Laura P McLafferty1, Madeleine Becker2, Nehama Dresner3, Samantha Meltzer-Brody4, Priya Gopalan5, Jody Glance5, Guitelle St Victor6, Leena Mittal7, Patrick Marshalek8, Laura Lander8, Linda L M Worley9. 1. Christiana Care Health System, Newark, DE. Electronic address: mclafferty.laura@gmail.com. 2. Thomas Jefferson University, Philadelphia, PA. 3. Northwestern University Feinberg School of Medicine, Chicago, IL. 4. University of North Carolina School of Medicine, Chapel Hill, NC. 5. Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA. 6. Nassau University Medical Center, East Meadow, NY. 7. Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 8. West Virginia University School of Medicine, Morgantown, WV. 9. Veterans Health Administration, Fayetteville, AR.
Abstract
BACKGROUND: Women of reproductive potential with substance use disorders, especially those who are pregnant, present many clinical challenges to healthcare providers, including comorbid psychiatric disorders, a history of trauma and abuse, avoidance of or poor access to prenatal care, fear of legal consequences, and countertransference reactions. METHODS: In November 2013, members of the Women's Mental Health Special Interest Group of the Academy of Psychosomatic Medicine presented a Workshop reviewing substance abuse in pregnancy, highlighting the specific contributions that psychosomatic medicine specialists can make in the care of these patients. The discussion focused on epidemiology; maternal and fetal risks; and screening and treatment considerations for tobacco, alcohol, cannabis, opioids, benzodiazepines, stimulants, and several other substances. OBJECTIVE: Our purpose in publishing this review is to provide clinicians and educators with the most up-to-date summary in this field to better engage these patients in care and break the intergenerational cycle of abuse and addiction.
BACKGROUND:Women of reproductive potential with substance use disorders, especially those who are pregnant, present many clinical challenges to healthcare providers, including comorbid psychiatric disorders, a history of trauma and abuse, avoidance of or poor access to prenatal care, fear of legal consequences, and countertransference reactions. METHODS: In November 2013, members of the Women's Mental Health Special Interest Group of the Academy of Psychosomatic Medicine presented a Workshop reviewing substance abuse in pregnancy, highlighting the specific contributions that psychosomatic medicine specialists can make in the care of these patients. The discussion focused on epidemiology; maternal and fetal risks; and screening and treatment considerations for tobacco, alcohol, cannabis, opioids, benzodiazepines, stimulants, and several other substances. OBJECTIVE: Our purpose in publishing this review is to provide clinicians and educators with the most up-to-date summary in this field to better engage these patients in care and break the intergenerational cycle of abuse and addiction.