Abstract:
BACKGROUND:Substance use disorders during pregnancy are a concern both to the public and medical community, because the negative consequences can be detrimental to both mother and the fetus. The accurate identification of prenatal drug exposure is necessary to determine appropriate medical and psychosocial intervention, and to identify risk factors that may affect outcomes for the mother and her newborn. The prevalence of prenatal drug exposure is very difficult to estimate because of flaws in all methods of identification. OBJECTIVE:The study is designed to identify risk factors and demographic variables that contribute to nondisclosure of illicit and nonillicit substance use. In addition, this study aims to determine if nondisclosure leads to adverse neonatal outcomes. STUDY DESIGN:Newborns delivered with a positive meconium or urine toxicology, and/or known maternal exposure to illicit and nonillicit substances, were identified. Maternal records were reviewed for disclosure of substance use during pregnancy at admission for delivery along with other medical and demographic variables. Women with antenatal prescription drug use that may alter toxicology screens were excluded from analysis. Pediatric records were also reviewed to obtain neonatal variables. RESULTS:One hundred sixty-eight newborns were identified as having prenatal exposure to an illicit or nonillicit substance over the 4-year period. Eighty-six per cent (145/168) of women tested positive or their newborn tested positive for at least 1 illicit substance, and 49% (82/168) tested positive for multiple illicit substances. Fifty-four per cent (91/168) of women did not disclose using at least one illicit drug for which she or her newborn tested positive.With regards to maternal characteristics, there was no statistically significant difference between age (P = 0.958), parity (P = 0.300), or race (P = 0.531), and disclosure or failure to disclose about illicit drug use. However, patients who did not report prenatal illicit drug use (33/82 = 40%) were less likely (P = 0.049) to receive complete prenatal care (defined as 3 or more visits) compared with those who acknowledged their substance use (40/70 = 57%). CONCLUSION:Substance use disorders during pregnancy are an often underestimated cause of maternal, fetal, and neonatal complications. Limited studies have examined the relationship between maternal characteristics and associated illicit or nonillicit drug use. The absence of correlation between maternal demographics and disclosure of illicit substance use demonstrates the fact that all antepartum patients are at risk for these behaviors. Furthermore, the fact that women who did not disclose their illicit drug use were less likely to seek complete prenatal care reflects the need for physicians to provide a destigmatized healthcare environment, encouraging pregnant women to disclose their substance use so they can be provided with appropriate counseling and treatment.
journal_name
J Addict Medjournal_title
Journal of addiction medicineauthors
Berra A,Kamo S,Mohnot S,Rosselot J,Suire A,Stafford J,Hagan J,Stafford Idoi
10.1097/ADM.0000000000000521subject
Has Abstractpub_date
2019-11-01 00:00:00pages
464-469issue
6eissn
1932-0620issn
1935-3227journal_volume
13pub_type
杂志文章abstract:OBJECTIVE:Individuals with substance use disorders have a high prevalence of smoking cigarettes. Hospitalization represents an opportunity to deliver concurrent treatment for tobacco and other substances. Using a sequential explanatory mixed methods design, we characterized practices and perspectives of patients and ph...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000503
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVES:Efforts to improve buprenorphine access for opioid use disorder have focused on increasing the number of waivered providers. However, it is unknown how efforts to increase initial prescribing result in a sustained pool of prescribers. We examine the prevalence of year-to-year provider-level buprenorphine pre...
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abstract:OBJECTIVES:Cocaine abuse is widespread in Europe, and Ireland ranks among the leading countries for prevalence of cocaine use among adolescents. This study aimed to examine demographic and substance use correlates of lifetime cocaine use among adolescents with substance use disorder, and to explore the relationship bet...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e318288daa2
更新日期:2013-05-01 00:00:00
abstract::Benzodiazepines are a controversial treatment for anxiety in patients with substance use disorders. Concerns include risk of addiction, overdose, and diversion. But benzodiazepines are among the most effective and well-tolerated treatments for anxiety, and are safe for the majority of patients who take them. Though no...
journal_title:Journal of addiction medicine
pub_type: 社论
doi:10.1097/ADM.0000000000000292
更新日期:2017-03-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
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abstract:OBJECTIVES:: To describe trends in court-mandated treatment in pregnancy. In particular, to determine whether pregnant women who enter treatment via the criminal justice system differ from women who enter voluntarily. METHODS:: Data were obtained from the Treatment Episode Data Set, an administrative data set that cap...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3181b562dc
更新日期:2010-09-01 00:00:00
abstract::This commentary reviews the limitations of the recent literature review by that examined the role of psychosocial interventions with medication for opioid addiction treatment. The commonly held belief that opioid agonist treatment alone is inferior treatment to such treatment combined with 'psychosocial' treatment (wh...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000236
更新日期:2016-07-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3181db69ef
更新日期:2011-03-01 00:00:00
abstract::Tobacco use is a major threat to public health in the United States, and the number one cause of preventable death. Although most smokers try to quit unaided, robust data indicate that pairing behavioral support to US Food Drug Administration-approved cessation medications significantly increase cessation rates. Those...
journal_title:Journal of addiction medicine
pub_type: 杂志文章,评审
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更新日期:2016-09-01 00:00:00
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journal_title:Journal of addiction medicine
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更新日期:2017-11-01 00:00:00
abstract::Fetal alcohol spectrum disorders (FASDs) are conditions caused by prenatal alcohol exposure in amounts sufficient to cause permanent deficits in brain functioning. Extent of damage largely depends on timing, dose, frequency, and pattern of exposure. Timing is especially important because prenatal alcohol exposure duri...
journal_title:Journal of addiction medicine
pub_type: 杂志文章,评审
doi:10.1097/ADM.0b013e31828b47a8
更新日期:2013-03-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000287
更新日期:2017-03-01 00:00:00
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journal_title:Journal of addiction medicine
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doi:10.1097/ADM.0000000000000455
更新日期:2019-01-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1097/ADM.0000000000000504
更新日期:2019-09-01 00:00:00
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journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000055
更新日期:2014-09-01 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
pub_type: 杂志文章
doi:10.1097/ADM.0b013e318045c038
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:This study examined differences in the clinical and treatment-related features of pathological gambling (PG) on the basis of the age of PG onset among pathological gamblers who sought treatment. METHODS:A total of 702 male outpatients with a primary diagnosis of PG and who were treated in a clinical practic...
journal_title:Journal of addiction medicine
pub_type: 杂志文章
doi:10.1097/ADM.0000000000000031
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:: Opioid detoxification with subsequent naltrexone is found to be an effective method as the first step in an abstinence-oriented approach. The aim of this study is to investigate the predictive value of variables for abstinence in opioid-dependent patients. METHODS:: Opioid-dependent patients were followed...
journal_title:Journal of addiction medicine
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doi:10.1097/ADM.0b013e31818a6596
更新日期:2008-01-01 00:00:00
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更新日期:2015-01-01 00:00:00
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更新日期:2013-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2016-07-01 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
pub_type: 杂志文章
doi:10.1097/ADM.0b013e3182a8a4f2
更新日期:2013-11-01 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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更新日期:2018-03-01 00:00:00
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更新日期:2020-12-01 00:00:00