Toward Improved Identification of Parental Substance Misuse: An Examination of Current Practices and Gaps in One US State.

Published on May 14, 2021in Maternal and Child Health Journal
· DOI :10.1007/S10995-021-03138-Y
Erin Knight (The Dartmouth Institute for Health Policy and Clinical Practice), Rebecca L. Butcher4
Estimated H-index: 4
(The Dartmouth Institute for Health Policy and Clinical Practice),
Mary K. Jankowski9
Estimated H-index: 9
(Dartmouth–Hitchcock Medical Center)
Sources
Abstract
INTRODUCTION The use of illicit substances, including opioids, is a serious public health issue in the United States. While there are reports of the impact of the ongoing opioid crisis on adults, a new focus has emerged on how parental substance misuse (PSM) affects children. This study explored existing screening and assessment practices and services for children and families affected by PSM across different service sectors in one state. The purpose of the study was to identify opportunities for training, policy development, and practice improvement related to identifying PSM and linking children and parents to services. METHODS Interviews (n = 15) with professionals from five service sectors (mental health, primary care, schools, community programs, and law enforcement) were used to inform development of a state-wide survey of the same groups (n = 498) to assess current practices, attitudes, knowledge, and training needs related to child screening of PSM. The survey was piloted using cognitive interviewing (n = 9) before it was distributed. RESULTS Fewer than 20% of survey respondents reported using standardized tools specific to screening PSM. Informal assessment practices predominate, though 60% of respondents saw value in adopting more standardized PSM screening. Attitudes about PSM and screening varied among sectors but interest in training was high. DISCUSSION Results indicate a need for more systematic PSM screening, cross-sector training and practice discussions, and policies to support early identification of children affected by PSM. Ramifications of these findings and recommendations are discussed.
📖 Papers frequently viewed together
9 Citations
16 Citations
3 Citations
References23
Newest
#1Kelly C. Young-Wolff (UCSF: University of California, San Francisco)H-Index: 19
#2Lue-Yen Tucker (KP: Kaiser Permanente)H-Index: 15
Last. Nancy Goler (KP: Kaiser Permanente)H-Index: 10
view all 6 authors...
Introduction Screening and referral for substance use are essential components of prenatal care. However, little is known about barriers to participation in substance use interventions that are integrated within prenatal care.
3 CitationsSource
#1Jean Chavez Hostage (Maine Medical Center)H-Index: 1
#2Julia Brock (Maine Medical Center)H-Index: 1
Last. Debra Sepulveda (Maine Medical Center)H-Index: 1
view all 4 authors...
OBJECTIVES: Universal screening for substance use during pregnancy, brief intervention, and referral to treatment (SBIRT) is recommended by ACOG and the USPSTF. Here we present the implementation of SBIRT into the electronic health record (EHR) to inform clinical intervention and collect data on the prevalence of substance use during pregnancy at three prenatal clinics. METHODS: A literature-based SBIRT instrument was developed. The tool was integrated into the EHR of a resident Ob/Gyn clinic, a...
3 CitationsSource
#1Angélica Meinhofer (Cornell University)H-Index: 7
#2Yohanis Angleró-Díaz (Boston Children's Hospital)H-Index: 1
23 CitationsSource
#1Polly RadcliffeH-Index: 13
#2Amy ChandlerH-Index: 11
Last. Anne Whittaker (University of Stirling)H-Index: 8
view all 4 authors...
3 CitationsSource
#1Robin Ghertner (HHS: United States Department of Health and Human Services)H-Index: 1
#2Annette Waters (HHS: United States Department of Health and Human Services)H-Index: 1
Last. Gilbert Crouse (HHS: United States Department of Health and Human Services)H-Index: 1
view all 4 authors...
Abstract Anecdotal evidence suggests that recent rises in foster care caseloads are due to increasing parental substance use, particularly misuse of opioids. This study tests the association between child welfare caseloads and two measures of substance use prevalence, including drug overdose deaths and drug-related hospitalizations, for most counties in the United States over the 2011 to 2016 period. We use several statistical models to account for confounding factors, including models examining...
30 CitationsSource
#1Shannon M. Monnat (SU: Syracuse University)H-Index: 1
#1Shannon M. Monnat (SU: Syracuse University)H-Index: 19
Last. Khary K. Rigg (USF: University of South Florida)H-Index: 14
view all 2 authors...
11 CitationsSource
Abstract Parental opioid use is affecting the physical, developmental, and mental health of the pediatric population nationwide and raises questions of safety when these children remain in the care of opioid-addicted parents. Pediatric providers face many barriers to identifying and caring for children beyond the neonatal period who have been affected by parental opioid abuse both in utero and in the home. These barriers include communication between providers and services, identification of int...
19 CitationsSource
#1Cory M. Morton (UNH: University of New Hampshire)H-Index: 9
#2Melissa Wells (UNH: University of New Hampshire)H-Index: 15
ABSTRACTThe United States has seen a crisis in the use and abuse of opioids since 2000 that has had impacts for the health care, criminal justice, and child welfare systems. After more than a decade of declines in out-of-home care placements, the increases in the last half of this decade may be attributed to parental misuse of opioids. While much is known about infants who are born drug exposed and the ramifications for child welfare practice and policy, less is known about children who grow up ...
5 CitationsSource
Children whose parents or caregivers use drugs or alcohol are at increased risk of short- and long-term sequelae ranging from medical problems to psychosocial and behavioral challenges. In the course of providing health care services to children, pediatricians are likely to encounter families affected by parental substance use and are in a unique position to intervene. Therefore, pediatricians need to know how to assess a child’s risk in the context of a parent’s substance use. The purposes of t...
72 CitationsSource
#1Gerald Cochran (University of Texas at Austin)H-Index: 16
#2Craig A. FieldH-Index: 31
Last. Carlton K. EricksonH-Index: 22
view all 4 authors...
Background In the USA prescription opioids, which are misused or abused by some patients, are often obtained from pharmacies. However, screening and brief intervention (SBI) for prescription opioid misuse has not been tested in this setting. The goal of this project was to assess pharmacists' attitudes and motivation towards delivering SBI for prescription opioid abuse. Methods A descriptive cross-sectional online survey was administered to pharmacists in Utah and Texas, USA. The survey assessed...
29 CitationsSource
Cited By0
Newest