Study Validates Substance Use Screening Protocol
A recent evaluation concluded that implementing a standardized obstetric substance use screening and biologic testing protocol can optimize neonatal drug testing. The study found that structured screening helps reduce both unnecessary interventions and missed cases. This approach supports evidence-based, non-stigmatizing care for at-risk infants and perinatal patients.
- The American College of Obstetricians and Gynecologists (ACOG) recommends universal verbal screening for substance use for all pregnant individuals at the first prenatal visit. This approach is favored over toxicology screening to avoid bias and stigma. - In 2020, it was estimated that 8% to 11% of pregnant women had used alcohol, tobacco, or illicit drugs in the previous month. Another 2020 study found that among pregnant and postpartum women, nicotine dependence was the most common substance use disorder, followed by cannabis and opioid use disorders. - Prenatal substance exposure can lead to a range of adverse outcomes for the infant, including low birth weight, preterm birth, congenital disorders, and Neonatal Abstinence Syndrome (NAS), which is a group of withdrawal symptoms. - In Virginia, licensed practitioners providing prenatal care are required by state law to implement a medical history protocol to screen all pregnant patients for substance use. The results of this screening are confidential and not admissible in criminal proceedings. - Virginia's Medicaid program, through the Addiction and Recovery Treatment Services (ARTS) program, has expanded access to a continuum of care for pregnant enrollees with substance use disorders, including medication-assisted treatment and peer recovery support. - Studies indicate that pregnant women who receive treatment for substance use disorders have improved pregnancy outcomes. However, a 2020 study found that only 7.6% of pregnant women with a substance use disorder received treatment. - Midwives are considered to be in a key position to screen for substance use, provide brief interventions, and refer patients to specialized care. Their role is crucial in offering non-judgmental support to improve maternal and infant outcomes. - Validated screening tools recommended for use in pregnancy include the 4P's, 5P's, T-ACE, and CRAFFT for adolescents. These questionnaires are designed to be brief and effective in identifying potential substance use.
