Pregnancy and Substance Abuse

Substance abuse is increasing in incidence worldwide, including pregnant women who are highly vulnerable to its effects. Pregnant women should be screened routinely for substance abuse. Because self-report may be unreliable, toxicology screens can be useful, especially if multiple drugs are being abused. Each individual drug has unique maternal and fetal effects. Licit substances such as alcohol, nicotine, and caffeine are more frequently abused. Complete cessation of alcohol should be encouraged to avoid the development of Fetal Alcohol Syndrome (FAS) and long-term neurobehavioral effects. Marijuana is the most commonly abused illicit drug. Opioid maintenance programs can be utilized in opioid addicted patients (including heroin and cocaine) to avoid relapses. Neonatal abstinence syndrome should be expected in these infants and managed appropriately.