Obstetrics & Gynecology

THE TRUETOX DIFFERENCE

Medication Monitoring with Urine Drug Testing in Obstetrics / Gynecology (OB/GYN) safeguards the health of mother and child

Why screen for substance use disorders (SUD)?

• Professional societies including ACOG recommend Universal Screening
• Sheer prevalence of SUD’s in all socioeconomic, cultural and ethnic strata
• Early screening and brief intervention has been validated as a way to decrease unhealthy behaviors including drinking and smoking.
• Especially in pregnant women, SUD’s can result in increased morbidity and mortality in both mother and fetus

Screening for Drug Abuse – A single question: How many times have you used a prescription drug for other than its intended purpose or an illicit drug in the last year? Greater than zero is a positive screen and you must assess the patient for degree of the problem.

• Many validated screens (DAST, NIDA quick screen, and others)
• Basically screen for lifetime use and current use and severity of the problem
• Consider that many patients have polysubstance use problems
• Referral to a specialist to co-manage a patient may be appropriate
• History – Look for ‘red flags’ – Missed appointments, late appointments, chaotic maternal life style, psychiatric diagnoses, spouse/partner alcohol or drug abuser

Consider Urine Drug Screening (UDS) after informed consent with ‘red flag’ history

Selective screening should have patient consent. Screening should enhance clinician/patient relationship, not conflict and there are patient autonomy considerations

Screening is useful for following compliance and abstinence but has limitations. Toxicologic screening may be useful in situations when the patient is symptomatic, when the nature of the presenting illness suggests drug use as a cause, and when the information will direct medical interventions.