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Maternal Substance Use, a Growing Problem :

December 14, 2018

Three years ago, I wrote this blog about the use of prescription painkillers. Pediatrics in Review published two review articles on the topic in December 2015. At the time, I described a 2014 Tennessee law allowing mothers to be charged with assault for illegally using narcotics during pregnancy. Although that law was ineffective and was allowed to expire in 2016, the underlying problem continues to grow. Nationally, there are now over 50 deaths each day from prescription painkiller abuse; 3.8% of those occur here in Tennessee. When including non-prescription opioids and other overdoses, the death toll increases tremendously.

If political ads offer any insight into the important issues of our time, the recent US Senate race is a prime example. My social media feeds were filled with competing ads, each blaming the other party’s candidate for contributing to the opioid epidemic in Tennessee. This is a problem that no one seems able to control. While legislators and law enforcement leaders battle each other over how to prevent and punish drug abuse, our patients suffer.

Alcohol, marijuana, cocaine, methamphetamine, opioids, and other substances are used frequently in by adults and adolescents, and many women continue to use these drugs throughout pregnancy. When they do so, the effects on the developing fetus can have life-long consequences.

In this month’s Pediatrics in Review, Drs. Bailey and Diaz-Barbosa give us an overview of addictive substances commonly consumed during pregnancy (, both legal and illegal. They highlight the effects on the growing fetus, assessment and treatment needs of the exposed neonate, and lasting consequences for the child. Awareness of these outcomes will help us support affected families by properly counselling the mother and providing appropriate care for the growing child.

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