3. Cigarette smoking. The extent of the patient’s smoking should be further discerned, as she admits to smoking one cigarette every 1-2 days. Given her desire to quit harmful substances and her success at quitting amphetamines and Zanex, it is possible that she is struggling to cease smoking and/or not admitting to the full extent of her use. She may be offered pharmacotherapy to aid in cessation. Both nicotine replacement therapy and Buproprion are first-line options in pregnancy [1]. Smoking cessation is particularly recommended in pregnant, opioid-addicted women, as smoking delays the onset and increases the severity of NAS [2], and smoking is also associated with increased post-partum narcotic requirements [3].
DISCUSSION:
Early screening. In the case of Ms. A, an opportunity was missed early in her pregnancy to identify her drug use and initiate prenatal care and addiction treatment. Prevalence of substance use is high among pregnant women and crosses all demographics. In a 2013 survey of pregnant women, 5% reported illicit drug use in the past month, 15.4% reported smoking cigarettes, and 9.4% reported drinking alcohol [4]. Early initiation of prenatal care and treatment should be the
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Opiate substitution therapy with either methadone of buprenorphine has numerous advantages over continued drug use. These include oral route of administration, drugs of known dose and purity, reliable availability, reduced criminal activity, reduced withdrawal symptoms, consistent prenatal care, and improved maternal and neonatal outcomes [1]. Furthermore, treatment should be initiated as early as possible, as longer treatment duration has been shown to associated with increased length of gestation and birth weight [1]. Medication-assisted withdrawal has also been shown to be safe for both the mother and fetus, and it reduces NAS [5]. However, substitution therapy remains standard due to decreased rates of maternal recidivism
Neonatal Abstinence Syndrome (NAS) is a group of problems a newborn experiences when exposed to addictive drugs that the mother consumes during pregnancy. NAS is a growing concern in the United States and can have significant adverse effects on newborns. Shortly after birth the infant can display many physical symptoms of withdrawal. In addition, substance abuse during pregnancy can cause premature birth, low birth weight, seizures, birth defects, Sudden Infant Death Syndrome (SIDS), and possible long-term cognitive and behavioral problems.
According to Brady and Ashley “Pregnant women with substance abuse issues faced many internal barriers to treatment. These include shame and fear of being judged by care providers, fear of being reported to social services and losing custody of children and public assistance resources, and co-morbid conditions such as depression and anxiety.If pregnant drug abusers know they will be punished for their actions, they will be less likely to search for help. Causing even greater complications in the fetus’s condition, instead of the mother seeking help to solve her addiction problem.” Just try to put yourself in the shoes of one of these
who used cigarettes and alcohol while pregnant and kids who are exposed to high levels of
Levinthal, C.F. (2005). Effects of psychoactive drugs on pregnant women and newborns (Ed.), Drugs, behavior, and modern society (4th ed., pp.45). Boston: Allyn and Bacon.
Magri, Raquel, et al. "Advances in the Determination of Alcohol and Other Drug Consumption during Pregnancy: A Study of 900 Births in Montevideo, Uruguay." Contemporary Drug Problems 34.3 (2007): 445,476,381. ProQuest. Web. 8 Apr. 2014.
Scharnberg, Kirsten. "Pregnant Addicts Face Rise in Prosecutions." SIRS.com. Chicago Tribune (Chicago, IL), 26 Nov. 2003. Web. 27 Oct. 2013.
Evidence of increasing drug use among pregnant women comes from many parts of the country. NIDA estimates that of the women of childbearing age (15 to 44 years), 15 percent are current subs...
The literature suggests that pregnancy is a motivating factor for obtaining substance treatment. Consequently, as a time of crisis, while as high as 50 % of women drop out of treatment, these women have a compelling reason to begin and sustain changes to afford them the opportunity to successfully parent their child by achieving and maintaining recovery. This formative evaluation utilized an experimental design with randomization of families to either a standard of care group or wraparound service provision in the Strong Start program. Pregnant women age 18-44 enrolling in a specialized substance treatment program were informed of the study. Randomization utilized minimization software to ensure the groups were balanced for key indicators such as court ordered to treatment, open child welfare case, or previous termination of parental rights.
This essay is aimed to explore, analyse and discuss smoking in adults. Smoking is a public health issue as such is one of the major contributors to high mortality and ill-health in the adults which is preventable (Health and Excellence Care (NICE) (2012). The United Kingdom (UK) is known to have the highest number of people with a history of smoking among people with low socio-economic status (Scriven and Garman, 2006; Goddard and Green, 2005). Smoking is considered a serious epidemic in the UK and the National institute for Health and Excellence Care (NICE, 2012) stated that 28% of adults with low economic status are tobacco smokers compared with 13% of those with economic status or having professional incomes. Furthermore almost 80,000 people died in England in 2011 as a result of smoking related issues and 9,500 admissions of children died due to being second hand smokers (WHO, 2005). This essay focuses on definition of smoking, the aim is to underline the relationship between smoking and the determinants of health and then, the size, prevalence, and morbidity trend of smoking will be explored. Furthermore, some public health policies introduced to confront the issues around smoking will be investigated and finally, the roles of nurses will identify health needs the public so as to promote good health and their wellbeing.
Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.
Substance abuse is a problem that exist all over the world, it’s affecting men, women, and children from all society level. Prenatal substance abuse remains a major problem in the United States and poses important health risk for a growing baby (Behnke & Smith, 2013). Treatment 4 addiction (T4a) mentioned approximately 2 to 3% of birth deficiency are the consequences of using other drugs than alcohol. Drug and alcohol or any other substances are recognized to have dangerous effect on the fetus. All drugs that that cross the placenta have somehow affected the fetus (Behnke & Smith, 2013).
The topic of interest I chose to write my article review on was babies born with neonatal abstinence syndrome. Drugs are extremely impacting our society in negative ways. Women who are addicted to drugs do not make the best decisions. One of the worst decisions they make is to have unprotected sex and get pregnant while still using. When babies are born addicted because their mothers used during the pregnancy they will have what is known as neonatal abstinence syndrome. In 2012, every 25 minutes a baby was born with NAS. In total that year there was 21,732 babies born addicted. These babies didn't even have the choice, they were born addicts. This will effect them negatively for the rest of their lives, and more than likely cause them to be an addict themselves. A child's mental health is so important during their younger months, and being
A growing issue that continues to go on today is the drug and alcohol abuse by pregnant women. This has become a growing issue due to the fact that pregnancy is starting at a much younger age. Women tend to become pregnant around the age of 15 to 44 (“Birth Data”). In young women among the ages of 18 to 24, the alcohol and tobacco rates were 25.5 percent and 15.5 percent, respectively (Chen). As of 2001, about 12 percent of all pregnant women admitted to consuming alcohol during their pregnancy (Burd). Out of the 4 million or so births in the United States, 64,000 have had high levels of exposure to alcohol while pregnant (Burd). Similarly, teenagers and those in their early adulthood are getting exposed to all different types of drugs. Both of these facts are the leading causes to the increase of drug and alcohol abuse by pregnant women. Another rising issue that is still going on up to this day is whether or not abortion should be legal. Due to the fact that in some states, having an abortion is considered murder; drug and alcohol abuse during pregnancy should be dealt with in a similar way. Drug and alcohol use not only makes an impact on the life of the mother but also puts the unborn baby in risk of danger. Drug and alcohol abuse during pregnancy has many adverse long term effects on a child and should be punished as a crime.
Handler, A., Kristin, N., Davis, F., & Ferre, C. (1991). Cocaine use during pregnancy: Perinatal outcome. American Journal of Epidemiology, 133, 818-825.
Chambers, C. D., Polifka, J. E., & Friedman, J. M. (2008). Drug safety in pregnant women and their babies: ignorance not bliss. Clinical Pharmacology & Therapeutics, 83(1), 181-183.