Treatment Guidelines for Substance Use Disorder in Perinatal Patients

 

 

 

Kyrah Coone

Virginia Commonwealth University

NURS 522

Professor Lyons

6/3/23

 

 

Substance Use Disorder in Perinatal Patients

Frazer, Z., McConnell, K., & Jansson, L. M. (2019). Treatment for substance use disorders in pregnant women: Motivators and barriers.  Drug and alcohol dependence,  205, 107652.

Summary: Amidst pregnant women’s challenges when seeking treatment for substance use disorders, this article highlights the motivators and barriers that determine their decision. Personal motivation, social support, stigma, and access to appropriate care are key factors driving their need to enter and stay in a treatment program. The study offers a peek into the distinct challenges unique to these women and proposes solutions to enhance their treatment engagement.

Assessment/Evaluation: During pregnancy, the factors that drive and hinder people’s willingness to seek help for substance use disorders are explored in this article. The study employs a qualitative approach, utilizing interviews and focus groups with pregnant women who have experienced substance use disorders. This methodology allows in-depth exploration of participants’ perspectives and provides rich data to support the authors’ arguments. The article is published in a reputable journal, enhancing its credibility.

Reflection: Interventions and support systems targeting substance use disorders in pregnant women can be better informed by analyzing the factors influencing their decision-making process. This article provides valuable information on identifying these motivators and barriers, ultimately enhancing the comprehensiveness of such programs. This article’s findings can be utilized in a case study to assess the factors influencing treatment engagement and develop appropriate strategies to support perinatal patients with substance use disorders.

 

Gopman, S. (2014). Prenatal and postpartum care of women with substance use disorders.  Obstetrics and Gynecology Clinics,  41(2), 213-228.

Summary: This piece aims to cognize readers about giving appropriate prenatal and postpartum medical attention to women with substance use disorders. This population requires comprehensive care while considering some specific factors, which can prove strenuous for caregivers. Important topics around standards for treating these patients are presented here, including screening tools employed for identifying issues early on or accessing timely interventions by professionals trained to assist them in every way possible. Examples like specialized psychiatric assistance or review procedures provide additional context throughout the article.

Assessment/Evaluation: This source provides treasured insight into prenatal and postpartum healthcare for women managing substance use difficulties. It encompasses various relevant topics while stressing the need for holistic, coordinated interventions customized toward addressing their exceptional necessities. Created by a learned professional from within this sphere and published through an esteemed channel fortifies its reliability further. Its contents come across as objective, concentrated chiefly on improving medical services delivered to individuals who are expecting while concurrently struggling with addiction-related conditions.

Reflection: This article provides valuable information for building comprehensive care plans for pregnant individuals dealing with substance abuse. It underscores the importance of accurately addressing challenges that emerge during the gestation and postpartum periods. By integrating suggestions articulated here into treatment protocols, healthcare providers can most effectively serve their patients’ unique needs during such a vulnerable time fully. Nevertheless, including additional sources featuring up-to-date research on emerging interventions could enhance our ability further to help those requiring more effective treatment.

Klaman, S. L., Isaacs, K., Leopold, A., Perpich, J., Hayashi, S., Vender, J., Campopiano, M., & Jones, H. E. (2017). Treating women who are pregnant and parenting for opioid use disorder and the concurrent care of their infants and children: Literature review to support national guidance.  Journal of Addiction Medicine, 11(3), 178–190.  https://doi.org/10.1097/ADM.0000000000000308

Summary: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for the mother, fetus, and child.  This comprehensive report explores the various challenges surrounding access faced by this group of women. It recommends women with OUD can be treated with methadone or buprenorphine during pregnancy. NAS is an expected and manageable condition. Although research has substantially advanced, opportunities to guide future research to improve maternal and infant outcomes are provided.

Assessment/Evaluation: This valuable source highlights the importance of critical components of patient support systems, given that women with OUD have a higher frequency of additional risk factors for adverse pregnancy outcomes than do pregnant women who do not use opioids, evidence-based clinical guidance on the treatment of these women and their children is needed.

Reflection: The present article, developed as part of a RAM process, serves as the basis for a series of recommendations for researchers and policymakers in the areas of OUD and pregnant women whose opioid exposure also exposed infants in utero. This work supports and extends the ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use, which includes guidance on treating pregnant women.

McLafferty, L. P., Becker, M., Dresner, N., Meltzer-Brody, S., Gopalan, P., Glance, J., … & Worley, L. L. (2016). Guidelines for the management of pregnant women with substance use disorders. Psychosomatics, 57(2), 115-130.

Summary: This article presents guidelines for addressing substance use disorders in pregnant women. The policies cover multiple care areas, such as screening, assessment, psychosocial interventions, pharmacotherapy, and postpartum care. Emphasis is placed on interdisciplinary approaches, provider cooperation, and personalized treatment strategies.

Assessment/Evaluation: Peer-reviewed, trustworthy, and timely, this source presents healthcare providers with detailed strategies for treating expectant mothers with substance use disorders. Full of expert-backed recommendations, it is comprehensive and unbiased – prioritizing what’s best for patients above all else. The publication’s credibility is further bolstered by its esteemed authors, leading authorities in the field. Ultimately, this guide serves as an invaluable resource for front-line healthcare professionals.

Reflection: Managing pregnant women with substance use disorders requires following the guidelines provided in a useful source. These will shape the approach to treatment and guarantee that evidence-based practices are carried out. Collaborative and individualized care is crucial for ideal results. Nevertheless, adding the latest research and recommendations for a well-rounded case study would be advantageous. More recent studies would supplement the current information.

Ramsey, K. S., Cunningham, C. O., Stancliff, S., Stevens, L. C., Hoffmann, C. J., Gonzalez, C. J., & Substance Use Guidelines Committee. (2021). Substance Use Disorder Treatment in Pregnant Adults.

Summary: Owing to its focus on providing evidence-based guidance regarding substance use disorder (SUD) treatment among pregnant adults, this publication is a crucial resource to healthcare providers within this field. The journal covers aspects related to care, such as screening processes, assessment methods, intervention approaches, pharmacotherapy programs, and psychosocial support services, while equally paying due attention to postpartum care.

Assessment/Evaluation: The guidelines presented here emphasize an all-embracing solution considering the unique situation of expectant mothers living under SUD conditions. These valuable insights are gleaned from professionals who are leaders within their industry; they include members whose publications were peer-reviewed on platforms like National Center for Biotechnology Information (NCBI).

Reflection: Implementation of these guidelines will aid in developing tailored case studies focused on pregnant patients living under SUD-laden conditions whose treatment will consist of evidence-based interventions delivered using patient-centered care supported at every juncture during pregnancy term baby delivery and into postpartum recovery stages critical for improved maternal health outcomes fetal wellness among other things.

 

 

 

 

References

Frazer, Z., McConnell, K., & Jansson, L. M. (2019). Treatment for substance use disorders in pregnant women: Motivators and barriers.  Drug and alcohol dependence,  205, 107652.

Gopman, S. (2014). Prenatal and postpartum care of women with substance use disorders.  Obstetrics and Gynecology Clinics,  41(2), 213-228. https://www.obgyn.theclinics.com/article/S0889-8545(14)00011-4/abstract

Klaman, S. L., Isaacs, K., Leopold, A., Perpich, J., Hayashi, S., Vender, J., Campopiano, M., & Jones, H. E. (2017). Treating women who are pregnant and parenting for opioid use disorder and the concurrent care of their infants and children: Literature review to support national guidance.  Journal of Addiction Medicine, 11(3), 178–190.  https://doi.org/10.1097/ADM.0000000000000308

McLafferty, L. P., Becker, M., Dresner, N., Meltzer-Brody, S., Gopalan, P., Glance, J., … & Worley, L. L. (2016). Guidelines for the management of pregnant women with substance use disorders.  Psychosomatics,  57(2), 115-130. https://www.sciencedirect.com/science/article/pii/S0033318215002066

Ramsey, K. S., Cunningham, C. O., Stancliff, S., Stevens, L. C., Hoffmann, C. J., Gonzalez, C. J., & Substance Use Guidelines Committee. (2021). Substance Use Disorder Treatment in Pregnant Adults. https://www.ncbi.nlm.nih.gov/books/NBK572854/

Miranda is a 28-year-old married, heterosexual woman, who comes to the family service agency seeking support following the recent death of her mother. Miranda complains of feeling sad every day, having difficulty sleeping and having difficulty parenting her three children, Marta age 8, Jose age 5, and Teresa age 3. Miranda and her family moved here from South America six years ago, as her husband found employment with a trucking company that paid significantly more money than he could earn in South America. Miranda’s mother moved with them and was living with Miranda, her husband, and her children when she died. Miranda’s mother was diagnosed with stage 4, metastasized lung cancer 8 months ago. Her death one month prior to Miranda’s initial appointment was surprising to Miranda as she had hoped that the treatment would work and would result in remission.

Miranda reports with pride that her elder daughter Marta is doing well in second grade. She describes her as a good girl who helps around the house and helps Miranda care for the younger children. Jose is currently attending preschool. Miranda reports some concerns about his behaviour as preschool teachers have been expressing concern to her that he may have ADHD. He is often in trouble at school and has difficulty following directions and focusing on simple tasks such as drawing pictures and listening during story circles. She reports that her relationship with her husband is good and that he is a good man, but that he is frequently away from home due to his job, which sometimes requires that he transport materials across the state. He is sometimes away from home for 2 or 3 nights in a row.

 

Miranda presents as very sad and tearful. She is seeking some relief from her sadness and some way to cope with the general stress of her current life circumstances.

Annotated Bibliography Instructions

 

For examples of annotated bibliographies, please visit Purdue Owl.

Using APA formatting, create an annotated bibliography. Each source should be followed by a 5 to 8 sentence summary/evaluation of the source (see below for more details). When writing the summary, consider how useful the source is for your topic.

The bullets below are only meant to give you ideas. You do not need to answer all the questions to create your annotation.

 

Summary:

The summary typically includes 2 to 4 sentences that summarize the main idea(s) of the source.

· Main arguments

· Main points

· Ideas, concepts, research findings

 

Assessment/Evaluation:

The annotation also includes 2 or 3 sentences to explain how the source applies to your topic.

· How does it compare to the other sources in this bibliography?

· Is this information current? Reliable?

· Is the author credible?

· Is the source objective or biased?

 

Reflection:

The reflection typically includes 1 to 2 sentences that show you have reflected on the source and how it applies to your topic.

· Was the information helpful?

· How can you use this information in your case study?

· Has it changed how you think about your topic?

· Is the article missing any information that you still need more information about?

 

 

 

Example of part of an annotated bibliography

 

Castagno, A.E. & Hausman, C. (2017). The tensions between shared governance and advancing educational equity. Urban Review, 49, 96-111.

 

Summary: The authors discuss the use of shared governance in one school district. They suggest that shared governance may be less aligned with equity efforts as others may think and that it may contribute to maintaining status quo operations. They distinguish two types of shared governance, shared decision making (SDM) and site-based management (SBM). They analyze data from a yearlong ethnographic study of a school district and use the personal experience of one of the authors who was an administrator in that school district to draw conclusions about how shared governance impacts equity in K12 education. Schools that used SBM appeared to have more variability and inconsistency with implementing programs designed to enhance equity. The central office placed blame on schools, and the school personnel felt unsupported by administrators outside of their individual schools.

 

Assessment/Evaluation: The paper is focused on K12 school districts and is less directly applicable to higher ed shared governance. Data used for this study were collected in 2005-2006 and are likely somewhat outdated. This is an ethnographic, qualitative study and provides useful information but should also be cross referenced with quantitative data. There is no discussion of the demographic composition or process used for SBM or SDM.

 

Reflection: This paper provided an interesting perspective that I had not considered. The findings could be applied conceptually to higher ed shared governance. The biggest takeaway for me is that without an administration that prioritizes and provides support for equity initiatives, shared governance may actually hinder these efforts by maintaining the status quo. The authors suggest that a top down approach may be more effective in the short term and that once there is a culture shift throughout the organization, moving back towards a shared governance model is desirable.

 

 

McGuire, F. (2019). The past, the present, and the future of shared governance. SCHOLE: A Journal of Leisure Studies and Recreation Education, 34(2), 132-137.

 

Summary: The author discusses the 1966 Statement on Government of Colleges and Universities from the American Association of University Professors. This statement established a precedent for the role of faculty in decision making related to curriculum, pedagogy, research, and faculty promotion and tenure. The author points out that the governing board still has authority in decision making even in institutions that practice shared governance. There are also a variety of ways that shared governance is understood and implemented.

 

Assessment/Evaluation: This review provides review and overview of various aspects of shared governance. There is no mention of staff participation in shared governance, but the author does mention challenges with the inclusion of non-tenure track faculty and contingent faculty at many universities. The author makes three recommendations for faculty who want to promote shared governance: establish a close relationship with board members, get involved in service related to faculty governance, and develop a knowledge base about policies, procedures, and processes.

 

Reflection: This paper is useful for understanding a historical perspective on shared governance and for reviewing research findings and specific recommendations for the ongoing promotion of shared governance in higher ed.

 

 

 

Warshaw, J.B. & Ciarimboli, E.B. (2020). Structural or cultural pathways to innovative change? Faculty and shared governance in the liberal arts college. Teachers College Record, 122, 1-46.

 

Summary: This paper is a lengthy report on a qualitative study evaluating faculty engagement with administration and professional staff at three universities and focusing on academic innovation. Professional staff members comprise 23% of the sample. Nevertheless, the findings of the study were primarily focused on faculty opinions.

 

Assessment/Evaluation: The study didn’t focus on staff inclusion in shared governance, but professional staff were included in the sample, and there was at least a mention of staff roles and responsibilities. The authors state that they specifically did not include non-tenure track faculty in the sample, because they were not identified as being associated with academic innovations. This is problematic. Since they were excluded from the study, their inclusion and participation in shared governance has been disregarded.

 

Reflection: This study perpetuates the appearance of exclusion of staff and non-tenure track faculty in shared governance processes. Many negative qualities of the practice of shared governance were uncovered.

Describe the neuroscience of anorexia. Does the characterization of anorexia as a brain disorder surprise you? What are your thoughts on the personal and/or cultural implications of classifying anorexia (and other mental illnesses) in this way, as opposed to a lifestyle choice or a matter of willpower? How might you support a family (or client) who is resistant to this interpretation? What should be included in a treatment plan for best efficacy? Support your statements with a minimum of two scholarly articles.

In Part 2 of the Family Analysis Project, you selected one of the life stages. For this assignment, you will use that selected life stage to analyze the overall impact of socialization on your selected life stage. Next, you will look at the challenges of Young Adulthood.

Complete the “Family Analysis Project Part 4: The Impact of Socialization” Worksheet.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a scoring guide. Please review the scoring guide prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Submit the assignment to your instructor by the end of Topic 5.