Substance Misuse in Pregnancy - NHS Lothian

woman’s aspirations and particular social and psychological circumstances.
Drug use may have been an integral part of the woman’s lifestyle for many
years and she may have no intention of changing this. She may have had a
previous pregnancy whilst using drugs with no apparent ill effects. This
may be reinforced by drug-using friends who have also successfully
delivered healthy babies (Johnstone 1998).
Different drug treatment options to consider include:
� Safer drug use advice and education
� Needle exchange and safer injecting advice
� Substitute prescribing
� Stabilisation
� Slow reduction
� Detoxification
Safer drug use
Injecting and chaotic drug use in pregnancy is associated with increased
risks for both mother and baby. These risks include:
• sudden death through drug overdose
• transmission of blood borne viruses (including HIV, hepatitis C and
hepatitis B)
• other complications associated with poor injecting practices and the
contaminants contained in non-pharmaceutically prepared street drugs
• pre-term labour and delivery
• multiple social problems
Reducing illicit, chaotic and injecting drug use in pregnancy is
therefore an important goal to work towards.
Pregnant women who are injecting drugs can be referred to the Harm
Reduction Team (HRT) at Spittal Street Centre for supplies of clean
injecting equipment, specialist advice about safer injecting practices and
the ‘low threshold’ methadone programme. Free supplies of clean needles &
syringes can be obtained from many pharmacies throughout Lothian.
Contact the HRT (Tele 0131 537 8300) for a list of pharmacies who
participate in the needle exchange scheme. Alternatively, refer women to
your local voluntary sector drug agency as most provide needle & syringe
exchange services as well as harm reduction advice. See ‘services list’.
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