Substance use disorder as a chronic disease

Dr. Caitlin Martin:

Hello, I'm Caitlin Martin. I study in Richmond, Virginia, at Virginia Commonwealth University. I am a board-certified OB/GYN with a subspecialty in addiction medicine.

What was the topic of your ACOG session?

Martin:

Yes, I had the honour of speaking at ACOG yesterday about substance use disorders as a chronic disease and about some practical, evidence-based steps that OB/GYNs and other healthcare professionals can take to address the overdose crisis that is occurring at the same time as the rising maternal mortality crisis in our nation.

What relevance does this subject have?

Martin:

Therefore, substance use problems are extremely common, have continued to become more common, and are contributing to rising rates of morbidity and mortality.for the past ten or so years. Then, in a new report released by the CDC last year, it was revealed that mental health conditions, which are largely fueled by overdose-related deaths in the postpartum period, primarily in the 6 to 12 months after pregnancy, are the leading cause of pregnancy-related deaths, both during pregnancy and for the first year following delivery. In light of the rising number of overdose deaths and the growing racial and ethnic disparities that we are seeing as a result of structural and systemic racism, it is now more important than ever for OB/GYNs and other healthcare professionals to take action to address the crisis that is currently occurring in our country

What were the three main points of your presentation?

Martin:

That is a valid query. I took away a couple things. I had 4. The first was what I just mentioned—that this epidemiological problem is growing along with a crisis in maternal mortality that is also growing. And we are observing these glaring differences based on race and ethnicity, particularly for expectant mothers and new mothers. The pathophysiology of addiction as a chronic disease was the second topic we discussed. We have traditionally conceived of addiction as being something apart from the overall traditional health care model because to the war on drugs. However, it is the time to adopt a public health strategy by treating substance use disorder as a chronic condition.

similar to diabetes, hypertension is an illness. So, we talked extensively about the neural underpinnings of this chronic condition of addiction yesterday. Finally, we discussed some evidence-based actionable tools that we can all start using in the exam room as of tomorrow. I spoke about these topics with a patient who had firsthand experience. The expert approach, which includes screening, brief intervention, and referral to treatment, was one of the topics we discussed. So, we discussed validated screening methods—not drug testing—that can be used to determine whether a patient is at high, low, or medium risk of developing a substance use disorder. We discussed quick interventions, which are typically going to be the most crucial.

dialogues about your patients' drug use that are kind and unjudgmental. And finally, we discussed treatment. We therefore need to make better use of evidence-based therapies, such as FDA-approved drugs for alcohol and opioid use disorders, and lessen the stigma attached to these potentially life-saving interventions. For instance, when used as part of opioid use disorder therapies, drugs cut mortality risks in the population by more than 50%. I can't think of another drug I've ever recommended as an OBG/YN that has such a significant advantage for my patients, their families, and society.

How have you found the conference thus far?

Martin:

Oh my goodness, I am loving ACOG. To begin with, it's nice tobe able to communicate with coworkers throughout the nation. The ability to offer my speech and interact with a co-presenter who has firsthand expertise made yesterday even better, in my opinion. And I like how motivated individuals are to learn more about addiction and consider what they can do to stop idly sitting on their hands. And watching it was incredibly energising.

Do you have any further information to share?

Martin:

Finally, all I have to say is that if you have ever felt apprehensive about dealing with substance use disorders, you should consider that dealing with them is like opening a can of worms.There are ways to complete it in your exam room that you can still complete in the 15 minutes that you have with the patient, for instance. Therefore, I urge you to simply set aside some time to attend some trainings, hear a speech, or get in touch with a colleague. In my address from yesterday, I discussed a few options, including a warm line we have manned by professionals who are available to respond to inquiries on substance use issues, including those that occur during pregnancy. But even those little first steps can make a big difference, so I strongly advise you to take them.

Reference: ( Contemporary OB/GYN https://www.contemporaryobgyn.net/view/substance-use-disorder-as-a-chronic-disease )