Perinatal Substance Abuse and Neonatal Abstinence

Abstract

A pproximately 15% of women aged 15 to 44 years use drugs at some point during their pregnancy. 1 Substance-abusing women face a multitude of challenges that interfere with successful recovery and obtaining prenatal care, including financial stability, housing, poor interpersonal relationships, domestic abuse, depression, anxiety, poor self-esteem, poorly developed coping patterns, difficulty trusting, and unrealistic expectations of self and infant. 2 Women are most often identified as the primary caregiver of their children; thus, maternal psychopathology can directly influence the perinatal time period. 2 Although prenatal care settings face numerous challenges to meet clinical needs in fast-paced, highdemand environments, they offer a crucial opportunity to engage substance-abusing women in physical and mental healthcare needs. Comprehensive assessment and treatment may improve long-term recovery outcomes for the mother-infant dyad. Thus, understanding the risks of perinatal substance abuse and the need for assessment and treatment is critical.Articles in this issue focus on the risks of perinatal substance abuse, the importance of screening and detection, and treatment needs. In the first article, Worley writes about the significant mounting problem of prescription drug abuse and the risk to pregnancy. Prescription drug abuse occurs upward toward 20% among pregnant women. 3 Prescription drugs used to treat pain and psychiatric disorders are most commonly misused. Identifying abuse among perinatal women requires not only routine screening but also healthcare settings that demonstrate trust and nonjudgment. Pregnant women commonly will hesitate to report such abuse due to feelings of shame, guilt, and fear of involvement of child services. Worley discusses perinatal risks, assessment, and treatment recommendations related to prescription drug abuse.