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Implementing Best Practice When Screening Birthing People for a Substance Use Disorder.

Sheila Kaufman1, Patricia D Suplee2, Damali M Campbell-Oparaji3

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|October 24, 2024
PubMed
Summary
This summary is machine-generated.

Screening for substance use disorder (SUD) in pregnancy requires validated tools, not routine urine drug tests. Evidence-based screening connects pregnant individuals to essential counseling and treatment.

Keywords:
certified midwifecertified nurse‐midwifemidwiferyprenatal careracismsubstance abuse detectionsubstance‐related disorderstoxicology

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Area of Science:

  • Obstetrics and Gynecology
  • Addiction Medicine
  • Midwifery Care

Background:

  • Screening for substance use disorder (SUD) is a critical component of comprehensive antepartum care.
  • Validated screening tools are recommended for early identification of at-risk pregnant individuals.
  • Urine toxicology testing is often misused as a screening tool, despite evidence against its routine use.

Purpose of the Study:

  • To review evidence-based tools for SUD screening in pregnancy.
  • To discuss the limitations and potential harms of urine toxicology testing in this population.
  • To highlight the role of midwifery care in implementing effective SUD screening.

Main Methods:

  • Review of current literature on SUD screening tools in pregnancy.
  • Analysis of the diagnostic limitations and clinical implications of urine toxicology testing.
  • Examination of best practices for integrating SUD screening into midwifery workflows.

Main Results:

  • Validated screening instruments are effective for identifying SUD risk during pregnancy.
  • Routine urine toxicology testing can lead to misinterpretation and negative consequences for patients.
  • Midwifery care models offer opportunities for improved SUD screening implementation.

Conclusions:

  • Evidence-based screening tools are superior to urine toxicology testing for SUD identification in pregnancy.
  • Addressing the misuse of urine toxicology testing is crucial for patient well-being.
  • Midwives are uniquely positioned to enhance SUD screening and linkage to care for pregnant individuals.