Implementing Best Practice When Screening Birthing People for a Substance Use Disorder.
Sheila Kaufman, Patricia D Suplee, Damali M Campbell-Oparaji and 1 others
PMID 39444170WHAT IT FOUND
A pregnant person with opioid use disorder received verbal screening, MOUD, prenatal care, urine testing, and child protection review, then had a healthy baby.
This composite case is not proof any single component caused the outcome.
Key findings
01The patient disclosed substance use after a prior urine drug test without consent produced a positive PCP result that was not confirmed after 5 days, and the newborn was removed for 5 days.
02The midwife used the 4P's Plus verbal screen at the first visit, discussed treatment and reporting rules, and connected the patient to a medication for opioid use disorder program.
03The case reports that the patient attended MOUD and prenatal care, consented to routine urine testing, gave birth at 38 weeks to a healthy newborn, breastfed, and had the child protection case closed at 6 weeks postpartum.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The case is a composite of elements from several patients, so it is not a single documented patient. There is no comparison group, control group, or formal outcome measurement, so the healthy birth and closed case cannot be attributed to screening, MOUD, or urine testing. The article is mainly a practice narrative and case illustration, not a study with methods and results.
Declared interests
The authors state they have no conflicts of interest to disclose.
The easy way to misread this
Do not read the healthy birth and closed child protection case as proof that verbal screening, MOUD, prenatal care, urine testing, and child protection review caused the outcome. It is a composite case with no comparison group, and the article says urine drug testing can be misleading and does not diagnose substance use disorder.