Prenatal Substance Abuse and Treatment
As a result of participating in this activity, learners should have a working knowledge of the following topics, essential to competency in addiction medicine and identify areas where more study may be needed:
- Epidemiology of alcoholism and addiction in women (including tobacco)
- Overview of screening tools designed for this population
- Overview of office-based brief interventions with pregnant patients and new moms,
- Changes in drug dosing/volume of distribution or metabolism during pregnancy
- Effects on the fetus of mode of maternal drug use (oral, intravenous, intranasal, inhalation, IM) and type of drug used
- Obstetrical complications and pregnancy-related disorders and complications involving alcohol, tobacco and drugs (preterm, SABO, ID, nutrition, routine medical care)
- Routes of fetal/neonatal exposure to alcohol, tobacco and drugs (placenta/nursing/second hand), fetal/perinatal effects of such exposure and if there are peaks of vulnerability (neurological/physical/ cognitive)
- Pharmacologic and non-pharmacologic intervention for neonatal intoxication and withdrawal for opioids and sedatives,
- Clinical management of the alcoholic/addicted/smoking pregnant patient (evidence-based, pharmacologic, residential, etc),
- Treatment modalities that work better or worse on this population or are contraindicated and why,
- FAS, cognitive and behavioral diagnoses secondary to in-utero alcohol and drug exposure.
- Management of adverse impact of alcohol on the fetus,
- Ethical/legal/liability considerations.
- Briefly describe the design, outcome, limitations and clinical implications of the MOTHERS Study.
Nancy Goler, MD
Dr. Goler is a physician in the Department of Obstetrics and Gynecology at Kaiser Permanente in Napa and Solano County. She is the Regional Medical Director of Kaiser Permanente''s Early Start Program linking pregnant women with substance abuse treatment and has published research on the efficacy of the program.
Dr. Goler has no relevant financial relationships with commercial interests
- 0.50 AAPA
- 0.50 AMA Category 1
- 0.50 CAADAC