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Though successful treatment programs do exist, without the proper and adequate personal support systems for the individual women with substance abuse histories relapse is highly indicated (Goler et al. 2008; Dowdell et al. 2009). Nursing practice must take this factor into account when prescribing and providing care and seeking out methods for the long-term health and wellness of pregnant and post-pregnant patients.
Changes to Nursing Practice
Current research suggests that the most effective manner in which nursing practice can be altered to combat and/or mitigate the effects of substance abuse during pregnancy is through early detection of abuse through effective screening processes (Neushotz & Fitzpatrick 2008; Cox et al. 2007; Goler et al. 2008). Substance abuse screening is an obvious first step in the treatment of substance abuse issues, and often the identification and acknowledgement with the patient of the substance abuse problem presents a major step forward in the patient's own acknowledgement of the issue and practice of self-care (Cox et al. 2007).
After screening has been accomplished, treatment and care plans must take each individual patients particular circumstances into account when suggesting methods for seeking outpatient or inpatient treatment for substance abuse issues; the degree of difference in situations and the magnitude of its effects on successful resistance from continued substance abuse can make a comprehensive treatment plan difficult to outline (Dowdell et al. 2009). Counseling visits from trained personnel -- which could easily include nurses who had received adequate education and training in the necessary perspectives and practices -- have proven effective in continuing resistance and recovery from substance abuse problems both during and following...
2008). In general, an awareness and explicit discussion of the issue with the patient in an understanding and open manner is one of the primary ways in which nurses can effectively encounter and treat substance abuse issues amongst pregnant women.
Conclusion
Substance abuse remains a controversial issue both socially and medically. In the case of pregnant women, however, the issue of the fetus -- for whom choice is not an option -- the issue takes on a new urgency. Though no program of treatment is entirely effective, there are measures that can be taken to limit the persistence and damage caused by substance abuse in pregnant women.
References
Cox, S.; Johnson, C.; Mekle, S.; Jamieson, D. & Posner, S. (2007). "Trends in rates of hospitalization with a diagnosis of substance abuse among reproductive-age women, 1998 to 2003." Women's health issues 17, pp. 75-83.
Dowdell, J.; Fenwick, J.; Bartu, A. & Sharp, J. (2009). "Midwives' description of the postnatal experiences of women who use illicit substances: A descriptive study." Midwifery 25, pp. 295-306.
Goler, N.; Armstrong, M., Taillac, C. & Osejo, V. (2008). "Successful substance abuse treatment program for pregnant women delivers new model of care." Journal of midwifery & women's health 53(6), pp. 567-8.
Neushotz, L. & Fitzpatrick, J. (2008). "Improving substance abuse screening and intervention in a primary care clinic." Archives of psychiatry nursing 22(2), pp. 78-86.
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