{"id":10644,"date":"2021-05-17T16:31:09","date_gmt":"2021-05-17T15:31:09","guid":{"rendered":"https:\/\/path-perinatal.eu\/uk\/?post_type=professionals&#038;p=10644"},"modified":"2022-04-28T11:38:06","modified_gmt":"2022-04-28T10:38:06","slug":"alcohol-tobacco-and-substance-use","status":"publish","type":"professionals","link":"https:\/\/path-perinatal.eu\/uk\/professionals\/alcohol-tobacco-and-substance-use\/","title":{"rendered":"Alcohol, tobacco and substance use"},"content":{"rendered":"\n<section id=\"gm20a9b4b\" class=\"wp-block-gutentor-m3 section-gm20a9b4b gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-gb53a09\" class=\"wp-block-gutentor-e6 section-gb53a09 gutentor-element gutentor-element-image text-align-center-desktop text-align-center-tablet text-align-center-mobile crop crop-top\"><div class=\"gutentor-element-image-box\"><div class=\"gutentor-bg-image\"><\/div><\/div><\/div>\n\n\n\n<div id=\"section-g546207\" class=\"wp-block-gutentor-e1 section-g546207 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">The concept of \u201csubstance use disorders\u201d includes dependence syndrome and harmful use of psychoactive substances such as alcohol, cannabis, amphetamine-type stimulants (ATS), cocaine, opioids and benzodiazepines.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm711dab8\" class=\"wp-block-gutentor-m3 section-gm711dab8 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g15b6b9\" class=\"wp-block-gutentor-e1 section-g15b6b9 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Pregnancy can be a motivator for women to stop or reduce her use of alcohol, tobacco or recreational drugs. Women can find it difficult to disclose use of substances as she can feel judged or worry that her parenting ability will be questioned. Therefore, empathic and non-judgemental enquiry is key during such assessments. Professionals also need to consider the broader factors occurring alongside alcohol and substance use in women in the perinatal period, such as misuse of alcohol or substances amongst other members of the household, domestic violence and whether there are any safeguarding concerns.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div id=\"section-g600a34\" class=\"wp-block-gutentor-e1 section-g600a34 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Professionals need to assess risk for women, unborn\/baby and family especially if there is polysubstance use and high levels of social, psychological or physical health concerns. They need to offer information to women about the potential effects of alcohol, tobacco or substance misuse on the unborn baby and what to expect when the baby is born, for example what medical care the baby may need and potential involvement of Children\u2019s Services. It is also important to explain to women the conditions where confidentiality might need to be breached to make a safeguarding referral.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div id=\"section-g130ca3\" class=\"wp-block-gutentor-e1 section-g130ca3 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">It is essential that pregnant\/postnatal women who misuse alcohol or substances are offered integrated care from different services including GP, maternity care team, health visitor and specialist substance misuse team.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm8aec6e4\" class=\"wp-block-gutentor-m3 section-gm8aec6e4 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-gda956d\" class=\"wp-block-gutentor-e1 section-gda956d gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong>Drug and alcohol misuse<\/strong><\/h3><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-g8d3ee9\" class=\"wp-block-gutentor-e1 section-g8d3ee9 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Heavy drinking and binge drinking in pregnancy is associated with an increased risk of prematurity and low birth weight and a range of physical, behavioural, and learning problems, collectively known as <a href=\"https:\/\/www.nhs.uk\/conditions\/foetal-alcohol-syndrome\/\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">foetal alcohol spectrum <\/span><\/a>disorders. Neonates may also experience a withdrawal syndrome.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div id=\"section-g051148\" class=\"wp-block-gutentor-e1 section-g051148 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Cannabis use in pregnancy has been associated with adverse obstetric and neonatal outcomes in some studies, although uncertainty still exists in light of which complete abstinence is encouraged. Use of opioids (street heroin and other prescribed and non-prescribed opiates) by the mother may lead to withdrawal in the foetus and\/or overdose in the mother.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div id=\"section-g88e472\" class=\"wp-block-gutentor-e1 section-g88e472 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Indirect risks include those from injecting (such as infected injection sites and bloodborne viruses); the effects of comorbid alcohol and substance use; poor diet and malnutrition; neglect of personal care; domestic violence; and poor engagement with obstetric services.<\/p><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm8ac5597\" class=\"wp-block-gutentor-m3 section-gm8ac5597 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-ge76c9d\" class=\"wp-block-gutentor-e7 section-ge76c9d gutentor-element gutentor-element-list\"><ul class=\"grid-row gutentor-grid-item-wrap list-indicator-icon\"><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-0\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">If hazardous drug or alcohol misuse is identified, refer the woman or offer brief interventions and information on self-help groups. Brief interventions are short and structured interventions to encourage behaviour change<br><br>A brief intervention consists of five basic steps and remain consistent regardless of the number of sessions or the length of the intervention. They include:<br><br>1. Introducing the issue in the context of the health of women and foetus\/baby<br>2. Screening, evaluating, and assessing<br>3. Providing feedback<br>4. Talking about change and setting goals<br>5. Summarising and reaching closure<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-1\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Liaise with midwifery for access to specialist midwife for substance misuse<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-2\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">If harmful or dependent drug or alcohol misuse is identified refer to local substance use services for advice and treatment<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-3\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Referral to specialist drug and alcohol services is advised for women who are dependent on substances such as alcohol and opioids, who require substitute prescribing, or those with complex comorbidities<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-4\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Women with comorbid mental health illness may also benefit from perinatal mental health services, if they are available<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-5\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">For women dependent on alcohol, refer to a service that can support early detoxification, ideally as an inpatient. Advise against stopping drinking suddenly because of the risk of life-threatening complications of alcohol withdrawal such as seizures<\/p><\/span><\/span><\/span><\/li><\/ul><\/div>\n\n\n\n<div id=\"section-gf848cc\" class=\"wp-block-gutentor-e1 section-gf848cc gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong><strong>Tobacco<\/strong><\/strong><\/h3><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-default\" \/>\n\n\n\n<div id=\"section-g9e7155\" class=\"wp-block-gutentor-e1 section-g9e7155 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Smoking during pregnancy is associated with a range of adverse offspring outcomes, including reduced foetal growth, increased risk of miscarriage, prematurity, placental abruption, and stillbirth.<\/p><\/div><\/div>\n\n\n\n<div id=\"section-g5beb38\" class=\"wp-block-gutentor-e7 section-g5beb38 gutentor-element gutentor-element-list\"><ul class=\"grid-row gutentor-grid-item-wrap list-indicator-icon\"><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-0\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">NHS England advise that carbon monoxide testing be offered at antenatal booking and as required throughout pregnancy to identify women exposed to tobacco<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-1\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Consider referral to smoking cessation services<\/p><\/span><\/span><\/span><\/li><li class=\"gutentor-list-item grid-lg-12 grid-md-12 grid-12\"><span class=\"gutentor-single-item gutentor-single-item-2\"><span class=\"gutentor-list-item-wrap g-s-list-wrap\"><span class=\"gutentor-single-list-item-icon\"><i class=\"list-item-icon fas fa-arrow-right\"><\/i><\/span><span class=\"gutentor-list-item\"><p class=\"gutentor-single-item-title\">Consider alternatives that are likely to be safer than cigarettes, such as nicotine replacement therapy<\/p><\/span><\/span><\/span><\/li><\/ul><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm3f7aee6\" class=\"wp-block-gutentor-m3 section-gm3f7aee6 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g6e6e70\" class=\"wp-block-gutentor-e1 section-g6e6e70 gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h1 class=\"gutentor-text\">Educational resources and patient information leaflets<\/h1><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gmce33208\" class=\"wp-block-gutentor-m3 section-gmce33208 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<section id=\"gmb7f2d02\" class=\"wp-block-gutentor-m4 section-gmb7f2d02 gutentor-module gutentor-advanced-columns\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\"><div class=\"grid-row\">\n<div id=\"col-gm13b658\" class=\"wp-block-gutentor-m4-col col-gm13b658 gutentor-single-column  grid-lg-6 grid-md-12 grid-12\"><div id=\"section-gm13b658\" class=\"section-gm13b658 gutentor-col-wrap\">\n<section id=\"gm0856e7a\" class=\"wp-block-gutentor-m3 section-gm0856e7a gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-g280a8a\" class=\"wp-block-gutentor-e1 section-g280a8a gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong>Royal College of Paediatrics and Child Health. Safeguarding\u2014learning resources<\/strong><\/h3><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm806715f\" class=\"wp-block-gutentor-m3 section-gm806715f gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-g9a217b\" class=\"wp-block-gutentor-e1 section-g9a217b gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\"><a href=\"https:\/\/www.rcpch.ac.uk\/resources\/safeguarding-learning-resources\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">rcpch.ac.uk\/resources\/safeguarding-learning-resources<\/span><\/a><\/p><\/div><\/div>\n<\/div><\/section>\n<\/div><\/div>\n\n\n\n<div id=\"col-gmcc7bfe\" class=\"wp-block-gutentor-m4-col col-gmcc7bfe gutentor-single-column  grid-lg-6 grid-md-12 grid-12\"><div id=\"section-gmcc7bfe\" class=\"section-gmcc7bfe gutentor-col-wrap\">\n<section id=\"gm2a0c6c8\" class=\"wp-block-gutentor-m3 section-gm2a0c6c8 gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-g403905\" class=\"wp-block-gutentor-e1 section-g403905 gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong>NCSCT. Smoking cessation: a briefing for midwifery staff<\/strong><\/h3><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gmac39588\" class=\"wp-block-gutentor-m3 section-gmac39588 gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-g8298ee\" class=\"wp-block-gutentor-e1 section-g8298ee gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\"><a href=\"https:\/\/www.ncsct.co.uk\/usr\/pub\/Midwifery_briefing_%20V3.pdf\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">ncsct.co.uk\/usr\/pub\/Midwifery_briefing_%20V3.pdf<\/span><\/a><\/p><\/div><\/div>\n<\/div><\/section>\n<\/div><\/div>\n<\/div><\/div><\/section>\n<\/div><\/section>\n\n\n\n<section id=\"gm764c88f\" class=\"wp-block-gutentor-m3 section-gm764c88f gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<section id=\"gmb6a5935\" class=\"wp-block-gutentor-m4 section-gmb6a5935 gutentor-module gutentor-advanced-columns\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\"><div class=\"grid-row\">\n<div id=\"col-gm39b71e\" class=\"wp-block-gutentor-m4-col col-gm39b71e gutentor-single-column  grid-lg-6 grid-md-12 grid-12\"><div id=\"section-gm39b71e\" class=\"section-gm39b71e gutentor-col-wrap\">\n<section id=\"gm1c38536\" class=\"wp-block-gutentor-m3 section-gm1c38536 gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-g999143\" class=\"wp-block-gutentor-e1 section-g999143 gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong>NHS Stop Smoking Services<\/strong><\/h3><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm3149a48\" class=\"wp-block-gutentor-m3 section-gm3149a48 gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-ge31835\" class=\"wp-block-gutentor-e1 section-ge31835 gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\"><a href=\"https:\/\/www.nhs.uk\/live-well\/quit-smoking\/nhs-stop-smoking-services-help-you-quit\/\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">nhs.uk\/live-well\/quit-smoking\/nhs-stop-smoking-services-help-you-quit\/<\/span><\/a><\/p><\/div><\/div>\n<\/div><\/section>\n<\/div><\/div>\n\n\n\n<div id=\"col-gm31785d\" class=\"wp-block-gutentor-m4-col col-gm31785d gutentor-single-column  grid-lg-6 grid-md-12 grid-12\"><div id=\"section-gm31785d\" class=\"section-gm31785d gutentor-col-wrap\">\n<section id=\"gm00b4a05\" class=\"wp-block-gutentor-m3 section-gm00b4a05 gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-g94d03c\" class=\"wp-block-gutentor-e1 section-g94d03c gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong><strong>Royal College of Obstetricians and Gynaecologists. Alcohol and pregnancy patient information leaflet<\/strong><\/strong><\/h3><\/div><\/div>\n<\/div><\/section>\n\n\n\n<section id=\"gm5d6a702\" class=\"wp-block-gutentor-m3 section-gm5d6a702 gutentor-module gutentor-container-cover\"><div class=\"grid-container gutentor-rm-ct-space-d gutentor-rm-ct-space-t gutentor-rm-ct-space\">\n<div id=\"section-g11312b\" class=\"wp-block-gutentor-e1 section-g11312b gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\"><a href=\"https:\/\/www.rcog.org.uk\/en\/patients\/patient-leaflets\/alcohol-and-pregnancy\/\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">rcog.org.uk\/en\/patients\/patient-leaflets\/alcohol-and-pregnancy\/<\/span><\/a><\/p><\/div><\/div>\n<\/div><\/section>\n<\/div><\/div>\n<\/div><\/div><\/section>\n<\/div><\/section>\n\n\n\n<section id=\"gmc152530\" class=\"wp-block-gutentor-m3 section-gmc152530 gutentor-module gutentor-container-cover has-color-bg has-custom-bg\"><div class=\"grid-container\">\n<div id=\"section-g32b5f4\" class=\"wp-block-gutentor-e1 section-g32b5f4 gutentor-element gutentor-element-advanced-text\"><div class=\"gutentor-text-wrap\"><h3 class=\"gutentor-text\"><strong><strong>Reference<\/strong><\/strong>s<\/h3><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color is-style-default\" \/>\n\n\n\n<div id=\"section-ge22d35\" class=\"wp-block-gutentor-e1 section-ge22d35 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">UK National Institute for Health and Care Excellence (NICE). Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors (clinical guideline CG110). 2010. <a href=\"https:\/\/www.nice.org.uk\/Guidance\/CG110\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">https:\/\/www.nice.org.uk\/Guidance\/CG110<\/span><\/a><\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color is-style-default\" \/>\n\n\n\n<div id=\"section-g944a42\" class=\"wp-block-gutentor-e1 section-g944a42 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">UK National Institute for Health and Care Excellence (NICE). Antenatal and postnatal mental health: clinical management and service guidance (clinical guideline CG192). 2018. <a href=\"https:\/\/www.nice.org.uk\/guidance\/CG192\"><span class=\"has-inline-color has-vivid-cyan-blue-color\">https:\/\/www.nice.org.uk\/guidance\/CG192<\/span><\/a><\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color is-style-default\" \/>\n\n\n\n<div id=\"section-g62b664\" class=\"wp-block-gutentor-e1 section-g62b664 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">World Health Organization. Guidelines for the identification and management of substance use and substance use disorders in pregnancy. 2014.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color is-style-default\" \/>\n\n\n\n<div id=\"section-g083ca8\" class=\"wp-block-gutentor-e1 section-g083ca8 gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Whicher, E et al 2012 Pilot Project to Evaluate the Effectiveness and Acceptability of Single-session Brief Counseling for the Prevention of Substance Misuse in Pregnant Adolescents, Addictive Disorders and Their Treatment.<\/p><\/div><\/div>\n\n\n\n<hr class=\"wp-block-separator has-text-color has-background has-white-background-color has-white-color is-style-default\" \/>\n\n\n\n<div id=\"section-g660c1c\" class=\"wp-block-gutentor-e1 section-g660c1c gutentor-element gutentor-element-advanced-text centre\"><div class=\"gutentor-text-wrap\"><p class=\"gutentor-text\">Wilson et al, BMJ 2020 Alcohol, smoking, and other substance use in the perinatal period.<\/p><\/div><\/div>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"parent":0,"template":"","class_list":["post-10644","professionals","type-professionals","status-publish","hentry","professionals-cat-resources-for-hcp"],"_links":{"self":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/professionals\/10644","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/professionals"}],"about":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/types\/professionals"}],"wp:attachment":[{"href":"https:\/\/path-perinatal.eu\/uk\/wp-json\/wp\/v2\/media?parent=10644"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}