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These guidelines have been developed to enable professionals to assist women who are pregnant, or have recently had a child, and who use alcohol or drugs or who have a substance use disorder, to achieve healthy outcomes for themselves and their fetus or infant. They have been developed in response to requests from organizations, institutions and individuals for technical guidance on the identification and management of alcohol, and other substance use and substance use disorders in pregnant women. They were developed in tandem with the WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy.
This book provides a first in-depth, comprehensive, and evidenced-based overview of the treatment of substance use disorders in the pregnant patient. It provides readers with materials that will not only aid them in identifying, assessing, and understanding the issues involved in treating these women, but also the practical tools to implement the best practices from comprehensive care programs specializing in this sort of treatment. Each chapter strikes a balance between the best scientific information available and reasoned, clinical wisdom to fill in where evidence-based information is unavailable -- all in a form that is practical and accessible. It is a valuable tool for clinicians and service providers across disciplines.
This book provides a first in-depth, comprehensive, and evidenced-based overview of the treatment of substance use disorders in the pregnant patient. It provides readers with materials that will not only aid them in identifying, assessing, and understanding the issues involved in treating these women, but also the practical tools to implement the best practices from comprehensive care programs specializing in this sort of treatment. Each chapter strikes a balance between the best scientific information available and reasoned, clinical wisdom to fill in where evidence-based information is unavailable — all in a form that is practical and accessible. It is a valuable tool for clinicians and service providers across disciplines.
Gain guidance and support when treating the high-risk population of women confronting (or battling) opioid-use disorders during pregnancy.
With the emergence of the biological sciences in the seventeenth and eighteenth centuries, some explanations of congenital malformations with a basis in scientific fact were formulated. It was not, however, until the thalidomide tragedy in 1961 that the necessity for further study of the effects of environmental factors on congenital malformations was recognized. By the early 1970s concentrated efforts had begun to be directed toward evaluating the effects on the unborn child of mood-altering drugs taken during pregnancy. Over the past decade, research and treatment programs have led to the recognition of a full range of psychoactive drugs that affect the developing fetus either somatically or behaviorally. Programs for the treatment of the pregnant drug addict have been developed which concentrate not only on the pharmacologic therapy of the woman but also on the social and psychologic characteristics that place her and her unborn child at risk. This book is an attempt to bring together clinicians and researchers who have been active in developing programs for the recognition and management of the chemically dependent pregnant woman and her newborn. The contributions of the multiple disciplines which the authors represent emphasize the need for a multifactorial approach to the problems of drug use and abuse during pregnancy. It is hoped that through this type of approach a better future for substance-exposed infants, innocent bystanders in the process of addiction, can be assured. Ira J. Chasnoff vii Contributing Authors I. J. CHASNOFF, MD W.
Alcohol and other drugs of abuse cause significant physi ological changes, especially during development. The effects on the infant and child range from severe mental retardation to mild changes in activity and neurological functions. Although the level of intake needed to cause fetal damage is not clear, the magnitude of the problem is significant, with many long-term sequelae. As a result, it becomes critical to better diagnose and manage drug and alcohol use during pregnancy. This must involve special training for health care professionals. In addi tion, recognition of the psychosocial factors affecting alcohol use, especially by youth and young adults, is critical to modi fying behavior, and thus reducing fetal alcohol exposure. Cultural considerations can also come into play in modi fying alcohol and drug use by women so as to reduce fetal damage. The trends in alcohol and drug use by youth forecast rising levels of damage to infants. These children will need extensive medical and educational care for years to decades. Clearly, understanding of the role women must take in modifying their alcohol and drug use during pregnancy will facilitate changes in our cultural and educational practices that will help reduce fetal trauma from alcohol.
The Interfaces of Perinatal Addiction Ira J ChasnofT In the last few years, problems associated with drug use in pregnancy have become endemic. As cocaine has become the drug of choice for millions of Americans, including pregnant women, as AIDS has become more commonly recognized in women and infants, and as legal cases have begun to raise the question of fetal abuse, no professional group has come forward to serve as advocate for this special population of substance abusers. Meanwhile, however, physicians, nurses, social service agencies and public health officials have all been faced with increasing numbers of infants showing the detrimental effects of their mothers' drug use. Although problems of substance abuse in pregnancy have received increasing attention in the medical literature since the early 1970s, there has recently been a very rapid increase in the number of articles published related to this field. The reasons for this new interest are easily understood when current statistics from the National Institute on Drug Abuse are reviewed 1. Although patterns of abuse of alcohol, marijuana, heroin and other substances by women of childbearing age have changed very little over the last ten years, the incidence of cocaine use in this special population has been rising rapidly, a reflection of cocaine's increasing popularity among the general population of the United States.
Fleshes out the story that is dominated by data concerning the effect of drugs on the unborn, by listening to pregnant or recently delivered women who take addictive drugs. Drawing on interviews with 120 such women, two sociologists explore such issues as how they decide whether or not to terminate their pregnancy, what their parents and family members think about the situation, and what options are available to them if they choose to keep the baby but kick the habit. Annotation copyrighted by Book News, Inc., Portland, OR