A Longitudinal Study on Substance Use and Related Problems in Women in Opioid Maintenance Treatment from Pregnancy to Four Years after Giving Birth

Background Women in opioid maintenance treatment (OMT) have a past characterized by drug abuse, which is a challenging start for parenthood. Studies of mothers in OMT are typically limited to pregnancy and early infancy. Knowledge about how they cope with substance use and related problems in the years following birth is therefore important. The aims of the study were to examine changes in mothers’ substance use, psychological problems, and other challenges; from one to four years after their children were born, and describe kindergarten attendance and prevalence and type of child protective services involvement when the children were four years old. Method A four-year prospective cohort study of mothers in OMT. The European severity index was used to map substance use and related problems during the third trimester of pregnancy, one and four years after birth. Results At the four-year follow-up, use of illegal substances remained low (4%) and use of legal substances (39%) was similar to the one-year follow-up. The proportion of women with psychological problems was significantly higher than at one-year follow-up (69 vs. 39%, P = .009). At age four, most children (89%) attended kindergarten, and the child protective services were following 73% of the families, mostly with voluntary measures. Conclusion Mothers in OMT cope well with substance use over time, given access to sufficient support. The findings imply that a preventive governmental strategy with close support of mother and child, have a positive impact contributing to making OMT and motherhood more compatible.

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Substance Use, Hospitalizations, and Co-Occurring Disorders among Patients Transferred from a Needle Exchange Program to Opioid Maintenance Treatment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020697 ◽

2022 ◽

Vol 19 (2) ◽

pp. 697

Author(s):

Martin Bråbäck ◽

Anna Brantefors ◽

Johan Franck ◽

Louise Brådvik ◽

Pernilla Isendahl ◽

...

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Maintenance Treatment ◽

Needle Exchange ◽

Needle Exchange Program ◽

Psychiatric Diagnoses ◽

Opioid Maintenance Treatment ◽

Exchange Program ◽

Sedative Hypnotics

Opioid use disorders (OUD) is a relapsing condition with high mortality. Opioid maintenance treatment (OMT) reduces heroin use, and overall morbidity and mortality. The prevalence of psychiatric and substance use disorders, potential baseline predictors for psychiatric hospitalization, and psychiatric diagnoses at follow-up were investigated and may give hints about possible preventative strategies. The medical records for 71 patients were reviewed 36 months following referral to OMT from a needle exchange program (NEP). Their psychiatric diagnoses and hospitalizations were identified. Their baseline characteristics were assessed for potential differences between hospitalized versus non-hospitalized patients and between patients with and without psychiatric diagnoses in a longitudinal observational study without controls. A regression analysis was performed to identify predictors for hospitalization when controlling for OMT status. Sixty-five percent of the patients were hospitalized at least once with a psychiatric diagnosis. Substance-related reasons were prevalent, and detoxification occurred among 59% of patients, with sedative- hypnotics (benzodiazepines, zopiclone, zolpidem, and pregabalin) being the substance used by 52% of patients. Baseline use of these drugs and/or buprenorphine predicted for hospitalization when controlling for OMT status. During the follow-up period, 72% of patients met the criteria for a psychiatric diagnosis other than OUD. The prevalence of non-substance use disorders overlapping with SUD was 41%, and that overlapping with anxiety disorder was 27% of all participants. Increased attention to psychiatric co-occurring disorders in the treatment of OUD is required and the importance of addressing sedative-hypnotics use when initiating OMT is highlighted.

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Infant Safe Sleep Promotion: Increasing Capacity of Child Protective Services Employees

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084227 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4227

Author(s):

Carolyn R. Ahlers-Schmidt ◽

Christy Schunn ◽

Ashley M. Hervey ◽

Maria Torres ◽

Cherie Sage ◽

...

Keyword(s):

Infant Death ◽

Child Protective Services ◽

Sudden Infant Death ◽

Sudden Infant ◽

Protective Services ◽

Safe Sleep ◽

Train The Trainer ◽

Baseline Knowledge ◽

One Year ◽

The Impact

Sleep-related infant deaths, including Sudden Infant Death Syndrome (SIDS), are the number one cause of death in infants between 28 days and one year of life. Nearly half of families experiencing a sleep-related infant death in Kansas were involved with the Department of Children and Families Child Protective Services (CPS), making CPS staff a priority for safe sleep training. This study assessed the impact of the two-day Kansas Infant Death and SIDS (KIDS) Network Safe Sleep Instructor (SSI) train-the-trainer program on CPS staffs’ knowledge of the American Academy of Pediatrics safe sleep recommendations. Training was attended by 43 participants, 27 (63%) of whom were employed by CPS. CPS staff had significantly lower baseline knowledge on the 10-item pretest (t = 3.33, p = 0.002), but both CPS and other attendees showed significant improvement by posttest (t = 8.53, p < 0.001 and t = 4.44, p < 0.001, respectively). Following SSI certification, CPS SSIs provided more safe sleep training to professionals than other SSIs (1051 vs. 165, respectively), and both groups of SSIs were able to significantly increase the knowledge of their trainees. Overall, the KIDS Network SSI training was successful. The innovative partnership with CPS allowed for provision of training to a group not historically targeted for safe sleep education.

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Using Bayesian Space-Time Models to Understand the Substance Use Environment and Risk for Being Referred to Child Protective Services

Substance Use & Misuse ◽

10.1080/10826080701690649 ◽

2008 ◽

Vol 43 (2) ◽

pp. 239-251 ◽

Cited By ~ 41

Author(s):

Bridget Freisthler ◽

Robert E. Weiss

Keyword(s):

Substance Use ◽

Child Protective Services ◽

Space Time ◽

Protective Services

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Help-Seeking in Depressed Out-patients Following Maintenance Therapy

The British Journal of Psychiatry ◽

10.1192/bjp.129.3.252 ◽

1976 ◽

Vol 129 (3) ◽

pp. 252-260 ◽

Cited By ~ 7

Author(s):

Myrna M. Weissman ◽

Stanislav V. Kasl

Keyword(s):

Maintenance Therapy ◽

Help Seeking ◽

Maintenance Treatment ◽

Suicide Attempts ◽

Clinical Status ◽

Subsequent Treatment ◽

Access To Treatment ◽

One Year

SummaryThis paper reports on the clinical status, help-seeking and subsequent treatment experiences of 150 women one year after they had completed out-patient maintenance treatment by amitriptyline and/or psychotherapy for a depressive episode.While the majority of patients were asymptomatic at follow-up, a substantial minority had a return of acute symptoms and 2 per cent made minor suicide attempts during the year. Admission to hospital was rare. However, only 30 per cent of the patients did not seek any treatment during the year and the majority received some psychotropic medication.The findings support the long-term need for prompt access to treatment by patients who have recovered from an acute depression.

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Pilot Study of Problem Gambling in Specialized Substance Use Disorder Treatment—High Lifetime Prevalence of Problem Gambling in Opioid Maintenance Treatment Patients

Open Journal of Psychiatry ◽

10.4236/ojpsych.2018.83020 ◽

2018 ◽

Vol 08 (03) ◽

pp. 233-243

Author(s):

Anders Håkansson ◽

Johanna Ek

Keyword(s):

Substance Use ◽

Pilot Study ◽

Problem Gambling ◽

Substance Use Disorder ◽

Maintenance Treatment ◽

Lifetime Prevalence ◽

Opioid Maintenance Treatment ◽

Substance Use Disorder Treatment ◽

Disorder Treatment

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Living a normal life? Follow-up study of women who had been in opioid maintenance treatment during pregnancy

Journal of Substance Abuse Treatment ◽

10.1016/j.jsat.2020.108004 ◽

2020 ◽

Vol 113 ◽

pp. 108004

Author(s):

Gabrielle K. Welle-Strand ◽

Svetlana Skurtveit ◽

Kristine Fiksdal Abel ◽

Fatemeh Chalabianloo ◽

Monica Sarfi

Keyword(s):

Maintenance Treatment ◽

Opioid Maintenance Treatment ◽

Follow Up Study ◽

Normal Life

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Persistence of psychological problems in adolescence: a one year follow-up study

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700008089 ◽

2004 ◽

Vol 21 (1) ◽

pp. 11-17 ◽

Cited By ~ 4

Author(s):

Deborah James ◽

Maria Lawlor ◽

Nick Sofroniou

Keyword(s):

Psychological Problems ◽

Self Report ◽

Slight Reduction ◽

Youth Self Report ◽

Increased Risk ◽

Externalising Problems ◽

Males And Females ◽

One Year ◽

Internalising Problems

AbstractObjectives: To examine the prevalence and persistence of psychological problems in older adolescents.Methods: This study is a one year follow-up of 110 adolescents, 64 girls and 46 boys attending three secondary schools in Ireland. All were 16 at initial testing. The Youth Self Report (YSR) was the measure used.Results: Over a fifth of adolescents have problems in the clinical range. These problems persisted from 16 to 17. Females reported more problems than males at both ages. Some females showed a slight reduction in internalising problems at 17. Both males and females showed an increase in externalising problems at 17. Odds ratios indicate that those in the clinical ranges of the YSR at 16, had increased risk of being in the clinical range at 17 compared to those in the no problem range at 16. In comparison to those with no suicidal feeling, those with suicidal feelings at 16 were at an increased risk of still feeling suicidal at 17. More males remained psychologically healthy than girls.Conclusions: A large proportion of adolescents in this sample have psychological problems and these appear to persist over a one year period. These problems impact substantially on the adolescents themselves, their families and society. Given the increasing suicide rate in young people and the persistence of suicidal feelings in this cohort, the inadequacy of mental health services in Ireland for adolescents, particularly those ages 16-18 is highlighted. The challenge of developing and providing adolescent friendly services is addressed.

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