Substance use disorders and women's health:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2003
|
| Schriftenreihe: | Obstetrics and gynecology clinics of North America
30,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 413 - 621 Ill., graph. Darst. |
Internformat
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| 245 | 1 | 0 | |a Substance use disorders and women's health |c Michael P. Bogenschutz ... guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2003 | |
| 300 | |a XII S., S. 413 - 621 |b Ill., graph. Darst. | ||
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| 650 | 4 | |a Alcohol abuse |x Women | |
| 650 | 4 | |a Alcoholism |x Psychological aspects | |
| 650 | 4 | |a Drug abuse |x Women | |
| 650 | 4 | |a Pregnancy Complications | |
| 650 | 4 | |a Substance use disorders | |
| 650 | 4 | |a Substance-Related Disorders | |
| 650 | 4 | |a Women | |
| 650 | 4 | |a Women's Health | |
| 650 | 4 | |a Women's Health Services |x ethics | |
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Datensatz im Suchindex
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| adam_text | SLIfclAM H l + TJISORIJLRS AM) WOMJ N S HEALTH
CONTENTS
Preface xi
Michael P. Bogenschutz and William E Rayburn
Epidemiology of Substance Use Disorders in Women 413
Shelly F. Greenfield, Sumita G. Manwani, and Jessica E. Nargiso
Significant gender differences exist in the prevalence of substance
use disorders in the United States; however, there is a trend among
boys and girls aged 12 to 17 years toward comparable rates of use
and initiation for alcohol, cocaine, heroin, and tobacco. If this trend
continues, over time there may be a narrowing of the male to
female prevalence ratios of substance abuse in the older age
groups. This possibility is particularly disturbing because women
have a heightened vulnerability to medical, physical, mental, and
social consequences of substance use. Women also carry additional
unique risks during pregnancy because of the effect on the
neonates. In addition, they have certain gender specific cancer
risks. Given this and the declining age of initiation of substance
use in women, prevention and treatment efforts especially geared
toward women are exceedingly important to stop and ultimately
reverse this growing trend. This article reviews the current
epidemiology and patterns of substance use, abuse, and dependence,
and the course, medical consequences, and treatment related
issues of substance disorders in women of all ages.
Screening and Prevention of Alcohol and Drug Use
Disorders in Women 447
Dace S. Svikis and Kathryn Reid Quinones
Substance use disorders are among the leading causes of morbidity
and mortality in the United States. Historically, identification and
screening efforts have focused largely on alcohol problems as they
occur in men. Greater attention has recently been directed toward
women, with a broader focus on not just alcohol, but other drugs
of abuse as well. An estimated 4.5 million women in this country
VOLUME 30 • NUMBER 3 • SEPTEMBER 2003 v
abuse alcohol, 3.5 million abuse prescription drugs, and over 3
million regularly use illicit drugs. This article examines alternative
strategies for identifying women at risk for substance use problems
and reviews the practical and scientific advantages and disadvan¬
tages for various screening methods.
Co occurring Psychiatric Disorders in Women with Addictions 469
Geetanjali Chander and Mary E. McCaul
There are very high rates of psychiatric disorders among alcohol
and drug dependent women. The most common co occurring
psychiatric conditions include affective, anxiety, and eating disor¬
ders. It is estimated that posttraumatic stress disorder is found in
approximately one third of substance abusing women, often as a
result of childhood or adult sexual and physical abuse. Current
psychosocial and pharmacotherapy treatments for depression and
anxiety appear to ameliorate the psychiatric symptoms, but
research is less clear as to additional benefits on alcohol and drug
related outcomes. Physicians providing women s reproductive
health services should pay particular attention to screening for the
presence and severity of alcohol/drug use and coordinating refer¬
rals for care as needed in patients with identified psychiatric dis¬
orders or receiving antidepressant or anxiolytic medications. It is
only when treatment is provided for both co occurring disorders
that patients will be successful in sustaining their recovery efforts.
Psychosocial Treatments for Women with Substance
Use Disorders 483
Theresa M. Winhusen and Frankie Kropp
Research on psychosocial treatments for women generally has con¬
sisted of quasi experimental studies, with few randomized con¬
trolled trials that specifically test the effectiveness of treatment for
women. Review of the available research literature suggests the
following: (1) women, compared with men, evidence poorer prog¬
nostic characteristics; (2) women generally do not differ signifi¬
cantly from men on treatment utilization or outcome, with the
possible exception of employment outcomes, which have been
found to be poorer for women; and (3) women may benefit signifi¬
cantly from enhanced treatment services. This article also discusses
guidelines for treatment providers and researchers.
Pharmacology of Drugs of Abuse 501
Eric W. Reynolds and Henrietta S. Bada
Opiates, cocaine, amphetamine, marijuana, nicotine, and alcohol
are some of the commonly used drugs of abuse. Common drugs of
abuse share a common mechanism of reward; repeated drug use
leads to perturbations of intracellular signal transduction pathway,
vi CONTENTS
altering target genes. Chronic use may also cause structural
changes in specific neurons. The pharmacology and pharmacoki
netics of these drugs are reviewed in this article.
Pharmacologic Treatments for Women with Addictions 523
Michael P. Bogenschutz and Cynthia M.A. Geppert
Physicians have a growing array of pharmacotherapies available
for the treatment of substance use disorders. These medications are
of central importance in the treatment of opioid and nicotine
dependence and of growing importance in the treatment of alcohol
and stimulant dependence. Pharmacotherapy alone is rarely suffi¬
cient treatment for substance use disorder; appropriate psychosocial
treatment or mutual help participation is almost always indicated
whether or not pharmacotherapy is used. Specialized facilities,
licensing, and training are necessary for the use of some of the
pharmacotherapies discussed in this article. The obstetrician gyne¬
cologist must determine the scope of his or her own practice in this
area (ie, when to treat and when to refer) based on interest, train¬
ing and experience, and available resources.
Substance Use Disorders in Women: Special Considerations
During Pregnancy 545
Jay M. Bolnick and William F. Rayburn
Care of substance using pregnant women is complex, difficult, and
often demanding. Women s care providers must be aware of these
women s unique psychologic and social needs and the related
legal and ethical ramifications surrounding pregnancy. In addition,
relating specific substances to perinatal outcome is difficult, because
concurrent use of multiple substances is frequent and many preg¬
nant abusers are members of economically disadvantaged segments
of society in which unfavorable perinatal outcomes are more
common. It is also difficult to follow up outcomes in such preg¬
nancies prospectively and to analyze research data. This article
discusses various issues related to pregnancies complicated by
substance use, including perinatal pharmacology and teratogenic
risks, identification of substance abuse, treatment approaches, and
comprehensive perinatal management.
Ethical Considerations in Caring for Women with Substance
Use Disorders 559
Laura Weiss Roberts and Laura B. Dunn
Clinicians who care for women with substance use disorders are con¬
fronted by many challenges, particularly in the care of pregnant and
parenting women. The dilemmas faced by patients with addiction
and by their providers often arise directly from tensions among core
ethical principles, from inconsistencies in the way these principles
CONTENTS vii
are applied, and from the pervasive effects of stigma. This article
characterizes the key principles underlying ethically sound clinical
care and applies these concepts generally to the treatment of addic¬
tion. Second, the article describes a clinical ethics decision making
model. Third, the article details central ethical practice domains in
the treatment of substance use disorders, including (1) voluntarism;
(2) beneficence, compassion, and harm reduction; (3) confidentiality
and truth telling; (4) respect for persons and justice; and (5) informed
consent. In addition, special ethical considerations and practices in
the care of women with substance use disorders are outlined, with
emphasis on the unique set of concerns related to pregnancy and par¬
enting. Finally, the article discusses enhancing the ethical caliber of
care for women with substance use disorders through enhancing vol¬
untarism and learning from model programs in the treatment of par¬
enting and pregnant women with substance use disorders.
Obstetrics and Gynecology Resident Education in Tobacco,
Alcohol, and Drug Use Disorders 583
Beth Potter and Michael F. Fleming
Substance use disorders are common problems that all primary
care physicians will encounter. These disorders have a significant
impact on the health of all affected women throughout their lifespan.
It is important to know the effects of drug use on women, so
primary care residents need to be prepared to discuss substance
use disorders with their patients. Residents also need to know that
brief interventions can reduce risky behaviors even if they do not
result in abstinence.
Specific Roles of the Obstetrician Gynecologist 601
Robert A. Welch and Veronique Poulin
A wide pattern of licit and illicit substance use occurs in our society.
The vast majority of obstetrician gynecologists see patients who
use legal substances in social and nonabusive ways; however, life
stresses and social situations move some of these patients to
destructive patterns of drug use, which may result in short or
long term social and health consequences. As primary health care
providers to women, obstetrician gynecologists need to consider
these risks at every patient encounter. Many routinely provide
varying levels of regular screening, advice, and prevention services
known as brief interventions, which serve as future substance abuse
prevention as well as a foundation for progressive steps in sub¬
stance use and abuse therapies.
Index 617
Subscription Information
viii CONTENTS
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| spelling | Substance use disorders and women's health Michael P. Bogenschutz ... guest ed. Philadelphia [u.a.] Saunders 2003 XII S., S. 413 - 621 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Obstetrics and gynecology clinics of North America 30,3 Drugsverslaving gtt Genotmiddelen gtt Verslaving gtt Vrouwen gtt Frau Psychologie Alcohol abuse Women Alcoholism Psychological aspects Drug abuse Women Pregnancy Complications Substance use disorders Substance-Related Disorders Women Women's Health Women's Health Services ethics Bogenschutz, Michael P. Sonstige oth Obstetrics and gynecology clinics of North America 30,3 (DE-604)BV000617486 30,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=010633804&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Substance use disorders and women's health |
| title_auth | Substance use disorders and women's health |
| title_exact_search | Substance use disorders and women's health |
| title_full | Substance use disorders and women's health Michael P. Bogenschutz ... guest ed. |
| title_fullStr | Substance use disorders and women's health Michael P. Bogenschutz ... guest ed. |
| title_full_unstemmed | Substance use disorders and women's health Michael P. Bogenschutz ... guest ed. |
| title_short | Substance use disorders and women's health |
| title_sort | substance use disorders and women s health |
| topic | Drugsverslaving gtt Genotmiddelen gtt Verslaving gtt Vrouwen gtt Frau Psychologie Alcohol abuse Women Alcoholism Psychological aspects Drug abuse Women Pregnancy Complications Substance use disorders Substance-Related Disorders Women Women's Health Women's Health Services ethics |
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