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
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
