Scientific Article | Special Issueform of vouchers or prizes if theydemonstrate changed behaviors.There seems to be data to support itsuse <strong>in</strong> coca<strong>in</strong>e and opioid abuse. 24,25Due to the large number ofpatients affected <strong>in</strong> the <strong>State</strong> of <strong>West</strong>Virg<strong>in</strong>ia by both substance abuseand alcohol abuse, we suggest aprogrammatic approach with theuse of both <strong>in</strong>patient and outpatienttherapy be used. Detoxification seemsa reasonable approach with treatmentof the psychological co‐morbiditiesassociated with substance use.Multidiscipl<strong>in</strong>ary cl<strong>in</strong>ics wouldappear the ideal solution with thecomb<strong>in</strong>ation of medical, psychiatric,counsel<strong>in</strong>g, and social supportnecessary to return healthy motherswith healthy drug-free neonates.References1. Ebrahim SH, Gfroerer J. Pregnancyrelatedsubstance use <strong>in</strong> the United <strong>State</strong>sdur<strong>in</strong>g 1996-1998. Obstet Gynecol.2003;101(2):374-9.2. Chasnoff IJ, McGourty RF, Bailey GW,Hutch<strong>in</strong>s E, Lightfoot SO, Pawson LL,Fahey C, May B, Brodie P, McCulley L,Campbell J. The 4P’s Plus screen forsubstance use <strong>in</strong> pregnancy: cl<strong>in</strong>icalapplication and outcomes. J Per<strong>in</strong>atol.2005;25(6):368-74.3. Azadi A, Dildy GA 3rd. Universal screen<strong>in</strong>gfor substance abuse at the time ofparturition. Am J Obstet Gynecol.2008;198(5):e30-2. Epub 2008 Feb 14.4. Montgomery D, Plate C, Alder SC, JonesM, Jones J, Christensen RD. Test<strong>in</strong>g forfetal exposure to illicit drugs us<strong>in</strong>gumbilical cord tissue vs meconium. JPer<strong>in</strong>atol. 2006;26(1):11-4.5. Montgomery DP, Plate CA, Jones M,Jones J, Rios R, Lambert DK, Schumtz N,Wiedmeier SE, Burnett J, Ail S, Brandel D,Maichuck G, Durham CA, Henry E,Christensen RD. Us<strong>in</strong>g umbilical cordtissue to detect fetal exposure to illicitdrugs: a multicentered study <strong>in</strong> Utah andNew Jersey. J Per<strong>in</strong>atol. 2008;28(11):750-3. Epub 2008 Jul 3.6. Baxter FR, Nerhood R, Chaff<strong>in</strong> D.Characterization of babies discharged fromCabell Hunt<strong>in</strong>gton Hospital dur<strong>in</strong>g thecalendar year 2005 with the diagnoses ofneonatal abst<strong>in</strong>ence syndrome. <strong>WV</strong> Med J.2009;105(2):16-21.7. Rementeria JL, Nunag NN. Narcoticwithdrawal <strong>in</strong> pregnancy. Am J ObstetGynecol 1973;116:1152-1156.8. F<strong>in</strong>negan JP. Treatment issues for opioiddependent women dur<strong>in</strong>g the per<strong>in</strong>atalperiod. J Psychoactive Drugs1991;23:191-2029. Jarvis MAE, Schnoll SH. Methadonema<strong>in</strong>tenance and withdrawal <strong>in</strong> pregnantopioid addicts. In CN Chiang & LPF<strong>in</strong>negan (eds). Medication developmentfor the treatment of pregnant addicts andtheir <strong>in</strong>fants. (pp 58-77). Wash<strong>in</strong>gton, D.C.:US Department of Health and HumanServices (NIDA Monograph 149).10. Dashe JS, Jackson GL, Olscher DA,Zane EH, Wendel GD. Opioiddetoxification <strong>in</strong> pregnancy. ObstetGynecol 1998;92:854-58.11. Luty J, Nikolaou V, Bearn J. Is opiatedetoxification unsafe <strong>in</strong> pregnancy? J of<strong>Substance</strong> <strong>Abuse</strong> Treatment2003;24:363-367.12. Hoegerman G, Schnoll SH. Methadonema<strong>in</strong>tenance and withdrawal <strong>in</strong> pregnantopioid addicts. Cl<strong>in</strong>ical Per<strong>in</strong>at1991;18:51-76.13. Briggs GG, Freeman RK, Yaffee SJ. Drugs<strong>in</strong> pregnancy and lactation. Williams andWilk<strong>in</strong>s, Baltimore, MD, 1994, pp 557-558,14. Cooper JR, Altman F, Brown BS,Czechowicz D. (Eds) (1983). Research onthe treatment of narcotic addiction: <strong>State</strong> ofthe art. (NIDA Research Monograph 83-1201). Rockville, MD: US Department ofHealth and Human Services.15. Andres RL, Jones KL. Social and illicit druguse <strong>in</strong> pregnancy. In RK Creasy & R Resnick(eds). Maternal-Fetal Medic<strong>in</strong>e (pp 191-192),1994, Philadelphia, PA: Saunders.16. W<strong>in</strong>klbaur B, Kopf N, Ebner N, Jung E,Thau K, Fischer G. Treat<strong>in</strong>g pregnantwomen dependent on opioids is not thesame as treat<strong>in</strong>g pregnancy and opioiddependence: a knowledge synthesis forbetter treatment for women and neonates.Addiction 2008;103:1429-1440.17. Chutuape MA, Jas<strong>in</strong>ski DR, F<strong>in</strong>gerhoodMI, Stitzer ML. One, three, and six monthoutcomes follow<strong>in</strong>g brief <strong>in</strong>patient opioiddetoxification. Am J Drug Alcohol <strong>Abuse</strong>2001;27:19-44.Please contact the authors for a complete listof references.© March of Dimes Foundation, 2009for preemiesThe fight goes on formore than 500,000 babiesborn too soon each year.They need your help.What will you do togive premature babiesa fight<strong>in</strong>g chance?marchofdimes.com/fightforpreemiesMarch of Dimes <strong>West</strong> Virg<strong>in</strong>ia(304) 720-22293508 Staunton Ave. SECharleston, <strong>WV</strong> 25304CME Post-Test19. Which of the follow<strong>in</strong>g substances isassociated with fetal growth abnormalitieswhen <strong>in</strong>gested dur<strong>in</strong>g pregnancy?a. Coca<strong>in</strong>eb. Marijuanac. Amphetam<strong>in</strong>esd. Opiatese. all the above20. In the study population, the detection ofalcohol <strong>in</strong>gestion was similar at all eight ofthe participat<strong>in</strong>g hospitals. True or False?21. Accord<strong>in</strong>g to the study results, the mostfrequently abused substance (exclud<strong>in</strong>gtobacco) dur<strong>in</strong>g pregnancy <strong>in</strong> <strong>West</strong> Virg<strong>in</strong>ia is:a. Benzodiazep<strong>in</strong>esb. Methadone/opiatesc. Alcohold. Cannab<strong>in</strong>oids/marijuanae. Methamphetam<strong>in</strong>e52 <strong>West</strong> Virg<strong>in</strong>ia <strong>Medical</strong> Journal
<strong>Substance</strong>abuse hurtsIf you have a patient whosuffers from substanceabuse or chemicaldependency, partner witha psychologist now to helpyour patient cope.Look for deteriorations <strong>in</strong>:- physical health- personal and familyrelationships- workplace safety orproductivity- f<strong>in</strong>ancial stabilityPartner with a licensed psychologist who can help <strong>in</strong>dividuals and families deal with jobloss, emotional stress, abusive behavior, and marriage and family problems associatedwith substance and chemical dependency. Psychological treatment is often covered bymedical <strong>in</strong>surance.The <strong>West</strong> Virg<strong>in</strong>ia Psychological <strong>Association</strong> is dedicated to positive health outcomesfor <strong>West</strong> Virg<strong>in</strong>ia citizens. Visit wvpsychology.org today for more <strong>in</strong>formation.<strong>West</strong> Virg<strong>in</strong>ia Psychological <strong>Association</strong>PO Box 58058 • Charleston, <strong>WV</strong> 25358Phone: 304.984.0308 • Email: <strong>in</strong>fo@wvpsychology.orgwww.wvpsychology.org
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