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Mathias H, Foster LA, Rushton A. Programs and practices that support pregnant people who use drugs' access to sexual and reproductive health care in Canada: a scoping review. BMC Pregnancy Childbirth 2024; 24:72. [PMID: 38254076 PMCID: PMC10804510 DOI: 10.1186/s12884-023-06225-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Pregnant people who use unregulated drugs (PPWUD) are at high risk of health complications yet experience a range of barriers to sexual and reproductive health care. Given that improving maternal health and access to reproductive health care are key targets underpinning the Sustainable Development Goals (SDG), there is an urgent need to improve access to appropriate supports and services for this population. Little is known about what programs and practices exist to support PPWUD's access to sexual and reproductive health care. This scoping review aimed to identify the available literature on these programs and practices in Canada. METHODS A scoping review was conducted using JBI methodology and reported using PRISMA guidelines. Scholarly databases and grey literature sources were searched to identify literature published between 2016-2023 in English or French that discussed, defined, conceptualised, or evaluated programs and practices that support PPWUD's access to sexual and reproductive health care in Canada. Identified literature was screened using Covidence. Data were extracted from included texts, then analysed descriptively. Frequencies and key concepts were reported. RESULTS A total of 71 articles were included, most of which were grey literature. Of the total, 46 unique programs were identified, as well as several useful practices. Most programs were in urban centres in Western Canada, and most programs offered holistic 'wrap-around services.' Several programs delivered these services on-site or as 'drop-in' programs with the support of staff with lived/living experience of substance use. Most frequent program outcomes included keeping parents and children together, improving connection to other services, and reducing substance use harms. Noted helpful practices included non-judgmental care and the use of harm-reduction strategies. CONCLUSIONS Several programs and practices that support PPWUD exist in Canada, though few focus exclusively on sexual and reproductive health. There remain opportunities to improve access to programs, including expanding geographic availability and range of services. The review has clinical application by providing an overview of available programs that may support clinicians in identifying services for PPWUD. Future research should consider client perspectives and experiences of these programs. REVIEW REGISTRATION NUMBER Open Science Framework https://osf.io/5y64j .
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Affiliation(s)
- Holly Mathias
- School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
| | - Lesley Ann Foster
- Department of Cultural Studies, Queen's University, 99 University Ave, Kingston, ON, K7L 3N6, Canada
| | - Ashleigh Rushton
- Faculty of Health Sciences, The University of the Fraser Valley, 45190 Caen Ave, Chilliwack, B.C, V2R 0N3, Canada
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Tele A, Kathono J, Mwaniga S, Nyongesa V, Yator O, Gachuno O, Wamalwa D, Amugune B, Cuijpers P, Saxena S, McKay M, Carvajal L, Lai J, Huang KY, Merali Z, Kumar M. Prevalence and risk factors associated with depression in pregnant adolescents in Nairobi, Kenya. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 10. [PMID: 36970124 PMCID: PMC10038142 DOI: 10.1016/j.jadr.2022.100424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Background Adolescent parenthood can be associated with a range of adverse outcomes for young mothers such as depression, substance abuse, and posttraumatic stress disorder. Identification of depression and understanding risk factors among pregnant adolescents is important for development of appropriate interventions and programs focused on adolescent mental health. This paper reports on the findings of the prevalence of depression and its associated risk factors among pregnant adolescents in Nairobi, Kenya. Methods We recruited 153 pregnant adolescent (14-18 years) who were accessing maternal health services in one of two Nairobi County primary health care facilities in the cross-sectional survey conducted in 2021. The Patient Health Questionnaire 9 was used to screen for depression. Multivariate Stepwise linear regression modelling was used to identify key predictors of depression. Results Using a cut off of 10 and above on PHQ-9, we found that 43.1% of the respondents were depressed. Depressive symptoms in were independently associated with being in school, experience of intimate partner violence, substance use within the family and having experienced pressure to use substances by family or peers. Limitations Cross-sectional by design and the applications of our findings are limited to settings that are similar to our study population. The PHQ-9 used has not been psychometrically validated locally in this sample. Conclusion We found a high prevalence of depressive symptoms among respondents. These risk factors identified merit further investigation. Comprehensive mental health screening needs to be integrated in primary and community health services on the possible presence of depression.
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Jaguga F, Kiburi SK, Temet E, Barasa J, Karanja S, Kinyua L, Kwobah EK. A systematic review of substance use and substance use disorder research in Kenya. PLoS One 2022; 17:e0269340. [PMID: 35679248 PMCID: PMC9186181 DOI: 10.1371/journal.pone.0269340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives The burden of substance use in Kenya is significant. The objective of this
study was to systematically summarize existing literature on substance use
in Kenya, identify research gaps, and provide directions for future
research. Methods This systematic review was conducted in line with the PRISMA guidelines. We
conducted a search of 5 bibliographic databases (PubMed, PsychINFO, Web of
Science, Cumulative Index of Nursing and Allied Professionals (CINAHL) and
Cochrane Library) from inception until 20 August 2020. In addition, we
searched all the volumes of the official journal of the National Authority
for the Campaign Against Alcohol & Drug Abuse (the African Journal of
Alcohol and Drug Abuse). The results of eligible studies have been
summarized descriptively and organized by three broad categories including:
studies evaluating the epidemiology of substance use, studies evaluating
interventions and programs, and qualitative studies exploring various themes
on substance use other than interventions. The quality of the included
studies was assessed with the Quality Assessment Tool for Studies with
Diverse Designs. Results Of the 185 studies that were eligible for inclusion, 144 investigated the
epidemiology of substance use, 23 qualitatively explored various substance
use related themes, and 18 evaluated substance use interventions and
programs. Key evidence gaps emerged. Few studies had explored the
epidemiology of hallucinogen, prescription medication, ecstasy, injecting
drug use, and emerging substance use. Vulnerable populations such as
pregnant women, and persons with physical disability had been
under-represented within the epidemiological and qualitative work. No
intervention study had been conducted among children and adolescents. Most
interventions had focused on alcohol to the exclusion of other prevalent
substances such as tobacco and cannabis. Little had been done to evaluate
digital and population-level interventions. Conclusion The results of this systematic review provide important directions for future
substance use research in Kenya. Systematic review registration PROSPERO: CRD42020203717.
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Affiliation(s)
- Florence Jaguga
- Department of Mental Health, Moi Teaching & Referral Hospital,
Eldoret, Kenya
- * E-mail:
| | | | - Eunice Temet
- Department of Mental Health & Behavioral Sciences, Moi University
School of Medicine, Eldoret, Kenya
| | - Julius Barasa
- Population Health, Academic Model Providing Access to Healthcare,
Eldoret, Kenya
| | - Serah Karanja
- Department of Mental Health, Gilgil Sub-County Hospital, Gilgil,
Kenya
| | - Lizz Kinyua
- Intensive Care Unit, Aga Khan University Hospital, Nairobi,
Kenya
| | - Edith Kamaru Kwobah
- Department of Mental Health, Moi Teaching & Referral Hospital,
Eldoret, Kenya
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Determinantes sociais da saúde e o uso de drogas psicoativas na gestação. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao0340345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gómez-Ruiz LM, Marchei E, Rotolo MC, Brunetti P, Mannocchi G, Acosta-López A, Ramos-Gutiérrez RY, Varela-Busaka MB, Pichini S, Garcia-Algar O. Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women. Pharmaceuticals (Basel) 2022; 15:ph15030382. [PMID: 35337179 PMCID: PMC8953434 DOI: 10.3390/ph15030382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 12/15/2022] Open
Abstract
For the first time, the present study employed hair testing to investigate the prevalence of classical drugs of abuse and new psychoactive substances use during gestation in a cohort of 300 Mexican pregnant women. An interview was conducted to collect data on sociodemographic aspects of the patients, and a 9 cm-long hair strand was taken from the back of the head of each mother one month after delivery. A validated ultra-high-performance liquid chromatography−high-resolution mass spectrometry method was used for the screening of classic drugs, new psychoactive substances, and medications in maternal hair. Out of 300 examined hair samples from pregnant women, 127 (42.3%) resulted positive for psychoactive substances: 45 (35.4%) for cannabis only, 24 (18.9%) for methamphetamine only, 13 (10.2%) for cocaine only, 1 (0.3%) for heroin, 1 for N-N-dimethyltryptamine (0.3%), 1 for ketamine (0.8%), and 35 (16.3%) for more than one psychoactive substance. Furthermore, seven samples (2.3%) resulted positive for new psychoactive substances (NPS): two samples for synthetic cannabinoids, two for synthetic cathinones, and three for nor-fentanyl, and 3.3% of women hair resulted positive for anticonvulsant, antidepressant, and antipsychotic medications. Finally, 83 women hair samples (27.7%) tested positive for nicotine. Nonsteroidal anti-inflammatory drugs (NSAIDs) and other painkillers (60.0%), medications for the treatment of nausea and vomiting (12.3%), antihistamines (8.7%) and nasal/sinus decongestants (6.7%), cough suppressants (5.0%), and bronchodilator agents (5.0%) were also detected in pregnant women hair. The gestational use of psychoactive substances and exposure to tobacco smoke, assessed by hair testing, were associated with a significantly younger age and with a low education grade of the mothers (p < 0.005). This study provides a significant preliminary indication of the under-reported gestational consumption of licit and illicit psychoactive and pharmacologically active drugs in a Mexican environment, showing the value of toxicological and forensic analyses in the global effort to determine the health risks caused by classic drugs and new psychoactive substances during pregnancy.
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Affiliation(s)
- Larissa-María Gómez-Ruiz
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Barcelona, 08036 Barcelona, Spain;
| | - Emilia Marchei
- National Centre on Addiction and Doping, Italian National Institute of Health (ISS), V.Le Regina Elena 299, 00161 Rome, Italy; (E.M.); (M.C.R.)
| | - Maria Concetta Rotolo
- National Centre on Addiction and Doping, Italian National Institute of Health (ISS), V.Le Regina Elena 299, 00161 Rome, Italy; (E.M.); (M.C.R.)
| | - Pietro Brunetti
- Unit of Forensic Toxicology, Section of Legal Medicine, Department of Excellence of Biomedical Scienc-Es and Public Health, Marche Polytechnic University, 60126 Ancona, Italy;
| | | | - Aracely Acosta-López
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
| | - Ruth-Yesica Ramos-Gutiérrez
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
| | - Mary-Buhya Varela-Busaka
- Servicio de Neonatología, División de Pediatría, Nuevo Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”, Guadalajara 44600, Mexico; (L.-M.G.-R.); (A.A.-L.); (R.-Y.R.-G.); (M.-B.V.-B.)
| | - Simona Pichini
- National Centre on Addiction and Doping, Italian National Institute of Health (ISS), V.Le Regina Elena 299, 00161 Rome, Italy; (E.M.); (M.C.R.)
- Correspondence: ; Tel.: +39-064990-6545
| | - Oscar Garcia-Algar
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Barcelona, 08036 Barcelona, Spain;
- Neonatology Unit, Hospital Clinic-Maternitat, ICGON, BCNatal, C/Sabino Arana 1, 08028 Barcelona, Spain
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Marchei E, Rotolo MC, Mannocchi G, Capomassi A, Gómez-Ruiz LM, Acosta-López A, Ramos-Gutiérrez RY, Varela-Busaka MB, Pichini S, García-Algar Ó. Assessment of licit and illicit drugs consumption during pregnancy by Ultra-High Performance Liquid Chromatography-High Resolution Mass Spectrometry (UHPLC-HRMS) target screening in Mexican women hair. J Pharm Biomed Anal 2022; 211:114607. [DOI: 10.1016/j.jpba.2022.114607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/19/2022] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
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Marangoni SR, Gavioli A, Dias LE, Haddad MDCFL, Assis FB, Oliveira MLFD. VULNERABILIDADE DE GESTANTES USUÁRIAS DE ÁLCOOL E OUTRAS DROGAS EM PRÉ-NATAL DE BAIXO RISCO. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0266pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: verificar os contextos que potencializam as dimensões de vulnerabilidade individual, social e programática associadas ao uso de álcool e outras drogas durante a gravidez. Método: estudo qualitativo, descritivo e exploratório, com corte transversal. Participaram 38 gestantes usuárias álcool e outras drogas, em nível moderado e grave, em atendimento pré-natal de baixo risco na Atenção Primária à Saúde de dois municípios da Região Metropolitana de Maringá - Paraná. Os dados foram coletados de dezembro de 2019 a março de 2020. O referencial analítico da Vulnerabilidade pautou a discussão. Resultados: no plano individual, os contextos de vulnerabilidade eram questões de gênero, raça/cor parda e preta, baixa escolaridade, período reprodutivo e alta paridade. No plano social, a ausência de inserção no mercado de trabalho, renda familiar na linha da pobreza, relações intrafamiliares abusivas, comportamento aditivo na família e violência na comunidade de convivência. No plano programático encontraram-se baixa procura a serviços de saúde, ausência de acolhimento para o tratamento do uso de drogas, rastreio para o uso de drogas deficitário, baixo vínculo com as equipes da saúde da família, ausência de atendimento odontológico, psicológico e do serviço social, inserção no nível de assistência pré-natal inadequado, risco habitual, enquanto deveriam ter sido classificadas como alto risco, e média de consultas pré-natal abaixo do preconizado. Conclusão: o estudo permitiu avançar nos contextos de vulnerabilidade dessas gestantes. O (re)conhecimento destes contextos possibilita a formulação de estratégias de redução de danos e de agravos à saúde materno fetal relacionados ao uso de drogas durante a gravidez, conduzindo a um desfecho gestacional favorável.
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Harris MTH, Laks J, Stahl N, Bagley SM, Saia K, Wechsberg WM. Gender Dynamics in Substance Use and Treatment: A Women's Focused Approach. Med Clin North Am 2022; 106:219-234. [PMID: 34823732 PMCID: PMC8881090 DOI: 10.1016/j.mcna.2021.08.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Gender impacts substance use initiation, substance use disorder development, engagement with treatment, and harms related to drug and alcohol use. Using the biopsychosocial model of addiction, this review provides a broad summary of barriers and facilitators to addiction services among women. It also reviews substance use among pregnant and parenting women and approaches to care. Given the increasing rates of substance use among women, there is a need to implement and scale-up gender-responsive addiction programming and pursue advocacy at the policy level that addresses the root drivers of substance use inequities among women.
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Affiliation(s)
- Miriam T H Harris
- Grayken Center for Addiction, Boston Medical Center, 801 Massachusetts Avenue, 1st Floor, Boston, MA 02118, USA; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA.
| | - Jordana Laks
- Grayken Center for Addiction, Boston Medical Center, 801 Massachusetts Avenue, 1st Floor, Boston, MA 02118, USA; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA
| | - Natalie Stahl
- Yale Program in Addiction Medicine, Yale University School of Medicine, E.S. Harkness Memorial Building A, 367 Cedar Street, Suite 417A, New Haven, CT 06520-8023, USA
| | - Sarah M Bagley
- Grayken Center for Addiction, Boston Medical Center, 801 Massachusetts Avenue, 1st Floor, Boston, MA 02118, USA; Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118, USA; Division of General Pediatrics, Department of Pediatrics, 801 Albany Street, Boston, MA 02118, USA
| | - Kelley Saia
- Department of Obstetrics and Gynecology, Boston Medical Center, 850 Harrison Avenue 5th Floor, Boston, MA 02118, USA
| | - Wendee M Wechsberg
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC 27709-2194, USA; Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Department of Psychology, North Carolina State University, Raleigh, NC 27599-7400, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27701, USA
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Marangoni SR, Gavioli A, Dias LE, Haddad MDCFL, Assis FB, Oliveira MLFD. VULNERABILITY OF PREGNANT WOMEN USING ALCOHOL AND OTHER DRUGS IN LOW-RISK PRENATAL CARE. TEXTO & CONTEXTO ENFERMAGEM 2022. [DOI: 10.1590/1980-265x-tce-2021-0266en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to verify the contexts that enhance the dimensions of individual, social, and programmatic vulnerability associated with the use of alcohol and other drugs during pregnancy. Method: qualitative, descriptive, and exploratory, cross-sectional study. Participants were 38 pregnant women who used alcohol and other drugs, at a moderate and severe level, in low-risk prenatal care in the Primary Health Care of two cities in the Metropolitan Region of Maringá - Paraná. Data was collected from, December 2019 to March 2020. The Vulnerability analytical framework guided the discussion. Results: at the individual level, the vulnerability contexts were issues of gender, brown and black ethnicity/color, low education, reproductive period, and high parity. At the social level, the lack of insertion in the job market, family income below the poverty line, abusive intra-family relationships, addictive behavior in the family, and violence in the living community. In the programmatic plan, there was a low demand for health services, lack of welcoming for the treatment of drug use, screening for deficient drug use, low bond with family health teams, absence of dental, psychological, and social services, insertion in the inadequate level of prenatal care, usual risk, while they should have been classified as high risk, and mean prenatal consultations below recommended. Conclusion: the study made it possible to advance in the contexts of the vulnerability of these pregnant women. Recognizing these contexts makes it possible to formulate strategies to reduce harm and damages to maternal and fetal health related to drug use during pregnancy, leading to a favorable gestational outcome.
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Anandan A, Athirah Daud NA, Vicknasingam B, Narayanan S, Azman A, Singh D. Factors associated with drug use during pregnancy and breastfeeding among females who use drugs (FWUDs) in Malaysia. J Ethn Subst Abuse 2021; 22:766-781. [PMID: 34965841 DOI: 10.1080/15332640.2021.2019162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Females who use drugs (FWUDs) are at risk of continuing illicit substance use during pregnancy and breastfeeding. We investigated the prevalence rates and factors associated with these practices in a sample of 200 FWUDs recruited from a publicly-run drug rehabilitation center. A semi-structured questionnaire was used to collect the data. The majority (86%) was Malay (n = 171/200), currently single (71%, n = 141/200), and 51% had nine years of education. The mean age of respondents was 32.2 years (SD = 8.61). Thirty-eight percent (n = 75/200) reported ever using illicit substances during pregnancy, while 15% (n = 30/200) had used them during breastfeeding. Higher odds of using drugs during pregnancy were associated with having an intimate male drug-using partner and with persons who reported abandoning an infant in the past. Lower odds were linked with women who used heroin with ATS (relative to those who used only ATS), and shorter-term ATS (≤3 years) relative to long term ATS users. At a lower level of significance (p = 0.054), being married also lowered the odds. Higher odds of drug use during breastfeeding were associated with having an intimate male drug-using partner, and previous methadone use history, while lower odds were associated with short-term ATS use and being employed. The findings highlight the need for timely and targeted interventions to inform, engage and promote the participation of FWUDs in pre- and post-natal care services.
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Affiliation(s)
- Asnina Anandan
- Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
| | | | | | - Suresh Narayanan
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Azlinda Azman
- School of Social Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Penang, Malaysia
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O'Connor M, Czarnik M, Morrow B, D'Angelo D. Opioid use during pregnancy: An analysis of comment data from the 2016 Pregnancy Risk Assessment Monitoring System survey. Subst Abus 2021; 43:649-656. [PMID: 34846993 PMCID: PMC10949341 DOI: 10.1080/08897077.2021.1986878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ABTSTRACTBackground: Opioid misuse during pregnancy has been associated with adverse infant outcomes including preterm birth, stillbirth, and neonatal opioid withdrawal syndrome. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an on-going state-based surveillance system of maternal behaviors, attitudes, and experiences prior to, during, and after pregnancy. Methods: We analyzed qualitative comments related to opioid use during pregnancy collected in 2016 from an open-ended prompt at the end of the PRAMS survey in 35 states (N = 40,408). Key word searches were conducted on the open-ended responses (n = 9,549) to identify opioid-related content with an automated function using Microsoft Excel. All responses from the initial screening (n = 1,035) were manually reviewed, and 69 responses were confirmed to relate to the respondent's personal experience with opioid use during pregnancy. Content analysis was conducted by 3 independent coders; key themes were compiled, discussed, and finalized by the coding team. Results: Five key themes related to opioid use during pregnancy were identified: (1) gratitude for treatment, recovery, and healthy infants; (2) pregnancy as motivation to seek treatment; (3) difficulty finding prenatal care providers with training in substance use disorders; (4) concern about the effects of treatment on the infant; and (5) experiences of discrimination and stigma in the hospital around the time of delivery. Conclusions: Women may be aware of the potential impact of opioid use during pregnancy on the health of their infants and motivated to seek treatment. Findings may help inform new and ongoing initiatives designed to improve care and reduce stigma for women needing or seeking treatment.
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Affiliation(s)
- Megan O'Connor
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michaila Czarnik
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Brian Morrow
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Denise D'Angelo
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abikoye GE, Ineme ME, Akinnawo EO, Okonkwo EA, Osinowo HO. Drug use and motivation for treatment in patrons of selected bunks in Uyo, Nigeria: a qualitative perspective. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1871979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Gboyega E. Abikoye
- Department of Psychology, University of Uyo, Uyo, Nigeria
- Center for Research and Information on Substance Abuse, Uyo, Nigeria
| | - Mfon E. Ineme
- Department of Psychology, University of Uyo, Uyo, Nigeria
| | - Ebenezer O. Akinnawo
- Department of Psychology, University of Uyo, Uyo, Nigeria
- Department of Behavioural Studies, Redeemers University, Ede, Nigeria
| | | | - Helen O. Osinowo
- Department of Psychology, University of Uyo, Uyo, Nigeria
- Department of Psychology, University of Ibadan, Ibadan, Nigeria
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