strategies for HIV screening and long-term follow up? Are these strategies effective for women of color and poor women?

Treatment Entry

1. What factors facilitate women entering drug treatment? Both qualitative and quantitative data are needed. It is important for a woman to know what benefits a program can offer to her family while she is in treatment.
2. What are the pathways through which women enter drug treatment? Are court referrals effective in directing women to treatment? It is assumed that women are less likely than men to enter treatment via a correctional system, but there are conflicting research findings.

Barriers to Treatment

1. Conduct research to design drug treatment and health services to address the issue of negative attitudes towards women who abuse drugs in order to decrease recruitment failures and drop out rates.
2. Research is needed on the effects of punitive approaches on the health of drug abusing women and the likelihood of their completing drug treatment.

Cost, Payment, and Cost-effectiveness

1. What are the costs and benefits of different programs, particularly comprehensive programs? For which women are comprehensive programs most cost-effective? Which groups of women need intensive drug treatment? What are the costs of not treating women who need treatment, in terms of physical and mental health costs, protective services, income maintenance programs, and effects on families? These data could be helpful in demonstrating why drug treatment should be covered by health insurance.
2. How do women typically pay for drug abuse treatment? Which groups of women, and what proportion, are self-paying, have private health insurance, or have public insurance?

Ethnic/Racial/Cultural Issues and Populations

Hispanic

1. Research is needed on the problems, needs, and access barriers experienced by Hispanic women who seek drug treatment. What is their rate of participation in treatment, and what factors motivate Hispanic women to seek treatment? How great a barrier for Hispanic women is the absence of Spanish-speaking staff at drug treatment facilities?

Native Americans

1. Research is needed on the barriers to drug abuse treatment faced by Native American women and on prevention, intervention, and treatment strategies that are appropriate to their needs. Better health education and outreach strategies are also needed.

 

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