Screening for Substance Use Disorders during Pregnancy: A Decision at the Intersection of Racial and Reproductive Justice

2021 ◽  
Author(s):  
Elizabeth Kravitz ◽  
Michelle Suh ◽  
Matthew Russell ◽  
Andres Ojeda ◽  
Judy Levison ◽  
...  
Keyword(s):  
Substance Use ◽  
Social History ◽  
Drug Screening ◽  
Racial Bias ◽  
The United States ◽  
Reproductive Justice ◽  
Black Mothers ◽  
Legislative History ◽  
Screening Policy ◽  
Screening Study

Objective: Improve racial equity with routine universal drug screening / Study Design: Commentary on the medicolegal and social history of the United States and the field of obstetrics and gynecology regarding drug screening policy / Results: Critical aspects to inform an equitable drug screening policy include (1) racial bias and stigma related to substance use, (2) the legislative history surrounding substance use during pregnancy, (3) the relationship between substance use and mass incarceration which disproportionately affects persons of color, (4) propensity toward punitive measures for Black mothers with substance use, including termination of parental rights, (5) the role of the medical field in fostering mistrust among our patients / Conclusion: new practices in screening for substance use during pregnancy are needed. Key Points

Exploring Black Women’s Pathways to Motherhood Within a Reproductive Justice Framework

2022 ◽  
pp. 104973232110668
Author(s):  
Seanna Leath ◽  
Patrice Wright ◽  
Bianka Charity-Parker ◽  
Erica Stephens
Keyword(s):  
Black Women ◽  
Family Planning ◽  
The United States ◽  
Structured Interview ◽  
Reproductive Decisions ◽  
Reproductive Justice ◽  
Consensual Qualitative Research ◽  
Black Mothers ◽  
Empirical Knowledge ◽  
Health Practitioners

Amidst the increasing push to address racial disparities in maternal health equity, fewer studies have considered Black women’s perspectives on their needs, concerns, and priorities regarding family planning care. Such evidence might help address the lack of support and information that many Black women report in patient–provider encounters, and broaden empirical knowledge on the contextual factors that influence Black women’s reproductive decisions. In the present qualitative study, we explored Black women’s pathways to motherhood within a reproductive justice framework. We drew on individual, semi-structured interview data from 31 Black mothers (25–50 years, Mage = 35 years) across the United States. Using consensual qualitative research methods, we elaborated on three themes: (1) intentional family planning, (2) unintended pregnancy, and (3) othermothering. The findings challenge deficit-based stereotypes of Black mothers’ reproductive choices and illuminate how health practitioners can facilitate humanizing conversations that prioritize Black women’s family planning goals and decision-making.

Reducing the Incidence of Substance Use Disorders in Anesthesiology Residents

2018 ◽  
Vol 129 (4) ◽  
pp. 821-828 ◽  
Author(s):  
Michael G. Fitzsimons ◽  
Keith Baker ◽  
Rajeev Malhotra ◽  
Andrew Gottlieb ◽  
Edward Lowenstein ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Drug Screening ◽  
Residency Program ◽  
Drug Testing ◽  
The United States ◽  
Nurse Anesthetists ◽  
Testing Program ◽  
Urine Drug ◽  
Urine Drug Screening

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background The incidence of substance use disorders in the United States among residents in anesthesiology is between 1% and 2%. A recent study reported that the incidence of substance use disorders in U.S. anesthesiology residents has been increasing. There are no reports of effective methods to prevent substance use disorder in residents. A comprehensive drug testing program including a random component may reduce the incidence of substance use disorders. Methods The authors initiated a comprehensive urine drug screening program of residents, fellows, faculty physicians, and certified nurse anesthetists. The authors performed 3,190 tests over 13 yr. The authors determined the incidence of substance use disorders among residents in our large anesthesiology residency program during the decade before (January 1, 1994, to December 31, 2003) and for the 13 yr after (January 1, 2004 to December 31, 2016) instituting a random urine drug testing program. A total of 628 residents trained in the program over these 23 yr; they contributed a total of 1,721 resident years for analysis. Fewer faculty and certified nurse anesthetists were studied, so we do not include them in our analysis. Results The incidence of substance use disorders among trainees in our department during the 10 yr before initiation of urine drug screening was four incidents in 719 resident years or 0.0056 incidents per resident-year. In the 13 yr after the introduction of urine drug screening, there have been zero incidents in 1,002 resident years in our residency program (P = 0.0305). Conclusions This single-center, comprehensive program including preplacement and random drug testing was associated with a reduction of the incidence of substance use disorders among our residents in anesthesiology. There were no instances of substance use disorders in our residents over the recent 13 yr. A large, multicenter trial of a more diverse sample of academic, government, and community institutions is needed to determine if such a program can predictably reduce the incidence of substance use disorders in a larger group of anesthesiology residents.

Pre-conceptual sex selection

2014 ◽  
Vol 155 (46) ◽  
pp. 1815-1819
Author(s):  
Máté Julesz
Keyword(s):  
Catholic Church ◽  
The United States ◽  
Criminal Code ◽  
Sex Selection ◽  
Reproductive Justice ◽  
Medically Assisted Procreation ◽  
Family Balancing ◽  
European Health ◽  
Selection For ◽  
The Catholic Church

According to Article 14 of the Oviedo Convention on Human Rights and Biomedicine of the Council of Europe, the use of techniques of medically assisted procreation shall not be allowed for the purpose of choosing a future child’s sex, unless serious hereditary sex-related disease is to be avoided. In Israel and the United States of America, pre-conceptual sex selection for the purpose of family balancing is legal. The European health culture does not take reproductive justice for part of social justice. From this aspect, the situation is very similar in China and India. Reproductive liberty is opposed by the Catholic Church, too. According to the Catholic Church, medical grounds may not justify pre-conceptual sex selection, though being bioethically less harmful than family balancing for social reasons. In Hungary, according to Section 170 of the Criminal Code, pre-conceptual sex selection for the purpose of family balancing constitutes a crime. At present, the Hungarian legislation is in full harmony with the Oviedo Convention, enacted in Hungary in 2002 (Act No. 6 of 2002). Orv. Hetil., 2014, 155(46), 1815–1819.

Racial Justice and Criminal Justice

2018 ◽  
Author(s):  
Andrew Valls
Keyword(s):  
Criminal Justice ◽  
African Americans ◽  
Criminal Justice System ◽  
Justice System ◽  
Racial Inequality ◽  
Racial Bias ◽  
The United States ◽  
Black Communities ◽  
Racial Justice ◽  
Black Neighborhoods

The criminal justice system in the United States both reflects racial inequality in the broader society and contributes to it. The overrepresentation of African Americans among those in prison is a result of both the conditions in poor black neighborhoods and racial bias in the criminal justice system. The American system of criminal justice today is excessively punitive, when compared to previous periods and to other countries, and its harsh treatment disproportionately harms African Americans. In addition, those released from prison face a number of obstacles to housing, employment, and other prerequisites of decent life, and the concentration of prisoners and ex-prisoners in black communities does much to perpetuate racial inequality.

scholarly journals Substance Use Disorder: A Model for Integration in Undergraduate Medical Education

2021 ◽  
Vol 8 ◽  
pp. 238212052110258
Author(s):  
Haritha Pavuluri ◽  
Nicolas Poupore ◽  
William Michael Schmidt ◽  
Samantha Gabrielle Boniface ◽  
Meenu Jindal ◽  
...  
Keyword(s):  
Medical Education ◽  
Substance Use ◽  
South Carolina ◽  
Substance Use Disorder ◽  
The United States ◽  
University Of South Carolina ◽  
Community Recovery ◽  
School Of Medicine ◽  
Treatment Gaps ◽  
The University

Substance Use Disorder (SUD) is a debilitating chronic illness with significant morbidity and mortality across the United States. The AAMC and LCME have supported the efforts for more effective medical education of SUD to address the existing stigma, knowledge, and treatment gaps. The Coronavirus 2019 (COVID-19) pandemic and associated social, economic, and behavioral impacts have added to this urgency. The University of South Carolina School of Medicine Greenville (USCSOMG), in collaboration with community organizations, has successfully implemented an integrated SUD education curriculum for medical students. Students learn about SUD in basic sciences, receive case-based education during clinical exercises, and are provided the opportunity to become a recovery coach and participate in the patient and family recovery meetings through this curriculum during preclinical years. During the clinical years, SUD education is enhanced with exposure to Medication for Addition Treatment (MAT). Students also partake in the care coordination of patients with SUD between the hospital and community recovery organizations. All students receive MAT waiver training in their final year and are prepared to prescribe treatment for SUD upon graduation. The experiences in this integrated curriculum integration can perhaps assist other organizations to implement similar components and empower the next generation of physicians to be competent and effective in treating patients with SUD.

Exploring Stakeholder and Parent Perspectives of a County Response to Adolescent Vaping and E-Cigarette Use

2021 ◽  
pp. 002204262199349
Author(s):  
Natasha Kurji ◽  
Thomas Koza ◽  
Amanda Sharp ◽  
Kathleen Moore
Keyword(s):  
United States ◽  
Substance Use ◽  
The United States ◽  
Classroom Observations ◽  
School Age ◽  
Parent Perspectives ◽  
Cigarette Use ◽  
Perceived Effectiveness ◽  
Tobacco Products ◽  
Hillsborough County

In the United States, regular cigarette use has steadily declined over the years; however, it has been met with an increase in vaping and e-cigarette use. In Tampa, Florida, this trend has been found especially prevalent among school-aged youth. To combat issues of substance use among youth and prevent criminalization for nonviolent crimes, school-age youth cited for use and possession of tobacco products in Hillsborough County were mandated to attend the Youth Tobacco Awareness Course (YTAC). The aim of this study was to investigate YTAC for its perceived effectiveness and usefulness in mitigating adolescent e-cigarette use. Classroom observations, parent focus groups, and program stakeholder interviews were conducted to comprehensively evaluate this program. Findings from this evaluation led to a deeper understanding of the barriers and facilitators to an effective course, the needs and perceptions of program stakeholders, as well as recommendations for improved future interventions.

scholarly journals Birthing #blackboyjoy: Black Midwives Caring for Black Mothers of Black Boys During Pregnancy and Childbirth

2021 ◽  
Author(s):  
Keisha L. Goode ◽  
Arielle Bernardin
Keyword(s):  
Black People ◽  
Professional Organizations ◽  
Black Boys ◽  
Reproductive Justice ◽  
Black Mothers ◽  
Snowball Sampling ◽  
Structural Racism ◽  
Psychosocial Experiences ◽  
Pregnancy And Childbirth ◽  
Black Life

Abstract Background Structural racism mediates all aspects of Black life. The medicalization of pregnancy and childbirth, and its detrimental impacts on Black birth, is well documented. The Black Lives Matter movement has elevated the national consciousness on all aspects of Black life, but significant attention has been directed toward the murder and dehumanization of Black men and boys. Black midwives, caring for Black people, using the Midwives Model of Care© which consistently demonstrates its efficacy and better outcomes for Black people, are uniquely positioned to witness the physical and psychosocial experiences of birthing Black boys in America. Methods Between 2011 and 2013, the first author conducted interviews with 22 Black midwives to understand their perceptions of, and experiences in, predominantly white midwifery education programs and professional organizations. Convenience and snowball sampling were used. This paper investigates previously unreported and unexamined data from the original study by focusing on the witness and insight of nine midwives who provided care for Black mothers of boys during pregnancy and childbirth. Findings The data presented three themes: It’s a Boy: On Restlessness and Complicated Uneasiness; Desensitization of Black Death; and, Physiological Impacts of Toxic Stress. Conclusions The findings demonstrate that caring for Black people must be simultaneously theorized and executed within an anti-racist, relationship-centered, reproductive justice framework. Black midwives are uniquely positioned to do this work. Greater attention, in practice and in research, is needed to investigate the birth experiences of Black mothers of boys.

Association Between Intimate Partner Violence Subtypes and Post-traumatic Stress Disorder Symptoms and Hazardous Substance Use

2021 ◽  
pp. 088626052110219
Author(s):  
Matthew M. Yalch ◽  
Sloane R. M. Rickman
Keyword(s):  
Substance Use ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Partner Violence ◽  
The United States ◽  
Cumulative Effects ◽  
Hazardous Substance ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

Intimate partner violence (IPV) is a common problem for women in the United States and is associated with symptoms of post-traumatic stress disorder (PTSD) as well as hazardous use of substances like alcohol and drugs. However, not all subtypes of IPV (i.e., physical, sexual, and psychological) are equally predictive of PTSD and hazardous substance use. Although previous research suggests that psychological IPV has the strongest relative effect on PTSD symptoms and substance use, there is less research on IPV subtypes’ cumulative effects. In this study, we examined the relative and cumulative effects of physical, sexual, and psychological IPV on PTSD symptoms and hazardous substance use in a sample of women in the United States recruited via Amazon’s Mechanical Turk ( N = 793) using bootstrapped multiple regression and configural frequency analyses. Results suggest that physical IPV had the most pronounced influence (medium-large effect sizes) on substance use across women, but that the cumulative effects of all three IPV subtypes were most closely associated with diagnostic levels of both PTSD and substance use at the level of groups of women. These findings clarify and extend previous research on the differential effects of IPV subtypes and provide directions for future research and clinical intervention.

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