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Substance abuse/dependence are common psychiatric disorders often associated with other co-morbid diagnoses. These disorders are further complicated by pregnancy. Our knowledge of the biology, diagnosis, treatment and prevention of substance abuse/dependence during pregnancy has evolved slowly over the past few decades. The mechanistic understanding of the consequences of prenatal substance exposure, driven by preclinical data, has advanced. However, clinical research advancing the treatment of this population has been limited, remaining generally dependent on retrospective, epidemiological, and survey-type data. Only recently has prospective pharmacological research in pregnant women been advocated. In the past year, reports of mechanistic actions, the use of pharmacotherapies, long-term outcome effects, risk factors, and the effectiveness of screening and treating licit and illicit drug misuse during pregnancy have been published.