Journal of Addiction & Prevention
Research Article
Horizons’ Outcomes Performance Evaluation: Residential Substance Use Disorder Treatment Outcomes for Pregnant and Parenting Women
Kittaneh AA*a, Andringa Ka, Carter Ga, Pranakoff Sa, Evans Da, Horton Ea, Johnson Ea, McGlothlin Sa and Jones HEa,b
AHorizons Division and Department of Obstetrics and Gynecology,
University of North Carolina at Chapel Hill, Chapel Hill, NC
27510,
BDepartments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224
BDepartments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224
*Address for Correspondence:Ahmad Kittaneh UNC Horizons, 410 North Greensboro St., Carrboro, NC
27510. E-mail Id: akittane@ad.unc.edu
Submission:03 June, 2026
Accepted:19 June, 2026
Published:23 June, 2026
Copyright: © 2026 Kittaneh AA, et al. This is an open access article
distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.
Keywords:Outcomes; Substance Use Disorder; Treatment; Maternal and Child Health; ASAM 3.5
Abstract
Objectives:Pregnant and parenting patients with substance
use disorders (SUDs) face increasing clinical complexity, while
access to long-term residential treatment has declined. This study
examined whether American Society of Addiction Medicine (ASAM)
3.5 residential treatment [1] combined with wraparound services
was associated with improved outcomes during treatment and up
to 24 months following enrollment, and whether treatment duration
influenced these outcomes.
Methods:Participants were pregnant and/or parenting women receiving residential SUD treatment at University of North Carolina (UNC) Horizons between December 2019 and February 2022. Assessments were conducted at intake and at 3, 6, 12, 18, and 24 months postenrollment. Measures included the Addiction Severity Index (ASI) and the Housing Instability Index (HII). Linear mixed models evaluated changes over time and compared outcomes for participants who completed ≥180 days versus <180 days of residential treatment across housing stability and six ASI domains.
Results:N=74 women in residential care were included in this analysis. Most (96.1%) completed the study with minimal missing visits. Significant main effects of time were observed for ASI drug, employment, medical, and psychiatric composite scores, and for housing instability. Post-hoc analyses demonstrated sustained improvements from baseline through multiple follow-up points. Participants who remained in residential treatment for at least six months reported significantly lower substance use across the entire 24-month follow-up period compared to those with shorter stays.
Conclusions: Comprehensive residential treatment with sufficient duration yields durable improvements across life domains for pregnant and parenting women with SUDs. Findings highlight the importance of longer residential stays and have critical implications for treatment and insurance coverage decisions.
Methods:Participants were pregnant and/or parenting women receiving residential SUD treatment at University of North Carolina (UNC) Horizons between December 2019 and February 2022. Assessments were conducted at intake and at 3, 6, 12, 18, and 24 months postenrollment. Measures included the Addiction Severity Index (ASI) and the Housing Instability Index (HII). Linear mixed models evaluated changes over time and compared outcomes for participants who completed ≥180 days versus <180 days of residential treatment across housing stability and six ASI domains.
Results:N=74 women in residential care were included in this analysis. Most (96.1%) completed the study with minimal missing visits. Significant main effects of time were observed for ASI drug, employment, medical, and psychiatric composite scores, and for housing instability. Post-hoc analyses demonstrated sustained improvements from baseline through multiple follow-up points. Participants who remained in residential treatment for at least six months reported significantly lower substance use across the entire 24-month follow-up period compared to those with shorter stays.
Conclusions: Comprehensive residential treatment with sufficient duration yields durable improvements across life domains for pregnant and parenting women with SUDs. Findings highlight the importance of longer residential stays and have critical implications for treatment and insurance coverage decisions.