Parental substance abuse is a risk factor for child maltreatment, neglect and multi-generational drug abuse. Developing efficacious, cost-efficient interventions is critical to addressing this growing problem. This article by Brian Porter, Luz Porter, Virginia McCoy, Mayra Lima, Clare Pryce and Sachin Nunnewar highlights lessons learned during the first year of a study based in Florida to evaluate a novel parenting intervention targeting substance-abusing mothers and their babies

Drug abuse rehabilitation, characterised by high recidivism and difficult-to-access populations, is one of the greatest challenges of modern health care. The estimated annual costs of substance abuse treatment, its co-morbidities and complications were upwards of $300 billion in 1995 (US Department of Health and Human Services 2001). The impact of substance abuse reaches all layers of society, significantly correlating with homelessness, physical abuse and a myriad of psychiatric illnesses, including chronic depression (Palacios et al 1999). Parental substance abuse, in particular, is a known risk factor for child maltreatment and neglect, as well as subsequent drug abuse in the children of substance-abusing parents (Millar and Stermac 2000, Stein et al 2002). In turn, effective treatment necessitates that rehabilitation programmes account for the sociocultural context of clients, their families and the surrounding community (Gabriel 1997, Yin and Kaftarian 1997, Chan et al 2004, Devieux et al 2005, Fisher and Ball 2005, Pantin et al 2005).