Substance use during pregnancy is a national health concern. Substance use (alcohol and drugs) by pregnant women is the leading preventable cause of mental, physical, and long-term psychological problems in infants and children (SAMHSA, 2006). Recent national survey findings suggest that alcohol use by pregnant women is significantly rising (SAMHSA, 2006). Women who abuse substances during pregnancy typically have a myriad of psychosocial problems varying from social/emotional issues to medical/health concerns.

This dissertation is guided by a modified version of the Mega Interactive Model of Substance Use Among Women (MIMSUAW) (Pagliaro & Pagliaro, 1996; 2000), a biopsychosocial framework. The MIMSUAW was developed to help clinical social workers understand the complex multidimensional etiology of substance use among women without enforcing a single theoretical focus (Pagliaro & Pagliaro, 1996; 2000). This dissertation study is a secondary data analysis of data obtained from the Center for Addiction and Pregnancy (CAP) at Johns Hopkins Hospital. The sample consists primarily of opiate-dependent pregnant women. For the purposes of this secondary data analysis, the sample consists of the first 111 participants who completed CAP's modified Addiction Severity Index in entirety. Six research questions were examined. Data were analyzed using a hierarchical cluster analysis, ANOVAs, MANOVAs, logistic regressions, and descriptive statistics. Primary research purposes were to: assess if the MIMSUAW is an effective psychosocial assessment; to replicate the Miles, Kulstead, and Haller 2002 cluster subtype study (three clusters were identified); and to assess if sample participants can be classified into alcohol consumption groups (no, low, moderate, and high).

A substantial amount of alcohol consumption and a suggestion of binge drinking were found for the sample. Findings suggest the MIMSUAW is a moderate psychosocial functioning assessment for the study population. The cluster analysis results suggest a three cluster solution indicating three distinct subtypes of pregnant substance using women based on psychosocial characteristics. Alcohol consumption was distinctive for each of the subtypes. A modified alcohol consumption classification was identified. The use of the MIMSUAW model, application of subtypes, and importance of alcohol consumption findings as well as implications for clinical practice, treatment, and future research are discussed.