The Brown Center For The

Study Of Children At Risk






Brown Center for the Study of Children at Risk
50 Holden Street
Providence RI 02908

Academic Administration:
(401) 453-7640

Clinical Services:
(401) 274-1122
x8936 or x8935

Contact Us

 

Intervention

Maternal Opioid Treatment: Human Experimental Research

Though clearly beneficial, the use of methadone during pregnancy remains controversial in part due to the large percentage of newborns having signs of opioid withdrawal requiring medical intervention and extended hospitalization.  A new medication, Buprenorphine, is approved by the Food and Drug Academic Administration: ( (FDA) for the treatment of non-pregnant opioid dependent patients and produces only a mild abstinence syndrome following abrupt withdrawal.  This randomized, parallel group study is the first multi-site trial to assess in opioid-dependent pregnant women the efficacy of buprenorphine for reducing withdrawal relative to methadone. Johns Hopkins School of Medicine (Dr. Hendree Jones) is the Lead Site for this study involving six United States and two international sites study. Opioid-dependent pregnant women at the Brown site in New Bedford will be randomized to optimal doses of methadone or buprenorphine and followed throughout pregnancy. Treatment groups will be compared on the primary outcome measures related to severity of withdrawal.  This study will provide pivotal data to the FDA to support an indication for the use of buprenorphine during pregnancy and potentially optimize strategies for safe and effective treatment of pregnant opioid-dependent women. The study is directed by Dr. Mara Coyle at Women and Infants Hospital and St. Lukes Hospital. For more information contact: Lee Breault at lbreault@wihri.org.

Outcome of the Rhode Island Family Treatment Drug Court-After ASFA

After ASFA: Outcome of the Rhode Island Family Treatment Drug Court (FTDC), examines the long-term trajectories of parents who participate in FTDC, the developmental outcomes of their substance-exposed infants, and the success of the FTDC in complying with the Adoption and Safe Families Act (ASFA) guidelines for permanent placement.  Parenting and child assessments are done at 6 month intervals between infant ages of 12 to 30 months.  This project will provide the first longitudinal preliminary descriptive data on participants of a FTDC specifically designed for perinatal substance users.  The outcome measures from this study includes data on parent and child strengths and vulnerabilities.  Factors that affect substance-using parents’ ability to successfully become the permanent placement for their infant, including home environments, substance use, mental health, parenting attitudes, social support and child abuse potential are examined.  Study results can be applied to developing more efficacious services for perinatal substance users and their children and to better inform public policy decisions related to families affected by perinatal substance use.  This work is being done in collaboration with Chief Judge Jeremiah at the Rhode Island Court and the National Perinatal Information Center.  For more information contact: Jean Twomey, at jtwomey@wihri.org.

Postpartum Sleep Effects on Smoking Relapse – The Rest Assured Study

Rates of postpartum smoking relapse are high (70-90%) among women who quit smoking in anticipation of or during pregnancy, despite the fact that relapse is unintentional for a substantial number of these women. In addition to well-established health consequences for smokers, maternal smoking poses health risks for infants, including respiratory and gastrointestinal problems. Standard relapse prevention interventions are not effective for postpartum women. Sleep loss and sleep fragmentation, prevalent for the first 3 months postpartum, may contribute to this problem. Poor sleep is known to diminish stress management skills and behavioral coping and may impact relapse prevention among new mothers through these and other mechanisms. The primary goals of this project are 1) to measure unique postpartum factors, such as sleep duration and continuity, to see if those factors affect new mothers’ ability to stay smoke-free and 2) to develop, refine, and pilot test an integrative smoking relapse prevention intervention for postpartum women called Rest Assured. The long-term objective of this research is to foster postpartum relapse prevention for women with a history of smoking, which, in turn, would improve the overall health of postpartum women and their families. For more information contact: Kristen Stone, PhD at kstone@wihri.org.