Drug-Exposed Infant Flashcards
Barriers to Accessing Supports and Resources
Stigma & judgement from HCP
Lack of childcare
Limited financial resources
Lack of transportation
Limited family or social support
Difficulty accessing treatment & care that addresses both addiction concerns & prenatal care
Treatment & Support
Treatment & support options for pregnant women with substance use concerns should include a combination of:
- prenatal care
- nutritional support
- Withdrawal mangement
- addiction treatment
- supportive maternity care & NICU
- housing options
- Family & parenting support
- Advocacy & outreach
Who’s at risk?
Always ask all women
Who’s at Higher Risk?
- poverty
- poor prenatal care
- poor nutrition and health
- psychiatric/mental health issues
- partner/parenting issues
- polydrug use
what is a polydrug?
alcohol
cigarettes
marijuana
prescription drugs
stimulants
opioids
Stimulants
Speed
Cocaine
methamphetamine (crystal meth)
Opioids
heroin
methadone
codeine
Which are Most Often Used?
- Alcohol
- Nicotine
- Cannabis
- Prescription drugs (pain, sleep, tranquilizers)
- Illicit drugs
When do drugs do the most harm
FIRST TRIMESTER
- does harm at each stage
Harm Reduction
A pragmatic approach that accepts active substance use as a fact and assumes that substance users must be engages where they are, not where the provider thinks they should be. It recognizes that substance use and its consequences vary among a continuum of harmful effects for the user and the community, and that behaviour generally changes by small incremental steps
Guiding Principles Guiding principles for Perinatal Care for Substance Using Women and their Newborns
- women with substance use concerns are encouraged to participate in their own care, in their baby’s care, and in discharge planning for both themselves & their babies
- information about potential risks of substance use in pregnancy and available options & resources is necessary for women to make informed decisions
- harm reduction is most promising approach to reducing drug-related harm to women, their babies, & society
- safety and well being of mother & her baby is of primary importance; early involvement of interdisciplinary team is essential to reduce negative impact of socioeconomic deprivation on pregnancy outcomes for mother & baby
- All health care providers are obligated to intervene where negative attitudes from other staff or patients are expressed towards women with substance misuse concerns
Duty to Report
Under section 14, every person has a duty to report situations where they have a reason to believe that a child needs protection
“Duty to report” does not become a legal requirement until a child is born
No laws specific to substance use during pregnancy in Canada
Neonatal Urine Drug Screening
Accuracy depends on timing of drug exposure prior to testing & metabolism of drug by individual
Collect as soon as possible after birth
Screening requires confirmation of substances detected from Provincial Toxicology
Strong argument exist against routine urine drug testing & meconium screening immediately following birth
HAVE TO HAVE CONSENT
What is NAS?
Neonatal Abstinence Syndrome
Narcotic Withdrawal Signs
Constellation of Symptoms
CNS irritability
GI dysfunction
Respiratory distress
Autonomic hyperfunction
