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Addiction Week 3 Summary

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Summary of the Literature for Week 3 - Addiction

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  • September 20, 2021
  • 26
  • 2021/2022
  • Summary

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Week 3: Developmental and Brain Consequences of
Substance Abuse


Substance Use During Pregnancy


Adverse Effects of Substance Use in Pregnancy
Alcohol Use

Heavy alcohol use in pregnancy – associated with range of negative birth outcomes –
including:

(1) Increased risk of miscarriage
(2) Stillbirth and infant mortality
(3) Congenital anomalies
(4) Low birthweight
(5) Reduced gestational age
(6) Preterm delivery
(7) Small-for-gestational age

Alcohol use in pregnancy – has the most well established adverse fetal health effects

- Associated with the development of (1) fetal alcohol spectrum disorders – and (2)
adverse neurodevelopmental outcomes

Prenatal drinking – associated with long-term effects – such as:

(1) Cognitive and behavioral challenges
(2) Adverse speech and language outcomes
(3) Executive functioning deficits in children
(4) Psychosocial consequences in adulthood

Smoking

Smoking during pregnancy – exerts direct adverse effects on birth outcomes – including:

(1) Damage to the umbilical cord structure
(2) Miscarriage

, (3) Increased risk for ectopic pregnancy
(4) Low birthweight
(5) Placental abruption
(6) Preterm birth
(7) Increased infant mortality

Deleterious health effects of second-hand smoke on newborns – including:

(1) Higher rates of respiratory and ear infections
(2) Sudden infant death syndrome
(3) Behavioral dysfunction
(4) Cognitive impairment

Women who were smokers before pregnancy – may stop breastfeeding early

- So, they can smoke again

Cannabis Use

Cannabis – linked with several deleterious effects – including:

(1) Preterm labor
(2) Low birthweight
(3) Small-for-gestational age
(4) Admission to the neonatal intensive care unit

Prenatal cannabis use – linked with aversive consequences for:

(1) The growth of fetal and adolescent brains
(2) Reduced attention and executive functioning skills
(3) Poorer academic achievement
(4) More behavioral problems

Cocaine Use

Identified several risk factors – including:

(1) Premature rupture of membranes
(2) Placental abruption
(3) Preterm birth
(4) Low birthweight

, (5) Small-for-gestational age

With long-term effects on language, motor, and cog development

Summary

The negative consequences of prenatal substance use – are confounded by (1) the frequency
of coexisting substance use – and (2) comorbid psychiatric illness

Women with substance use disorders – frequently experience:

(1) Inadequate prenatal care, (2) poor nutrition, (3) chronic medical problems, (4)
poverty, and (5) domestic violence

It can also result in – an early dysfunctional maternal-infant relationship

- Which can potentiate the negative effects of prenatal drug exposure

Treatment of Substance Use in Pregnancy
Small number of effective therapies – primarily involve behavioral counseling

Behavioral Interventions for Substance Use Disorders

Contingency Management (CM)

CM – based on the principle of positive reinforcement – as a means of operant conditioning
to influence behavior change

- Appears to show the greatest promise as an effective therapy

The premise – systematically use reinforcement techniques – e.g., monetary vouchers – to
modify behavior in a positive and supportive manner

Originally used for cocaine users – and since used for opioids, marijuana, cigarettes, alcohol,
etc.

Motivational Interviewing (MI)

MI – a patient-centered, collaborative – and highly empathic – counseling style for eliciting
behavior change

- By helping clients explore and resolve ambivalence

It draws from the trans theoretical model of change

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