Women, Pregnancy, and Substance Use — Speaker Companion

Duration: 40 Minutes | Slides: 14

Slide 04
MOUD vs. Detox
5 min

Speaker Notes

  • Emphasize: MOUD is first-line, NOT detox
  • 59-90% relapse rate with detox is key statistic
  • Frame as fetal safety issue, not just maternal preference
  • Address common misconception that "baby will be addicted"
⚠️ Watch for: Trainees suggesting taper before delivery to "prevent NAS"
🎯 Key Point: Tapering triggers fetal stress and relapse. Treat mom to stability.

Anticipated Questions

Q1 "Won't the baby be born addicted?"

Babies aren't "addicted"—they experience withdrawal (NOWS). This is treatable and temporary. The risks of continued illicit use (fetal hypoxia, overdose, infections) far outweigh NOWS. MOUD provides stability.

Medium · 2 min
Slide 08
Fourth Trimester Cliff
5 min

Speaker Notes

  • This is the most surprising statistic for most trainees
  • Emphasize: risk is HIGHEST postpartum, not during pregnancy
    • >li>7-12 months is the danger zone
  • Connect to Medicaid cliff at 60 days
🎯 Key Point: The "hard part" starts at discharge, not delivery

Anticipated Questions

Q1 "Why is risk higher postpartum than during pregnancy?"

Multiple factors: loss of protective motivation ("doing it for baby"), sleep deprivation, hormonal drops, loss of tolerance (relapse at pre-abstinence dose = overdose), insurance loss, CPS stress, decreased monitoring.

Medium · 2 min