Making Lemonade Out of Lemons

Davis, Katherine J.; Yonkers, Kimberly A.

doi:10.4088/jcp.11cr07363

Cited by 13 publications

(2 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is unclear if this difference reflects a higher baseline threshold for relapse or a greater commitment to stay clean. There may also be extrinsic factors, such as the involvement of child protective services, which might contribute to the lower rate of relapse (Davis and Yonkers, 2012). …”

Section: Discussionmentioning

confidence: 99%

Perinatal substance use: A prospective evaluation of abstinence and relapse

Forray¹,

Merry²,

Lin³

et al. 2015

Drug and Alcohol Dependence

Self Cite

119

View full text Add to dashboard Cite

Background Substance use decreases in pregnancy but little prospective data are available on the rates of abstinence and relapse for specific substances. This study compared rates of abstinence in pregnancy and relapse postpartum for nicotine cigarettes, alcohol, marijuana, and cocaine. Methods Data from 152 women drawn from a randomized controlled trial comparing psychological treatments for substance use in pregnancy were analyzed. Self-reports of substance use and urine for toxicology testing throughout pregnancy and 3-months, 12-months and 24-months post-delivery were collected. Multivariate Cox models were used to compare rates of abstinence and relapse across substances. Results In pregnancy, 83% of all women achieved abstinence to at least one substance. The mean (SE) days to abstinence was 145.81 (9.17), 132.01 (6.17), 151.52 (6.24), and 148.91 (7.68) for cigarettes, alcohol, marijuana and cocaine, respectively. Participants were more likely to achieve abstinence from alcohol (HR 7.24 (95% CI 4.47-11.72), marijuana (HR 4.06; 95% CI 1.87-6.22), and cocaine (HR 3.41; 95% CI 2.53-6.51), than cigarettes. Postpartum, 80% of women abstinent in the last month of pregnancy relapsed to at least one substance. The mean days to relapse was 109.67 (26.34), 127.73 (21.29), 138.35 (25.46), and 287.55 (95.85) for cigarettes, alcohol, marijuana and cocaine, respectively. Relapse to cocaine was only 34% (HR 0.34; 95% CI 0.15-0.77) that of cigarettes. Conclusions Pregnancy-related abstinence rates were high for all substances except cigarettes. Postpartum relapse was common, with cocaine using women being less likely to relapse after attaining abstinence compared to women using cigarettes, alcohol or marijuana.

show abstract

Section: Discussionmentioning

confidence: 99%

Perinatal substance use: A prospective evaluation of abstinence and relapse

Forray¹,

Merry²,

Lin³

et al. 2015

Drug and Alcohol Dependence

Self Cite

119

View full text Add to dashboard Cite

show abstract

“…Loss of custody, termination of parental rights, and fear of incarceration contribute to decreased retention rates in health and social services. 29 , 32 Fear was a common sentiment among pregnant and parenting women with OUDs as they expressed worry and stress over child welfare involvement. They described this as being counterproductive to their recovery and a potential trigger for substance use relapse.…”

Section: Stigma Perinatal Suds and Nasmentioning

confidence: 99%

The Role of Stigma in the Nursing Care of Families Impacted by Neonatal Abstinence Syndrome

Recto

McGlothen-Bell

McGrath

et al. 2020

Advances in Neonatal Care

View full text Add to dashboard Cite

Background: The current US opioid crisis has resulted in a significant increase in opioid use disorder among pregnant and parenting women. Substance use disorders, in general, are highly stigmatized conditions. Stigma serves as a well-documented global barrier to health-seeking behaviors and engagement in healthcare. While extensive research exists on the stigma of mental illness, few studies have explored the stigma experienced by families impacted by neonatal abstinence syndrome (NAS). Purpose: Therefore, the purpose of this article is to explore the role of stigma in the care of families impacted by NAS. Methods: In this article, we present a discussion about the effects of stigma on this patient population and provide exemplars of stigma experiences from our previous research and the existing literature. Findings/Results: Mothers of infants with NAS faced the challenges of overcoming stigma as they were often ostracized, excluded, and shamed. Nurses who provide care for these women and their infants have reported experiencing ethical distress, moral distress, and compassion fatigue. Implications for Practice: Greater awareness of the impact of opioid use on the maternal–child population has resulted in numerous educational offerings for healthcare providers; however, this alone is not adequate to end stigma. Fortunately, promising tools and methods have been developed for assisting nurses with addressing stigma in a manner that can be both nonconfrontational and highly effective. Implications for Research: Future research is needed to explore and evaluate the efficacy of various existing strategies for counteracting harmful stigma in this patient population.

show abstract