Mothers and Substance Use

By Christopher Welsh, MD

Women have some unique challenges when it comes to alcohol, tobacco and drug use and misuse. These differences are based on both biology and culturally defined expectations of women. Hormonal changes, the menstrual cycle, fertility issues, pregnancy, breastfeeding and menopause can all impact a woman’s use of substances. Women often use smaller amounts of a substance for shorter amounts of time before developing a problem. They also may have greater physical problems from their substance misuse.

Alcohol, tobacco and drug use during pregnancy can present significant problems for both the mother and the fetus/baby. Different substances can increase the chances of:

  • miscarriage,
  • stillbirth,
  • premature birth,
  • small head size,
  • low birth weight, and
  • delayed physical and brain development.

When a woman uses substances – especially opioid pain killers, sedatives and alcohol – during pregnancy, the baby may go through withdrawal after birth. This condition is often called neonatal abstinence syndrome (NAS).

Although it can be hard for anyone with a substance use disorder to stop, women, in particular, may be afraid to get help during or after pregnancy due to concerns over possible legal or social services involvement. Issues related to child care also make it harder for women to get treatment.

If you have a problem with substance misuse, it is important to get help. Counseling and medications can be very helpful, as FDA-approved medicines do exist to help with addiction to opioids, alcohol and tobacco.

Call the University of Maryland Medical Center’s Outpatient Addictions Treatment Services (OATS) at 410-328-6600. The program even has a play center where children are watched while you participate in counseling.

Dr. Welsh is the medical director of Substance Abuse Consultation Service and medical director of the Comprehensive Recovery Program at University of Maryland Medical Center, and an associate professor of psychiatry at University of Maryland School of Medicine.

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