Recovery Plus: Workplace wellbeing 44 September 2016 Alert: perinatal substance use Women of childbearing years represent about 1 out of every 4 individuals globally. The total population of women aged 15-44 in the UK in 2014 was 22.5 million with a total of 695,000 births (Office for National Statistics, 2014). In 2015, 1.6 billion women aged 15-44 years accounted for about 45% of the total female population (US Census Bureau, 2015). Women of childbearing years are projected to increase by over 0.4 billion between 2002-2050 (US Census Bureau, 2015). In 2012, there were almost 63 million women in the US aged 15-44 of whom 6% resulted in 3.9 million births (US Census Bureau). Given these statistics, women of childbearing years who represent a significant portion of the population and pregnancy, both intended and unintended, should be considered when addressing the health of our population. Substance use and overdose-related deaths are a public-health crisis and women represent a significant portion of this. An alarming 30% of people addicted to substances are women of childbearing years aged 15-44. The National Survey on Drug Use and Health showed that 5% of pregnant women in the US report using illicit substances in the past month, compared to 10% of nonpregnant women (SAMHSA, 2015). Alcohol use among pregnant women was 16.4% compared to 53.2% of nonpregnant women. These results, while promising, might be conservative due to stigma and fear of reporting, and might have not included women who did not know they were pregnant. NSDUH data also suggests that substance use curtails during pregnancy but resumes after pregnancy. Various risk factors exist for illicit substance use, including family history of drug addiction, history of addiction to any drug (including tobacco), history of psychiatric or psychological illness, and history of childhood trauma (SAMHSA, 2015). Research suggests that 55% to 99% of women who abused substances had a significant trauma history (Najavits et al, 1997). Other risk factors include involvement in an intimate relationship with a partner who abuses substances. Protective factors include marriage and partner support. Women are more likely than men to experience co-occurring substance use and mental-health disorders. It is estimated that 72% of women diagnosed with alcohol use disorder have cooccurring psychiatric illness, and 86% diagnosed with alcohol dependence have co-occurring psychiatric illness (Kessler et al, 1997). Anxiety disorders, depression, PTSD and eating disorders are the most common co-occurring psychiatric illnesses among women (Agrawal et al, 2005). Management of a pregnancy in a substanceabusing woman can be complex and involve psychosocial, medical and addiction issues. The perinatal period is a critical transitional time in a woman’s life where healthcare providers – and even employers – must address concerns with substance use and mental-health issues. Perinatal depression is estimated to affect 10% to 15% of women globally and is considered the most significant risk factor for postpartum depression (Agency for Healthcare Research and Quality, 2015; Melville, Gavin, Guo, Fan & By the end of this presentation at Recovery Plus Workplace Wellbeing, delegates will be able to: 1) Cite the prevalence and significance of substance use among perinatal women 2) Identify negative outcomes of substance use during pregnancy 3) Identify the healthcare provider’s role in substance use screening and treatment referral – and how that can help concerned employers.
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