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Review
. 2016 Nov;215(5):539-547.
doi: 10.1016/j.ajog.2016.06.038. Epub 2016 Jul 1.

The role of screening, brief intervention, and referral to treatment in the perinatal period

Tricia E Wright  1 , Mishka Terplan  2 , Steven J Ondersma  3 , Cheryl Boyce  4 , Kimberly Yonkers  5 , Grace Chang  6 , Andreea A Creanga  7
Affiliations
Review

The role of screening, brief intervention, and referral to treatment in the perinatal period

Tricia E Wright et al. Am J Obstet Gynecol. 2016 Nov.

Abstract

Substance use during pregnancy is at least as common as many of the medical conditions screened for and managed during pregnancy. While harmful and costly, it is often ignored or managed poorly. Screening, brief intervention, and referral to treatment is an evidence-based approach to manage substance use. In September 2012, the US Centers for Disease Control and Prevention convened an Expert Meeting on Perinatal Illicit Drug Abuse to help address key issues around drug use in pregnancy in the United States. This article reflects the formal conclusions of the expert panel that discussed the use of screening, brief intervention, and referral to treatment during pregnancy. Screening for substance use during pregnancy should be universal. It allows stratification of women into zones of risk given their pattern of use. Low-risk women should receive brief advice, those classified as moderate risk should receive a brief intervention, whereas those who are high risk need referral to specialty care. A brief intervention is a patient-centered form of counseling using the principles of motivational interviewing. Screening, brief intervention, and referral to treatment has the potential to reduce the burden of substance use in pregnancy and should be integrated into prenatal care.

Keywords: alcohol; brief intervention; opioid use; pregnancy; referral to treatment; screening; substance use disorders; tobacco.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

FIGURE 1
FIGURE 1. Risk pyramid for assessment of substance use during pregnancy
SUD, substance use disorder.
FIGURE 2
FIGURE 2. Flow chart of screening, brief intervention, and referral to treatment (SBIRT) in practice
Flow chart of screening, brief intervention, and referral to treatment (SBIRT) in practice.
See this image and copyright information in PMC

Comment in

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