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Patient is undecided about pregnancy - Tobacco, Drug and Alcohol Use


  • Scope:

    • Tobacco: Though the U.S. has made significant progress in smoking prevention, it is still a leading cause of premature death. More than 16 million Americans have at least one disease caused by smoking.

      • In Ohio, 21.6 percent of adults smoked cigarettes in 2015.

    • Alcohol: Alcohol deaths are the leading preventable deaths in the U.S. Alcohol deaths were the cause of 1 in 10 deaths in working age adults (20-64) from 2006-2010.

      • 90 percent of those who binge drink are not alcoholics or dependents on alcohol, however about 46 percent of adult women report drinking alcohol in the last 30 days and 12 percent binge drink 3 times a month.

    • Prescription Drug Use: 91 Americans die every day from an opioid overdose. Prescription drug use is the biggest factor in this 15 year increase. Heroin overdose deaths have quadrupled since 2010, increasing by 20.6 percent from 2014 to 2015.

      • Ohio has a statistically significant increase in opioid drug overdose deaths from 2014-15 by 21.5 percent.

      • Ohio has a statistically significant increase in heroin drug overdose deaths from 2014-15 by 19.8 percent.

  • Preconception Significance:

    • Substance use is very risky for sexually active women in that the effects of usage can affect the baby before the woman is aware that she is pregnant.

    • Excessive drinking may cause infertility and women who binge drink are likely to have multiple sexual partners, increasing the risk for pregnancy and sexually transmitted infections.

    • Women who drink while pregnant risk their babies developing Fetal Alcohol Spectrum Disorders (affects about 1 percent of all births in the U.S.) and other developmental risks in the child.

    • Tobacco usage and second-hand smoke can increase infertility, risk of pregnancy complications and preterm birth, and risk of developmental disorders in the baby.

    • Women are more likely to have chronic pain and be prescribed painkillers and use them for longer than men. With that, women are more likely to become dependent, which can be a risk to the baby as it could develop neonatal abstinence syndrome (NAS).

  • Risk Identification Strategies:

    • MOMS Ohio features training tools for health care providers, community health care workers, and child welfare workers to identify exposure and usage, as well as how to respond.

    • The NIDA quick screen tool is a very efficient way for providers to quickly screen for substance use and abuse.

      • In the past year, how often do you do the following?

        • Four or more drinks of alcohol in a day (never, once or twice, monthly, weekly, daily or almost daily).

        • Tobacco? (never, once or twice, monthly, weekly, daily or almost daily).

        • Prescription drugs – non-medical reason? (never, once or twice, monthly, weekly, daily or almost daily).

        • Illegal drugs? (never, once or twice, monthly, weekly, daily or almost daily).

Page Updated: 8/15/2017