Substance use disorders (SUDs) occur in every socioeconomic class and racial and ethnic group and require a comprehensive approach to screening. While there are evidence based screening tools validated for internal medicine settings, more research is needed to determine best drug use screening approaches in OB-GYN settings. Recommendations from a 2012 Centers for Disease Control and Prevention Expert Meeting on Perinatal Illicit Drug Abuse highlight the need for universal drug screening during pregnancy, and many professional organizations—including the American College of Obstetricians and Gynecologists—recommend it. Using a validated screening tool can help detect substance use that can lead to adverse long-term outcomes in infant growth, behavior, cognition, language, and achievement (Viteri et al., 2015).
Several studies have shown the efficacy of screening, brief intervention, and referral to treatment (SBIRT) for pregnant women using alcohol and tobacco; this approach allows tailored treatment for women based on their pattern of use (Wright et al., 2016). In addition, limited, but promising, evidence suggests that brief interventions reduce illicit drug use among women in the postpartum period (Farr, Hutchings, Ondersma, & Creanga, 2014).
Insights From a Family Medicine Physician
Tipu V. Khan, MD, FAAFP
University of Southern California/California Hospital Medical Center Obstetrics Fellowship
Board Certified in Family and Addiction Medicine Fellowship Director,
Ventura County Medical Center Addiction Medicine Fellowship
Core Faculty, Ventura Family Medicine Residency
Assistant Clinical Professor, University of California at Los Angeles, David Geffin School of Medicine
Special Project: Residency Training
Dr. Khan leads a family medicine primary care residency program in California. His goal as a primary care provider and addiction specialist is to integrate addiction curricula into residents’ training. He hopes to increase and enhance the experiences residents and the next generation of providers have with treating substance misuse and addiction.
Dr. Khan offers these tips for screening for substance misuse in the family medicine setting, with special considerations for screening pregnant women. He encourages you to consider these recommenations if you are just getting started or looking for support in these areas.
Screening for Substance Use: Getting Started
Getting a Positive Screen: What’s Next?
Visit NIDAMED for additional resources for you and your patients.
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