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Addiction Week 3 Summary
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Summary of the Literature for Week 3 - Addiction
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Week 3: Developmental and Brain Consequences ofSubstance 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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