New Pathways for Women (NPW), funded by the Center for Substance Abuse Treatment (CSAT; 2007-2012), is a community-based,trauma-informed, gender-specific pretreatment program designed to increase women’s readiness for treatment and engage women in a self-directed recovery process. This occurs through three integrated service components which include; (1) community-based assertive outreach and engagement, (2) at least three Motivational Interviewing-based individual recovery support sessions with a Case Manager and (3) twice weekly facilitated group sessions. To be eligible to enroll in NPWwomen,including transgender women, must be 18 years or older, have used a drug other than marijuana in the past 30 days, have not been in a drug treatment program in the past 30 days, and speak English or Spanish. All women enrolled in the project are requested to participate in survey interviews at Intake and approximately 6 months post-enrollment.

This data brief summarizes selectchanges in program outcomesand women’s recovery over time including,drug and alcohol use, substance abuse treatment, physical and emotional health and sexual risk behaviors. Summarized below is a comparison of matched Intake and 6-month follow-up data from surveys conducted with a subset of 190 women who enrolled in NPW between February 6, 2008 and June 30, 2011.

Client characteristics(N=190)

  • 87% are Black or African American.
  • Average age: 43 years old (range=21-61 years old).
  • 77% identified as heterosexual or straight.
  • 52% had less than a high school education; 41% had a high school diploma or GED.
  • Nearly all (94%) wereunemployed.
  • The majority of clients (87%) are crack users.
  • Three out of four (74%) clients had ever been in a drug or alcohol treatment program.
Drug and alcohol use in the past 30 days at Intake and 6-month follow up

One of the main outcomes of NPW is women’s cessation or reduction of substance use. As a pretreatment program targeting women in active addiction, all 190 clients included in this analysis engaged in substance use during the 30 days prior to enrollment in NPW.

  • At 6-month follow up, 65% of clients had abstained from using any illegal drugs in the past 30 days.
  • The proportion of clients who reported abstaining from drinking any alcohol in the past 30 days increased from 30% at Intake to 63% at follow up.
  • Half (54%) of clients reported that they had abstained from both alcohol and drug use during the past 30 days at 6-month follow up.
  • The proportion of clients reporting daily drug use in the past 30 days dropped from 30% to 5%.

The chart below summarizes the proportion of women who used specific drugs or alcohol in the past 30 days at Intake and at 6-month follow up:

Substance used past 30 days / Intake
n (%) / Follow up
n (%) / Amount of reduction
Crack or cocaine / 165 (87) / 42 (22) / -75%
Marijuana / 81 (43) / 38 (20) / -53%
Hallucinogens / 24 (13) / 7 (4) / -71%
Heroin / 20 (11) / 3 (2) / -85%
Percocet / 7 (4) / 3 (2) / -57%
Drank to intoxication / 95 (50) / 67 (35) / -29%
Binge drank / 78 (41) / 53 (28) / -32%

History of substance abuse treatment and participation in self-help meetings

As a pretreatment program for substance-involved women, one of the primary goals of our program is to facilitate access and linkageto substance abuse treatment, and/or other pathways to recovery including self-help groups, as directed by the women enrolled in the program.

  • 4 out of 10 clients entered substance abuse treatment between Intake and 6-month follow up.
  • The proportion of clients who said they had ever been in a drug or alcohol treatment program increased from 73% at Intake to 86% at 6-month follow up.
  • Thirty-one clients who reported that they had never been in a drug or alcohol treatment program at Intake reported at 6-month follow up that they had enrolled in a program.

NPW understands that participation in a drug treatment program is one of a number of recovery support options, therefore we also examined women’s attendance at self-help recovery support groups. These may include faith-based or 12-Step model substance abuse recovery, including those groups conducted at NPW.

  • The proportion of clients who reported they had participated in at least one self-help group in the past 30 days increased from 30% at Intake to 62% at 6-month follow up.
CONCLUSION

Preliminary analysis of Intake and 6-month follow up data provides evidence of promising direct and indirect effects of the New Pathways for Women (NPW) project. Women who enroll in NPW are primarily Black or African American, heterosexually-identified, socioeconomically disadvantaged, and socially isolated. The primary drug of choice for women enrolled in NPW is crack or cocaine, which has been shown to be associated with elevated risk for HIV and other sexually transmitted infections. Comparison of Intake and 6-month follow-up data provides a preview of encouraging improvements over time in reduction of drug and alcohol use and increased enrollment in substance abuse treatment and recovery services.

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