Paper
Saturday, July 14, 2007
An Interagency Response to a Midwestern Epidemic of Methamphetamine, Alcohol, and Prescription Drug Abuse
Martha Hoffman Goedert, CNM, FNP, PhD, Graduate Nursing, Family Nurse Practitioning Program, Clarkson College, Omaha, NE, USA
| Learning Objective #1: legally and morally delineate objective decisions regarding their screening practices for substance abuse during pregnancy.
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| Learning Objective #2: recognize behavioral and clinical presentations resulting from common drugs of abuse and differentiate pregnancy and neonatal effects and complications from these substances. |
The National Survey on Drug Use and Health (NSDUH) reports that there is a 4.3 percent illicit drug use in pregnant women aged 15-44 years in 2003. The rate of drug use for teenagers 15-17 years old is upwards of 15 percent. Increasing rates of substance abuse during pregnancy translates into higher numbers of drug-exposed infants. In one Midwestern state this increased rate has been confirmed, but still lags behind the numbers expected as predicted from the NSDUH report. The discrepancy between what is reported and what should have been reported is mainly due to poor screening practices. Trends in Drug Use in the United States suggests that the predisposition for drug abuse is similar through all racial, economic, and educational strata. Poor single mothers and their infants are more frequently screened for exposure to substances of abuse. When screening identifies substance-abusing pregnant women, a window of opportunity to intervene is opened at a time when women are powerfully motivated to abstain from illicit drug use.
Overwhelmingly positive outcomes of sobriety have been demonstrated with treatment for substance abuse during pregnancy. Treatment affects fetal outcomes with less intensive care admissions due to higher gestational ages and birth weights. Unrecognized infants continue to be exposed to drugs and the associated chaotic life style, lack of supervision, and lack of an involved and nurturing parent.
Key features of this taskforce’s success will be detailed, including creative funding sources. Specific information about the availability of patient education will be presented for use as public service messages.