Substance Use Disorders

Substance use disorder is a growing clinical and public concern, especially among pregnant and puerperal women. This chapter provides a comprehensive analysis of the negative impacts of substance use, including cannabinoids, opioids, and psychostimulants, on both maternal and neonatal physical and/or mental health during pregnancy. Exposure to these substances may determine risks in the teratogenesis, foetal malformations, and perinatal complications, including low birth weight, preterm delivery, and neonatal abstinence syndrome. In addition, prenatal exposure has been associated with long-term behavioural and neurodevelopmental disorders in the offspring. The chapter also aims at providing clinicians working in the field of addiction medicine and psychiatry a set of practical, evidence-based, recommendations for the management of pregnant and puerperal women with SUDs, emphasizing the importance of multidisciplinary approaches that integrate both pharmacological and non-pharmacological interventions. Moreover, an overview of the commonly used pharmacotherapeutic approaches in SUD will be provided here; a range of practical recommendations in balancing risks versus benefits of an untreated SUD versus the treatment of these conditions in pregnant and puerperal women will be offered as well. Early screening is fundamental to optimize outcomes for both the mother and her child.