Substance Abuse

Substance Abuse

refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs

Addiction

a state of psychological and/or physical dependence on the use of drugs or other substances, such as alcohol, or on other activities or behaviors, such as sex, exercise, and gambling

Tolerance

when the substance does not have much effect on you or you need more of the substance to get the effect you want

Withdrawal Symptoms

feelings of physical illness when not using the substance. These symptoms are relieved by taking more of it

tobacco, alcohol, cannabis, amphetamine, painkillers/sedatives (opioids), cocaine, ecstasy

substances commonly abused

amphetamine-type stimulants and non-medical use of pharmaceuticals

these substances are used in a high proportion of females

opiates and cocaine

these substances are used in a high proportion of males

Opioids

continue to be the group of substances with the highest contribution to severe drug-related harm, including fatal overdoses

Tobacco

leading preventable cause of morbidity and death in the United States

Nicotine

a powerfully addictive substance with multiple physiologic and psychological effects

Alcohol Use Disorder (AUD)

 a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences

mild, moderate, and severe AUD

spectrums of AUD

Cannabis

Continues to be the most used drug

placenta previa, abruptio placentae, PROM, preterm labor, increased perinatal mortality, ectopic pregnancy, decreased maternal thyroid function

effects of tobacco on maternal health during pregnancy

risks of orofacial clefts, FGR, LBW, increased risk of respiratory infections/asthma/infantile colic/bone fractures, and obesity

effects of tobacco on fetal health during pregnancy

Fetal Alcohol Syndrome (FAS)

The most severe form of FASD, characterized by distinctive facial features like small eyes, a thin upper lip, and a smooth philtrum, alongside growth problems and CNS impairments

small eyes, a thin upper lip, and a smooth philtrum

facial features of newborn with FAS

Alcohol-Related Neurodevelopmental Disorder (ARND)

May not have the full FAS facial features but still experience learning and behavioral difficulties like poor attention, memory problems, and difficulty with impulse control

physical abnormalities (birth defects), cognitive impairments, behavioral problems, growth restriction (LBW and smaller head circumference), premature birth, stillbirth

effects of alcohol in fetal health during pregnancy

miscarriage, premature labor

effects of alcohol in maternal health during pregnancy

alcohol

acts as a teratogen by disrupting critical developmental processes in the fetus, primarily by interfering with cell proliferation, migration, and differentiation, particularly affecting the developing central nervous system

• Increased oxidative stress

• Disturbed glucose, protein, lipid, and DNA metabolism

• Impaired neurogenesis and increased cellular apoptosis, especially or neural crest cells

• Endocrine effect

• Effects on gene expression

mechanisms of alcohol teratogenicity

Neonatal Abstinence Syndrome (NAS)

Use of alcohol, barbiturates, benzodiazepines, and caffeine during pregnancy may cause the baby to show withdrawal symptoms upon birth

• blotchy skin coloring

• diarrhea

• excessive or high-pitched crying

• abnormal sucking reflex

• fever

• hyperactive reflexes

• increased muscle tone

• irritability

• poor feeding

• rapid breathing

• seizures (w/ eyeballs rolling upward)

• sleep problems (sleeping too much)

• slow weight gain

• stuffy nose and sneezing

• sweating

• trembling (twitches)

• vomiting

symptoms of drug withdrawal in newborn

withdrawal in newborn

can occur or develop immediately after or up to 14 days after birth due to substance abuse during pregnancy

immediately after or up to 14 days after birth

when can withdrawal symptoms show in newborns

counseling to hospital treatment, depending on which substance is involved and how dependent is the patient on it; and the level of risk and how much support they have at home

treatment and management for substance abuse during pregnancy

lifestyle changes

individual or group counselling

peer support

rehabilitation (rehab) programs

residential or hospital treatment

social support

treatment options for substance abuse

Withdrawal or detoxification (detox)

means stopping or reducing intake of the substance. This may need medical treatment as well as counseling, support, and rehab to help during or after withdrawal