A Multi-national pre-consensus survey: The principles of treatment of substance use disorders during pregnancy

Abstract

While substance use disorders during pregnancy are a problem that every nation and community faces, there is a lack of written consensus or guidance on the principles that should serve as the foundation for best treatment practices for these women during this finite life experience. An on-line survey was completed by 62 individuals representing 22 countries. Findings from this pre-consensus survey indicate over 90% agreement on many of the principles of treating pregnant women for substance use disorders found in the literature. These data suggest that substance-using pregnant women are in need of treatment for abuse of multiple and diverse substances and that treatment must be readily available, dynamic, monitored, individualized, and address multiple social, medical, psychological functioning, and psychiatric issues in an integrated way. Areas where agreement fell below 90% included: (a) the efficacy of medications to treat nicotine-dependent pregnant patients; (b) incarceration as an ineffective intervention for stopping substance use during pregnancy; and (c) the need for treatment to be voluntary. These data also indicate strong support for a global consensus statement on the principles of substance use treatment during pregnancy. These findings, representing respondents from 22 countries from 6 continents, provide the critical momentum needed to pursue a formal global consensus statement on the principles of substance use treatment during pregnancy in an effort to improve the treatment of this vulnerable population of women.