Polysubstance use during pregnancy: The importance of screening, patient education, and integrating a harm reduction perspective

Board, Amy; D’Angelo, Denise V.; Essen, Beatriz Salvesen von; Denny, Clark H.; Miele, Kathryn; Dunkley, Janae; Baillieu, Robert; Kim, Shin Y.

doi:10.1016/j.drugalcdep.2023.109872

Cited by 14 publications

(3 citation statements)

References 56 publications

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“…The majority of polysubstance use involved a combination of amphetamines and opioids (55%), but there was also a wide variety of other substance use patterns. Board et al (2023) similarly found a wide variety of polysubstance use patterns during pregnancy and, similarly to our sample, found a high prevalence of co-use of opioids and amphetamines.…”

Section: Discussionsupporting

confidence: 87%

Prenatal substance use and mental health comorbidities predict continued use.

Kruger,

Rodriguez,

Leeman

et al. 2024

Psychology of Addictive Behaviors

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Section: Discussionsupporting

confidence: 87%

Prenatal substance use and mental health comorbidities predict continued use.

Kruger,

Rodriguez,

Leeman

et al. 2024

Psychology of Addictive Behaviors

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“…Other studies have indicated that pregnant women who use one substance (including nicotine) tend to also use others. 5 , 22 , 26 , 30 , 31 , 32 , 33 , 34 We found that of 198 positive cases, 7.1% were positive for two substances (mostly nicotine and cannabis) (Table 1 ).…”

Section: Discussionmentioning

confidence: 88%

Screening of substance use in pregnancy: A Danish cross‐sectional study

Rausgaard,

Ibsen,

Fruekilde

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionThere is a paucity of objectively verified data on substance use among Danish pregnant women. We estimated the prevalence of substance use including alcohol and nicotine among the general population of Danish pregnant women.Material and MethodsIn this anonymous, national, cross‐sectional, descriptive study, pregnant women were invited when attending an ultrasound scan between November 2019 and December 2020 at nine Danish hospitals. Women submitted a urine sample and filled out a questionnaire. Urine samples were screened on‐site with a qualitative urine dipstick for 15 substances including alcohol, nicotine, opioids, amphetamines, cannabis, and benzodiazepines. All screen‐positive urine samples underwent secondary quantitative analyses with gold standard, liquid chromatography‐tandem mass spectrometry (LC–MS/MS) analysis. Results were compared to questionnaire information to analyze the validity of self‐reporting and to examine possible cross‐reactions.ResultsA total of 1903 of 2154 invited pregnant women participated (88.3%). The prevalence of dipstick‐positive urine samples was 25.0%. 44.0% of these were confirmed positive, resulting in a total confirmed prevalence of 10.8%. The prevalence of nicotine use was 10.1%—and for all other substances, <0.5%. Nicotine use was more prevalent among younger pregnant women, while other substance use appeared evenly distributed over age groups. Self‐reporting of use of nicotine products was high (71.1%), but low for cannabis and alcohol intake (0% and 33.3%, respectively). Prescription medication explained almost all cases of oxycodone, methylphenidate, and benzodiazepine use.ConclusionsSubstance use among pregnant women consisted mainly of nicotine. Dipstick screening involved risks of false negatives and false positives. Except for alcohol intake and cannabis use, dipstick analyses did not seem to provide further information than self‐reporting. LC–MS/MS analyses remain gold standard, and future role of dipstick screenings should be discussed.

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“…The third risk factor taken into account in the FAR SEAS project is the use of other psychoactive substances, i.e., tobacco and illicit drugs ( 20 ). The prevalence of current tobacco smokers among Polish women of age 15 + is 17%, e-cigarettes smokers is 4% ( 21 ), lifetime prevalence of any drug among women from 18 to 64 years of age is 10% (the most popular illegal substances is marijuana and hashish, i.e., cannabis products –8% of surveyed women) ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Reducing the risk of prenatal alcohol exposure and FASD through social services: promising results from the FAR SEAS pilot project

Okulicz-Kozaryn,

Segura-García,

Bruguera

et al. 2023

Front. Psychiatry

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IntroductionWithin FAR SEAS, a multi-component evidence-based community intervention was implemented and evaluated in Mazovia (Poland), with the aim of preventing alcohol-exposed pregnancies, and therefore preventing FASD.MethodsMulti-disciplinary professionals from different services (social, addiction, and psychology), recruited women of child-bearing age (pregnant and not pregnant) in local communities, screened them for alcohol risk, and allocated participants (n = 441) to groups for low- (70%), moderate- (23%), or high-risk (7%) of alcohol exposed pregnancy, to provide interventions tailored to their needs. The non-parametric sign test, testing differences between pairs of observations before and after intervention was used to evaluate the outcomes.ResultsFollow-up data (collected from 93% of participants) indicated positive changes in the key outcome variables: risky alcohol consumption dropped by 81%, contraception use increased by 15% and visiting a gynecologist increased by 39%; as well as in associated psychosocial risk factors (decrease in cigarette and drug use, domestic violence and depressive symptoms). No changes were noted in frequency of other service use (medical, psychological, or social). The most prominent changes were observed in the moderate-risk group.DiscussionChanging risky behaviors (alcohol consumption and sex without contraception) to prevent alcohol exposed pregnancies is feasible at the local level, even without engagement of medical professionals. Key challenges, related to engaging professionals and local authorities, must be addressed; and procedures should be adapted to local contexts and needs.

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Polysubstance use during pregnancy: The importance of screening, patient education, and integrating a harm reduction perspective

Cited by 14 publications

References 56 publications

Prenatal substance use and mental health comorbidities predict continued use.

Prenatal substance use and mental health comorbidities predict continued use.

Screening of substance use in pregnancy: A Danish cross‐sectional study

Reducing the risk of prenatal alcohol exposure and FASD through social services: promising results from the FAR SEAS pilot project

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