Managing Pregnancy and Substance Use Disorders Using a Reproductive Justice Framework-VIDEO: Compassionate Care of Substance Use During Pregnancy and Beyond

Video Transcription

Video Summary

In this video, Tricia Wright, an obstetrician and addiction medicine specialist at the University of California, San Francisco, discusses screening and treating substance use disorders in pregnancy. She begins by addressing the historical perception of addiction as a man's disease and highlights the increase in addiction among women, particularly during the opioid epidemic.<br /><br />Wright emphasizes the need for validated screening tools to identify substance use disorders in pregnant individuals. She mentions several examples, such as the NIDA-4, 4Ps, and SIRT-P, which can be followed by assessments if positive. The video then delves into the practical aspects of assessing substance use and managing pain in opioid-dependent pregnant individuals. Wright emphasizes the importance of maintaining opioid agonist pharmacotherapy, such as methadone or buprenorphine, for the treatment of opioid use disorders in pregnancy. These medications have been endorsed by the American College of Obstetricians and Gynecologists and offer numerous benefits, including a reduction in overdose-related deaths and engagement in prenatal care.<br /><br />The video also touches on urine toxicology as a screening tool, opioid management during labor, and post-operative pain management. Wright discusses the challenges of treating pain in opioid-dependent pregnant individuals due to increased opioid tolerance and the emotional component of pain. She recommends a multimodal approach and reminds healthcare providers to carefully assess and prescribe pain medications to avoid under or over-treatment.<br /><br />The video concludes with a focus on alcohol use disorders during pregnancy. Wright highlights the targeting of women in alcohol advertising and discusses the harmful effects of alcohol on fetal development, emphasizing the importance of screening and counseling pregnant individuals regarding alcohol use. She also addresses the role of stigma in substance use disorders and urges healthcare providers to use person-first language and approach addiction with empathy and support.<br /><br />Creator Credits: Dr. Tricia Wright, Obstetrician and Addiction Medicine Specialist, Clinical Professor at the University of California, San Francisco

Keywords

substance use disorders

pregnancy

treatment options

maternal mortality

screening tools

opioid use disorder

pain management strategies

alcohol use disorder