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CHICAGO — Careful screening for substance abuse in pregnant women and recognizing that intervention can make a difference for these patients and their offspring are two important ways to improve obstetric outcomes.
Physicians might also examine the attitudes and biases they bring to their treatment of expectant patients who are chemically dependent.
“We need to remember that addiction is a disease, not a moral failure, and that patients can change,” said Dr. Ellen Mason, an internist and attending physician in the department of obstetrics and gynecology at John H. Stroger Jr. Hospital, Chicago, in a presentation on substance abuse and psychiatric disorders among pregnant women.
“For doctors, [pregnancy and substance abuse] is not just a medical issue, it's a personal issue. In medicine, regardless of how much [physicians] think they're detached or nonjudgmental, they have a lot of trouble being nonjudgmental about [chemically dependent] women” and often view these patients as neglectful or deliberately hurting their fetuses, she said.
She stressed, however, that “treatment is ultimately more successful for women when they are not made to feel like monsters or made to feel more guilty than they already feel. Some patients, regardless of how much bravado they display … feel terrible about it.”
In her presentation, Dr. Mason cited the 2005 National Survey on Drug Use and Health (www.oas.samhsa.gov
She urged physicians to “translate ethical principals into [practices] that will serve our patients well and help them succeed.”
These practices include using the “Five A's,” the screening and behavioral counseling intervention for alcohol misuse recommended by the U.S. Preventive Services Task Force (Ann. Intern. Med. 2004;140:554–6), which asks physicians to take these steps:
▸ Assess alcohol consumption with a brief screening tool followed by clinical assessment as needed.
▸ Advise patients to reduce alcohol consumption to moderate levels.
▸ Agree on individual goals for reducing alcohol use or abstinence (if indicated).
▸ Assist patients with acquiring the motivation, self-help skills, and support needed for behavior change.
▸ Arrange follow-up support and repeated counseling, including referring dependent drinkers for specialty treatment.
CHICAGO — Careful screening for substance abuse in pregnant women and recognizing that intervention can make a difference for these patients and their offspring are two important ways to improve obstetric outcomes.
Physicians might also examine the attitudes and biases they bring to their treatment of expectant patients who are chemically dependent.
“We need to remember that addiction is a disease, not a moral failure, and that patients can change,” said Dr. Ellen Mason, an internist and attending physician in the department of obstetrics and gynecology at John H. Stroger Jr. Hospital, Chicago, in a presentation on substance abuse and psychiatric disorders among pregnant women.
“For doctors, [pregnancy and substance abuse] is not just a medical issue, it's a personal issue. In medicine, regardless of how much [physicians] think they're detached or nonjudgmental, they have a lot of trouble being nonjudgmental about [chemically dependent] women” and often view these patients as neglectful or deliberately hurting their fetuses, she said.
She stressed, however, that “treatment is ultimately more successful for women when they are not made to feel like monsters or made to feel more guilty than they already feel. Some patients, regardless of how much bravado they display … feel terrible about it.”
In her presentation, Dr. Mason cited the 2005 National Survey on Drug Use and Health (www.oas.samhsa.gov
She urged physicians to “translate ethical principals into [practices] that will serve our patients well and help them succeed.”
These practices include using the “Five A's,” the screening and behavioral counseling intervention for alcohol misuse recommended by the U.S. Preventive Services Task Force (Ann. Intern. Med. 2004;140:554–6), which asks physicians to take these steps:
▸ Assess alcohol consumption with a brief screening tool followed by clinical assessment as needed.
▸ Advise patients to reduce alcohol consumption to moderate levels.
▸ Agree on individual goals for reducing alcohol use or abstinence (if indicated).
▸ Assist patients with acquiring the motivation, self-help skills, and support needed for behavior change.
▸ Arrange follow-up support and repeated counseling, including referring dependent drinkers for specialty treatment.
CHICAGO — Careful screening for substance abuse in pregnant women and recognizing that intervention can make a difference for these patients and their offspring are two important ways to improve obstetric outcomes.
Physicians might also examine the attitudes and biases they bring to their treatment of expectant patients who are chemically dependent.
“We need to remember that addiction is a disease, not a moral failure, and that patients can change,” said Dr. Ellen Mason, an internist and attending physician in the department of obstetrics and gynecology at John H. Stroger Jr. Hospital, Chicago, in a presentation on substance abuse and psychiatric disorders among pregnant women.
“For doctors, [pregnancy and substance abuse] is not just a medical issue, it's a personal issue. In medicine, regardless of how much [physicians] think they're detached or nonjudgmental, they have a lot of trouble being nonjudgmental about [chemically dependent] women” and often view these patients as neglectful or deliberately hurting their fetuses, she said.
She stressed, however, that “treatment is ultimately more successful for women when they are not made to feel like monsters or made to feel more guilty than they already feel. Some patients, regardless of how much bravado they display … feel terrible about it.”
In her presentation, Dr. Mason cited the 2005 National Survey on Drug Use and Health (www.oas.samhsa.gov
She urged physicians to “translate ethical principals into [practices] that will serve our patients well and help them succeed.”
These practices include using the “Five A's,” the screening and behavioral counseling intervention for alcohol misuse recommended by the U.S. Preventive Services Task Force (Ann. Intern. Med. 2004;140:554–6), which asks physicians to take these steps:
▸ Assess alcohol consumption with a brief screening tool followed by clinical assessment as needed.
▸ Advise patients to reduce alcohol consumption to moderate levels.
▸ Agree on individual goals for reducing alcohol use or abstinence (if indicated).
▸ Assist patients with acquiring the motivation, self-help skills, and support needed for behavior change.
▸ Arrange follow-up support and repeated counseling, including referring dependent drinkers for specialty treatment.