Prenatal and Postpartum Care of Women with Substance Use Disorders
Abstract
The incidence of substance abuse in pregnancy is substantial and affects pregnancy health and outcomes. Multiple challenges exist in the identification of women with substance abuse disorders in pregnancy and the provision of care. A multidisciplinary approach has been shown to be most successful in providing comprehensive and effective care. This article outlines key aspects of prenatal and postpartum care, with a brief overview provided of intrapartum care. Issues covered include screening, opioid replacement therapy, comorbid medical and psychiatric conditions, environmental stressors, parenting preparation, pain management in labor and postpartum, breastfeeding guidance, prevention of relapse, and assistance with postpartum transition to primary care.
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A 2016 review by Richards and colleagues found that calcium channel blockers can lower hypertension and vasospasm but may not affect tachycardia, while benzodiazepines seem safe for non-cardiovascular symptoms.
“In a systematic review focused on cocaine-related cardiovascular toxicity, Richards et al (2016) concluded that calcium channel blockers may decrease hypertension and vasospasm but not necessarily tachycardia, whereas benzodiazepines appear safe for non-cardiovascular related symptoms.153”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [153]
Limited data indicate that alpha-2 adrenergic agonists (e.g., dexmedetomidine for severe symptoms, clonidine for mild to moderate symptoms) are beneficial for stimulant-induced agitation and can help with hypertension and tachycardia.
“Limited data indicate that alpha-2 adrenergic agonists (eg, dexmedetomidine for more severe symptoms, clonidine for mild to moderate symptoms) are beneficial in treating stimulantinduced agitation and can also be useful in the treatment of hypertension and tachycardia and, thus, should be considered in the management of the hyperadrenergic state of stimulant intoxication.152,153”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [153]
Dexmedetomidine was reported to successfully treat cocaine-associated hypertensive emergencies, while propranolol, sodium nitroprusside, nifedipine, labetalol, and phentolamine were reported to successfully treat ATS-associated hypertensive emergencies.
“All evidence came from case reports and case series; cocaine-associated hypertensive emergencies were successfully treated with dexmedetomidine, and ATS-associated hypertensive emergencies were successfully treated with propranolol, sodium nitroprusside, nifedipine, labetalol, and phentolamine.”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [153]
The evidence base for treating stimulant-associated hypertensive emergency consisted entirely of case reports and case series.
“All evidence came from case reports and case series; cocaine-associated hypertensive emergencies were successfully treated with dexmedetomidine, and ATS-associated hypertensive emergencies were successfully treated with propranolol, sodium nitroprusside, nifedipine, labetalol, and phentolamine.”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [153]
Two systematic reviews examined treatment for stimulant-associated hypertensive emergency.
“Two systematic reviews were identified that examined treatment for stimulant-associated hypertensive emergency.152,153”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [153]
Cites
Psychosocial interventions for supporting women to stop smoking in pregnancy
Chamberlain, C., O'Mara-Eves, A., Porter, J., Coleman, T., Perlen, S. M., Thomas, J., & McKenzie, J. E. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001055.pub5 · Cited by 650 · see citing works
Harm reduction: come as you are.
Marlatt, G. A. (1996) · Addictive Behaviors · doi:10.1016/0306-4603(96)00042-1 · Cited by 620 · see citing works
Maintenance Medication for Opiate Addiction: The Foundation of Recovery
Bart, G. (2012) · Journal of Addictive Diseases · doi:10.1080/10550887.2012.694598 · Cited by 461 · see citing works
Psychosocial interventions for supporting women to stop smoking in pregnancy
Chamberlain, C., O'Mara-Eves, A., Oliver, S., Caird, J. R., Perlen, S. M., Eades, S. J., & Thomas, J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001055.pub4 · Cited by 251 · see citing works
Treatment of opioid-dependent pregnant women: Clinical and research issues
Jones, H. E., Martin, P. R., Heil, S. H., Kaltenbach, K., Selby, P., Coyle, M. G., Stine, S. M., O'Grady, K. E., Arria, A. M., & Fischer, G. (2008) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2007.10.007 · Cited by 191 · see citing works
Suchman, N., Pajulo, M., DeCoste, C., & Mayes, L. (2006) · Family Relations · doi:10.1111/j.1741-3729.2006.00371.x · Cited by 162 · see citing works
Appleyard, K., Berlin, L. J., Rosanbalm, K. D., & Dodge, K. A. (2011) · Prevention Science · doi:10.1007/s11121-010-0193-2 · Cited by 154 · see citing works
Postpartum Substance Use and Depressive Symptoms: A Review
Chapman, S. L. C., & Wu, L.-T. (2013) · Women & Health · doi:10.1080/03630242.2013.804025 · Cited by 125 · see citing works
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The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder
(2024) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000001299 · Cited by 78 · see citing works
Lopian, K. M., Chebolu, E., Kulak, J. A., Kahn, L. S., & Blondell, R. D. (2019) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2018.11.002 · Cited by 16 · see citing works
- Authors
- Gopman, S.
- Affiliations
- University of New Mexico (US)
- Corresponding author
- Gopman, Sarah
- Venue
- Obstetrics and Gynecology Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 41
- Issue
- 2
- Pages
- 213-228
- ISSN
- 0889-8545 (ISSN-L)
- OpenAlex
- W2030887951
- Cited by
- 88
- References
- 8
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 6 · 2023: 2 · 2022: 11 · 2021: 10 · 2020: 9 · 2019: 13 · 2018: 7 · 2017: 12 · 2015: 4 · 2014: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- substance use disorders in pregnancy, prenatal care, postpartum care, intrapartum care, screening, opioid substitution therapy, psychiatric comorbidity, environmental stressors, parental preparation, labor analgesia, postpartum pain management, breastfeeding, relapse prevention, transition to primary care, multidisciplinary care
- MeSH terms
- Mental Disorders, Female, Humans, Physician-Patient Relations, Postnatal Care, Pregnancy, Prenatal Care, Referral and Consultation, United States, Women's Health, Practice Guidelines as Topic, Substance-Related Disorders, Opiate Substitution Treatment
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