Population: Pregnant or postpartum patients using alcohol or illicit drugs.

Organizations

WHO 2014, ASAM 2020, CMQCC 2020

Recommendations

–Ask all pregnant women about their use of alcohol and other illicit drugs at prenatal visits.

–Offer a brief intervention and individualized care to all pregnant women using alcohol or drugs.

–Refer pregnant women with alcohol, cocaine, or methamphetamine abuse to a detoxification center.

• Women with opioid use disorder should continue a structured opioid maintenance program with either methadone or buprenorphine.

• Women with a benzodiazepine use disorder should gradually wean the dose.

–Encourage mothers with a substance abuse history to breastfeed unless the risks outweigh the benefits.

–Carefully monitor and treat infants of substance abusing mothers.

Sources

–The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder. https://www.asam.org/Quality-Science/quality/2020-national-practice-guideline http://www.who.int/substance_abuse/activities/pregnancy_substance_use/en/

–California Maternal Quality Care Collaborative Opiate Use Disorder Toolkit. https://www.cmqcc.org/qi-initiatives/mother-baby-substance-exposure-initiative