Abstract:
BACKGROUND:Screening for prenatal drug use is recommended. The NIDA-modified Alcohol, Smoking, and Substance Involvement Screening Test (NM-ASSIST) is a screener for drug use that has not yet been validated with pregnant women. This study aims to assess the substance-specific diagnostic validity of the NM-ASSIST (not including tobacco or alcohol) in pregnant women and determine optimal cut-points for substance-specific substance involvement (SI) scores. METHODS:Five hundred (500) pregnant women were recruited from 2 obstetric practices as part of a larger study of substance use screeners. Participants completed the NM-ASSIST, and provided urine and hair samples for testing. Receiver-operating characteristic curves were derived to determine the optimal SI score cut-points for each drug. FINDINGS:Prevalence estimates of prenatal drug use as determined by hair/urine drug testing were: cannabis (32.0%), cocaine (9.9%), benzodiazepines (1.0%), prescription opioids (4.3%), and street opioids (1.7%). The proportion of participants screening positive based on optimal SI score cut-points were as follows: cannabis (39.1%), cocaine (2.3%), benzodiazepines (0.8%), prescription opioids (2.7%), and street opioids (1.7%). There were no screen positives for amphetamines, but 6 (1.2%) women had a positive amphetamine hair or urine test. Optimal cut-points to identify prenatal drug use were: cannabis, 2 (area under the curve [AUC] 0.87; sensitivity 0.82; specificity 0.85; diagnostic odds ratio [DOR] 26.9); cocaine, 2 (AUC 0.58; sensitivity 0.17; specificity 0.99; DOR 29.0); benzodiazepines, 15 (AUC 0.59; sensitivity 0.20; specificity 0.99; DOR 38.8); prescription opioids, 3 (AUC 0.61; sensitivity 0.25; specificity 0.98; DOR 18.3); and street opioids, 4 (AUC 0.55; sensitivity 0.13; specificity 0.99; DOR 9.3). CONCLUSIONS:The NM-ASSIST reliably distinguished pregnant women who use cannabis from those who do not, but performed poorly for all other substances. More research is needed to identify screeners that reliably detect all prenatal drug use. Although more cost-prohibitive, a combination of self-report and toxicological screening may be preferable for detecting prenatal drug use.
journal_name
J Addict Medjournal_title
Journal of addiction medicineauthors
Oga EA,Mark K,Peters EN,Coleman-Cowger VHdoi
10.1097/ADM.0000000000000614subject
Has Abstractpub_date
2020-09-01 00:00:00pages
423-430issue
5eissn
1932-0620issn
1935-3227pii
01271255-202010000-00014journal_volume
14pub_type
杂志文章abstract:OBJECTIVE:The aim of the study is to determine length of stay and length of treatment in infants with neonatal abstinence syndrome (NAS) in the neonatal intensive care unit (NICU) compared to those in the pediatric floor. METHODS:Retrospective cohort of infants ≥34 weeks gestation admitted with diagnosis of NAS at a s...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000455
更新日期:2019-01-01 00:00:00
abstract::The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed...
journal_title:Journal of addiction medicine
pub_type: 杂志文章,实务指引
doi:10.1097/ADM.0000000000000166
更新日期:2015-09-01 00:00:00
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journal_title:Journal of addiction medicine
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更新日期:2014-11-01 00:00:00
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journal_title:Journal of addiction medicine
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更新日期:2013-01-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000112
更新日期:2015-05-01 00:00:00
abstract::: With the growing public interest in the potential therapeutic benefits of cannabis and cannabinoids in the treatment of opioid use disorder (OUD), some states have now either added or proposed to add OUD as an indication for their state's medical marijuana program. However, these initiatives are based on weak eviden...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000711
更新日期:2020-09-08 00:00:00
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pub_type: 杂志文章
doi:10.1097/ADM.0000000000000458
更新日期:2019-01-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000765
更新日期:2020-11-03 00:00:00
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journal_title:Journal of addiction medicine
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journal_title:Journal of addiction medicine
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doi:10.1097/ADM.0b013e318288daa2
更新日期:2013-05-01 00:00:00
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更新日期:2020-09-01 00:00:00
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journal_title:Journal of addiction medicine
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更新日期:2016-01-01 00:00:00
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doi:10.1097/ADM.0b013e31815b5590
更新日期:2008-03-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000020
更新日期:2014-05-01 00:00:00
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更新日期:2020-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-03-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e31823ae56d
更新日期:2012-06-01 00:00:00
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doi:10.1097/ADM.0b013e31815b32df
更新日期:2007-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/ADM.0000000000000109
更新日期:2015-03-01 00:00:00
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更新日期:2014-05-01 00:00:00
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更新日期:2011-09-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2013-03-01 00:00:00
abstract::Although buprenorphine is approved for use in the outpatient treatment of opioid addiction in 2 tablet formulations, a monoproduct containing buprenorphine only (Subutex) and a buprenorphine/naloxone combination product (Suboxone), much of the clinical data that support the approval by the U.S. Food and Drug Administr...
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pub_type: 杂志文章
doi:10.1097/ADM.0b013e31806dcc3e
更新日期:2007-06-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000508
更新日期:2019-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/ADM.0b013e31817e6105
更新日期:2008-09-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000331
更新日期:2017-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/ADM.0000000000000266
更新日期:2017-01-01 00:00:00