Abstract
Knowledge of substance use disorders is essential for health care providers treating pregnant women. Early intervention is vital to improve the health and welfare of both the mother and child. This chapter provides an overview of the consequences and treatments of maternal substance use disorders during pregnancy and breast-feeding. Effective techniques for assessment and intervention are reviewed, as well as psychosocial problems that often accompany maternal substance abuse. Information about various illicit drugs is presented along with strategies for managing withdrawal symptoms. This chapter also outlines potential short- and long-term effects on the child from drug exposure during pregnancy and breast-feeding. Reporting and legal issues are addressed for cases of drug- and/or alcohol-dependent women who present late in pregnancy or who do not respond to available treatments before delivery.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Archie, C. (2002) Substance abuse in pregnancy. In: Pregler, J. P. and De Cherney, A. H., eds. Women’s Health: Principles and Clinical Practice. Hamilton, Ontario: BC Decker Inc., pp. 206–217.
Substance abuse during pregnancy: guidelines for screening (2002) Retrieved March 25, 2005, from Washington State Department of Health website: http://www.doh.wa.gov/cfh/mch/documents/screening_guidelines.pdf
Friedmann, P. D., McCullough, D., and Saitz, R. (2001) Screening and intervention for illicit drug abuse: a national survey of primary care physicians and psychiatrists. Arch. Intern. Med. 161, 248–251.
Foster, K. (2003) Protecting fetal neurons. Retrieved April 14,2005, from Sonoma Medicine website: http://www.scma.org/magazine/scp/Fall03/foster.html
ASI Pregnancy Status National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20852. 1-800-729-6686.
Pregnant, substance-using women: treatment improvement protocol (TIP) series. (1993) Retrieved April 19, 2005, from Substance Abuse and Mental Health Services Administration. Center for Substance Abuse Treatment website: http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.section.22581
Guide to clinical preventive services, 2nd ed. Mental disorders and substance abuse: screening for drug abuse. (1996) Retrieved April 5, 2005, from website: http://cpmcnet.columbia.edu/texts/gcps/gcps0063.html
The National Survey on Drug Use and Health Report. (2004) Pregnancy and substance use. Retrieved March 27, 2005, from website: http://www.drugabusestatistics.samhsa.gov/2k3/pregnancy.htm
The DASIS report: Pregnant Women in Substance Abuse Treatment (2002). Retrieved March 21, 2005, from http://www.drugabusestatistics.samhsa.gov/2k4/pregTX/pregTX.htm
Goldberg, M. E. (1995) Substance-abusing women: false stereotypes and real needs. Soc. Work 40, 789–798.
Wilsnack, S. C., Vogeltanz, N. D., Klassen, A. D. and Harris, T. R. (1997) Childhood sexual abuse and women’s substance abuse: national survey findings. J. Stud. Alcohol 58, 264–271.
Martin, S. L., English, K. T., Clark, K. A., et al. (1996) Violence and substance use among North Carolina pregnant women. Am. J. Psychiatry 86, 991–998.
Martin, S. L., Beaumont, J. L.K., and Kupper, L. L. (2003) Substance use before and during pregnancy: links to intimate partner violence. Am. J. Drug Alcohol Abuse 29, 599–617.
National Institute on Alcohol Abuse and Alcoholism (2005) Retrieved April 28, 2005 from website: http://www.niaaa.nih.gov/press/2005/Recovery.htm.
Floyd, R. L., Decoufle, P., and Hungerford, D. W. (1999) Alcohol use prior to pregnancy recognition. Am. J. Prev. Med. 17, 101–107.
Dufour, M. C., Williams, G. D., Campbell, K. E., et al. (1994) Knowledge of FAS and the risks of heavy drinking during pregnancy, 1985 and 1990. In: Fetal Alcohol Syndrome Prevention Research (Hankin, J. R., August 2002). Retrieved April 9,2005, from NIDA website: http://www.niaaa.nih.gov/publications/arh26-1/58-65.htm
Preventing alcohol-exposed pregnancies: increasing public awareness of the risks of alcohol use during pregnancy through targeted media campaigns. (August 2004) Retrieved April 9, 2005, from website: http://www.cdc.gov/ncbddd/fas/pubawarenss.htm
Gomby, D. and Shiono, P. (1991) Estimating the number of substance-exposed infants. In: Hot Topic: Drug-Exposed Children. Retrieved April 1, 2005, from the National Adoption Information Clearinghouse website: http://www.nurtureadopt.org/af/adoptionarticles/drug-expo sedchildren.htm
Kvigne, V. L., Leonardson, G. R., Neff-Smith, M., et al. (2004) Characteristics of children who have full or incomplete fetal alcohol syndrome. J. Pediatr. 145, 635–640.
Jones, K. L., Smith, D. W., Ulleland, C. N., and Streissguth, P. (1973) Pattern of malformation in offspring of chronic alcoholic mothers. Lancet 1, 1267–1271.
Weiner, L. and Morse, B. A. (1988) FAS: clinical perspectives and prevention. In: Chasnoff, I. J., ed. Drugs, Alcohol, Pregnancy and Parenting. Hingham, MA: Kluwer Academic Publishers.
Sokol, R. J. and Clarren, S. K. (1989) Guidelines for use of terminology describing the impact of prenatal alcohol on the offspring. Alcohol Clin. Exp. Res. 13, 597–598.
Michaelis, E. K. and Michaelis, M. L. (2001) Cellular [W1] and molecular bases of alcohol’s teratogenic effects. Retrieved March 23, 2005, from website: http:// www.fetalalcohol.com/articles/docs/Cellmolecular.rtf
Coles, C. (2001) Critical periods for prenatal alcohol exposure: evidence from animal and human studies. Retrieved March 25, 2005, from website: http://www. fetalalcohol.com/articles/docs/CritPeriod.rtf
Rostand, A., Kaminski, M., Lelong, N., et al. (1990) Alcohol use in pregnancy, craniofacial features, and fetal growth. J. Epidemiol. Comm. Health 44, 302–306.
Danis, R. P., Newton, N., and Keith, L. (1981) Pregnancy and alcohol. Curr. Probl. Obstet. Gynecol. 4, 2–8.
Caruso, K. and Bensel, R. (1993) Fetal alcohol syndrome and fetal alcohol effects. J. Clin. Health Aff. 76, 25–29.
Streissguth, A. P., Aase, J. M., Clarren, S. K., et al. (1991) Fetal alcohol syndrome in adolescents and adults. JAMA 265, 1961–1967.
Connor, P. D. and Streissguth, A. P. (2001) Effect of prenatal exposure to alcohol across the life span. NIAAA. Retrieved March 10, 2005, from website: http:// www.fetalalcohol.com/articles/docs/PrenatalExposure.rtf
National Center on Birth Defects and Developmental Disabilities (NCBDDD) and Centers for Disease Control and Prevention. Fetal Alcohol Information. Retrieved November 23, 2005, from website: http://www.cdc.gov/ncbddd/fas/fasask.htm
Dolovich, L. R., Addis, A., Vaillancourt, J. M. R., et al. (1998) Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. Br. Med. J. 317, 839–843.
Ormond, K. and Pergament, E. (1998) Update: Benzodiazepines in pregnancy. Illinois teratogen information services (IT IS) newsletter. Retrieved March 5, 2005, from website: http://www.fetal-exposure.org/BENZOUPDATE.html
Ashton, H. (1995) Toxicity and adverse consequences of benzodiazepine use. Retrieved April 28, 2005, from website: http://www.benzo.org.uk/ashtox.htm.
Gunzerath, L., Faden, V., Zakhari, S., et al. (2004) National Institute on Alcohol Abuse and Alcoholism report on moderate drinking. [editorial] Alcohol. Clin. Exp. Res. 28, 829–847
Mennella, J. (2001) Alcohol’s effect on lactation. AlcoholRes. Health 25, 230–234.
Little R.E., Northstone, K., and Golding, J. (ALSPAC Study Team). (2002) Alcohol, breast-feeding, and development at 18 months. Pediatrics 109, E72.
National Organization for the Reform of Marijuana Laws (NORML). (2001) Multidisciplinary Association for Psychedelic Studies (MAPS) Study shows vaporizers reduce toxins in marijuana smoke. (January 2001) Retrieved April 9, 2005, from website: http://www.canorml.org/healthfacts/vaporizerstudy1.html
U.S. Drug Enforcement Administration. Cannabis. Retrieved April 9, 2005, from the DEA website: http://www.usdoj.gov/dea/pubs/abuse/7-pot.htm
Leweke, F. M., Gerth C. W., and Klosterkotter, J. (2004) Cannabis-associated psychosis: current status of research. CNS Drugs 18, 895–910.
Verdoux, H., Sorbara, F., Gindre, C., et al. (2003) Cannabis use and dimensions of psychosis in a nonclinical population of female subjects. Schizophr. Res. 59, 77–84.
National Survey on Drug Use and Health: pregnancy and substance use (2004) Retrieved on April 21, 2005, from Substance Abuse and Mental Health Services Administration (SAMHSA) website: http://www.oas.samhsa/gov/2k3/pregnancy/pregnancy.pdf
Mathias, R. (January/February 1995) NIDA Survey provides first national data on drug use during pregnancy. Nida Notes 10(1). Retrieved April 9, 2005, from website: http://www.drugabuse.gov/NIDA_Notes/NNVol10N1/NID ASurvey.html
Stocker, S. (March 2000) Marijuana-like compound in womb may influence early pregnancy. Nida Notes 15(1). Retrieved April 9, 2005, from website: http:// www.drugabuse.gov/NID A_Notes/NNVol15N1/M arijuana.html
Fergusson, D. M., Horwood, L. J., and Northstone, K. (2002) Maternal use of cannabis and pregnancy outcome. BJOG Int. J. Obstet. Gynaecol. 109, 21–27.
Fried, P. and Watkinson, B. (1988) 12-and 24-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes and alcohol. Neurotoxicol. Teratol. 10, 305–313.
Day, N., Sambamoorthi, U., Taylor, P., et al. (1991) Prenatal marijuana use and neonatal outcome. Neurotoxicol. Teratol. 13, 329–334.
Day, N., Cornelius, M., Goldschmidt, L., et al. (1992) The effects of prenatal tobacco and marijuana use on offspring growth from birth through three years of age. Neurotoxicol. Teratol. 14, 407–414.
Astley, S. J., Clarren, S. K., Little, R. E., et al. (1992) Analysis of facial shape in children gestationally exposed to marijuana, alcohol, and/or cocaine. Pediatrics 89, 67–77.
Lester, B. M. and Dreher, M. (1989) Effects of marijuana use during pregnancy on newborn cry. Child. Dev. 60, 765-771.
Dreher, M. C., Nugent, K. and Hudgins, R. (1994) Prenatal marijuana exposure and neonatal outcomes in Jamaica: an ethnographic study. Pediatrics 93, 254–260.
Day, N. L. and Richardson, G. A. (2001) Comparative teratogenicity of alcohol and other drugs. Retrieved March 20,2005, from website: http://www.fetalalcohol. com/articles/docs/CompTerat.rtf
Astley, S. J. and Little, R. E. (1990) Maternal marijuana use during lactation and infant development at one year. Neurotoxicol. Teratol. 12(2), 161–188.
Zickler, P. (September 1999) Methamphetamine, cocaine abusers have different patterns of drug use, suffer different cognitive impairments. NIDA Notes 16(5). Retrieved April 15,2005, from website: http://www.drugabuse.gov/NIDA_Notes/ NNVol16N5/Meth_Coc.html
NIDA info facts: crack and cocaine (2005). Retrieved April 9, 2005, from website: http://www.nida.nih.gov/Infofax/Cocaine.html
Pauli, R. M. (December 1996) In depth: cocaine, pregnancy and risk of intrauter-ine death. Newslett. Wisconsin Stillbirth Service Program 3(4). Retreived March 7, 2005, from website: http://www.wisc.edu/wissp/wisspers/dec97001.htm
Addis, A., Moretti, M. E., Ahmed, S. F., et al. (2001) Fetal effects of cocaine: an updated meta-analysis. Reprod. Toxicol. 15, 341–369.
Chiriboga, C. A., Brust, J. C., Bateman, D., et al. (1999) Dose-response effect of fetal cocaine exposure on newborn neurologic function. Pediatrics 103, 79–85
Coles, C. D., Platzman, K. A., Smith, I., et al. (1992) Effects of cocaine and alcohol use in pregnancy on neonatal growth and neurobehavioral status. Neurotoxicol. Teratol. 14, 23–33.
Chiriboga, C. M. (2003) Fetal alcohol and drug effects. Neurologist 9, 267–279.
Zickler, P. ( September 1999) NIDA studies clarify developmental effects of prenatal cocaine exposure. NIDA Notes 14(3). Retrieved March 15, 2005, from website: http://www.drugabuse.gov/NIDA_Notes/NNVol14N3/Prenatal.html
Behnke, M., Eyler, F. D., Warner, T. D., et al. (2005) Outcome from a prospective, longitudinal study of prenatal cocaine use: preschool development at 3 years of age. J. Pediatr. Psychol. E-publication.
Methamphetamine/amphetamine. Retrieved April 25, 2005, from the Indiana State Department of Toxicology website: http://isdt.iusm.iu.edu/METHAMPHETAMINE.htm
NIDA research report series — methamphetamine abuse and addiction: what are the immediate effects of methamphetamine abuse? (2005) Retrieved April 12, 2005, from website: http://www.drugabuse.gov/ResearchReports/methamph/methamph3.html#short
Cohen, J. B., Dickow, A., Horner, K., et al. (2003) Abuse and violence history of men and women in treatment for methamphetamine dependence. Am. J. Addict. 12, 377–385.
NIDA research report series — methamphetamine abuse and addiction: what is the scope of methamphetamine abuse in the United States? Retrieved April 12, 2005, from website: http://www.drugabuse.gov/ResearchReports/Methamph/methamph2.html#scope
Semple, S. J., Grant, I., and Patterson, T. L. (2004) Female methamphetamine users: social characteristics and sexual risk behavior. Women Health 40, 35–50.
Smith, L., Yonekura, M. L., Wallace, T., et al. (2003) Effects of prenatal methamphetamine exposure on fetal growth and drug withdrawal symptoms in infants born at term. J. Dev. Behav. Pediatr. 24, 17–23.
Mackenzie, R. G. and Heischober, B. (1997) Methamphetamine. Pediatr. Rev. 18, 305–309.
Newton, T. F., Kalechstein, A. D., Duran, S., et al. (2004) Methamphetamine abstinence syndrome: preliminary findings. Am. J. Addict. 13, 248–255.
Chang, L., Smith, L. M., LoPresti, C., et al. (2004) Smaller subcortical volumes and cognitive deficits in children with prenatal methamphetamine exposure. Psychiatry Res. 132, 95–106.
Steiner, E., Villen, T., Hallberg, M., and Rane, A. (1984) Amphetamine secretion in breast milk. Eur. J. Clin. Pharmacol. 27, 123–124.
Pharmacodynamics. Retrieved April 1, 2005, from website: http://www.druglibrary.org/schaffer/heroin/ase/chap_2_1.htm
NIDA info facts: heroin (2004) Retrieved April 9, 2005, from website: http://www.drugabuse.gov/PDF/Infofacts/Heroin.pdf
U.S. Drug Enforcement Administration. Heroin. Retrieved April 9, 2005, from the DEA website: http://www.dea.gov/concern/heroin_factsheet.html#2
Leshner, A. I. (June 2001) Continuing concern over imported pharmaceuticals. Hearing before the Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, U.S. House of Representatives. Retrieved on March 16, 2005, from the NIDA website: http://www.nida.nih.gov/Testimony/6-7-01Testimony.html
Alcohol and other drug treatment guidelines for pregnant substance-using women: guide-line 4-opioid stabilization. In: Marion, I. J., chair. Pregnant, Substance-Using Women: Treatment Improvement Protocol (TIP) DHHS publication: Series 2 (1993), 18–21.
Broekhuysen, E. S. (April 2000) Methadone. Retrieved March 22, 2005, from the Office of National Drug Control Policy (ONDCP) website: http://www. whitehousedrugpolicy.gov/publications/factsht/methadone/
Berghella, V., Lim, P. J., Hill, M. K., et al. (2003) Maternal methadone dose and neonatal withdrawal. Am. J. Obstet. Gynecol. 189, 312–317.
Finnegan, L.P. and Kandall, S.R. (1997) Maternal and neonatal effects of alcohol and drugs. In:. Lowinson, H. L., Ruiz, P., Milman, R. B., and Langrod, J. G., eds. Substance Abuse: A Comprehensive Textbook. Baltimore: Williams and Wilkins, pp. 513–534.
Jansson, L. M., Velez, M., and Harrow, C. (2004) Methadone maintenance and lactation: a review of the literature and current management guidelines. J. Hum. Lactation 20, 62–71.
The Medical Letter on Drugs and Therapeutics (February 2003) Retrieved April 28, 2005, from website: http://www.medletter.com/freedocs/buprenorphine.pdf
Johnson, R. E., Jones, H. E., and Fischer, G. (2003) Use of buprenorphine in pregnancy: patient management and effects on the neonate. Drug Alcohol Depend. 70, S87–S101.
Johnson, R. E., Jones, H. E., Jasinski, D. R., et al. (2001) Buprenorphine treatment of pregnant opioid-dependent women: maternal and neonatal outcomes. Drug Alcohol Depend. 63, 97–103.
Fischer, G., Johnson, R. E., Eder, H., et al. (2004) Treatment of opioid-dependent pregnant women with buprenorphine. Addiction 95, 239–244.
Clinical guidelines for the use of buprenorphine in pregnancy. (2003) Retrieved April 25, 2005, from website: http://www.turningpoint.org.au/library/CTG_Bup_Pregnancy_060104.pdf
Brady, J. P., Posner, M., Lang, C., and Rosati, M. J. (1994) Risk and reality: the implications of prenatal exposure to alcohol and other drugs. The Education Development Center, Inc. Retrieved, March 21, 2005, from Risk and Reality, a joint project of the U.S. Department of Health and Human Services (DHHS) and the U.S. Department of Education (ED) website: http://www.aspe.hhs.gov/hsp/cyp/ drugkids.htm
Harris, L. H. and Paltrow, A. A. L. (2003) The status of pregnant women and fetuses in US criminal law. JAMA 289, 1697–1699. Retrieved March 28, 2005, from website: http://jama.ama-assn.org/cgi/content/full/289/13/1697#REF-JMS0402-3-1-21
Dailard, C. and Nash, E. (December 2000) State responses to substance abuse among pregnant women. The Guttmacher Report on Public Policy 3(6) Retrieved March 23, 2005, from website: http://www.guttmacher.org/pubs/tgr/03/6/ gr030603.html
Dailard, C. and Nash, E. (2000) State responses to pregnant substance abuse among women. The Guttmacher Report on Public Policy 3(6) (see table: Laws Pertaining to Pregnant Women Who Use Drugs). Retrieved March 23, 2005, from website: http://www.guttmacher.org/tables/gr030603t.html
MacMahon J. R. (1997) Perinatal substance abuse: the impact of reporting infants to child protective services. Pediatrics 100(5), E1.
About Us. (2003) National Center on Substance Abuse and Child Welfare. Retrieved March 15, 2005, from SAMHSA website: http://www.ncsacw.samhsa.gov/aboutus.asp
The Impact of Substance Abuse on Foster Care. (February 1999) Retrieved April 25, 2005, from website: http://www.connectforkids.org/articles/substance_abuse_foster_care#theories
Substance Abuse and Child Welfare. Retrieved April 22, 2005, from Children’s Home Society website: http://www.chs-wa.org/2_advsubstanceabuseBACK.htm
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Humana Press Inc., Totowa, NJ
About this chapter
Cite this chapter
Miotto, K.A., Suti, E., Hernandez, M.M., Pham, P.L. (2006). Pregnancy and Substance Abuse. In: Hendrick, V. (eds) Psychiatric Disorders in Pregnancy and the Postpartum. Current Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-013-3_7
Download citation
DOI: https://doi.org/10.1007/978-1-59745-013-3_7
Publisher Name: Humana Press
Print ISBN: 978-1-58829-486-9
Online ISBN: 978-1-59745-013-3
eBook Packages: MedicineMedicine (R0)