2024 Addiction Medicine Board Certification Review Course-2024

Video Transcription

Video Summary

Dr. Marla Kushner's comprehensive lecture on substance use disorders in pregnancy, neonatal abstinence syndrome, and adolescent substance use highlights several critical points. She emphasizes the importance of understanding the risks of substance use during pregnancy and its multifactorial causes, noting the significant stigma and difficulty pregnant women face in overcoming substance use. Effective screening involves the T-ACE, TWEAK, and AUDIT-C tests, alongside lab testing of maternal and infant urine and cord tissue.<br /><br />Dr. Kushner elaborates on the teratogenic risks of substances like tobacco, alcohol, and opioids during pregnancy, stressing the dangerous outcomes such as fetal alcohol syndrome and neonatal abstinence syndrome (NAS). She explains the treatment and monitoring approaches, including the cautious use of medications like methadone and buprenorphine, and advises against Naloxone except as a last resort due to potential severe effects.<br /><br />Neonatal abstinence syndrome, often caused by opioid exposure in utero, presents various symptoms and requires supportive and sometimes pharmacological treatment. Dr. Kushner underscores the necessity of thorough, consistent follow-up and the potential for negative long-term effects.<br /><br />Addressing adolescent substance use, she reflects on its alarming prevalence and its critical impact on later-life substance use disorder risks. She details effective screening methods such as the CRAFT, BSTAD, and S2BI, and emphasizes the significance of confidentiality and proper treatment planning, including medication-assisted treatments and the importance of family involvement and support networks. With actionable insights and recommendations for practical interventions and ongoing monitoring, Dr. Kushner provides a robust framework for managing substance use across these vulnerable populations.

Keywords

substance use disorders

pregnancy

neonatal abstinence syndrome

adolescent substance use

screening tests

teratogenic risks

treatment approaches

methadone

buprenorphine

long-term effects

family involvement