Critical to the wellbeing of pregnant women and their infants is universal screening for drug and alcohol use. This is an essential first step in identifying women with harmful substance use and connecting them with appropriate services. Screening, Brief Intervention and Referral to Treatment or SBIRT has been shown to be a quick and effective means of identifying and intervening with patients whose patterns of use put them at risk for, or who already have, substance-related health problems.
Brief interventions refer to short counseling sessions (up to 20 minutes) provided as part of routine clinical care. Multiple sessions, particularly when provided within the context of an established relationship, have been shown to be more effective than single sessions from an unfamiliar provider. Cochrane reviews of counseling interventions for alcohol and cigarette smoking during pregnancy demonstrated the effectiveness of brief interventions in terms of promoting abstinence, reducing alcohol use and cigarette smoking during pregnancy, and improving obstetrical outcomes.
Emerging evidence suggests electronic screening, brief intervention, or referral to treatment (e-SBIRT) may help to overcome some of the typical barriers to treatment for alcohol and drug use women may encounter during pregnancy. A brief intervention delivered through a mobile device may be as effective as SBIRT delivered by a health care professional in terms of preventing maternal drug use, minimizing the effects to the exposed child, and providing a clear pathway to treatment.
Resources:
Screening for substance use during pregnancy using an SBIRTframework (Northern New England Perinatal Quality Improvement Network)
Brief Intervention Training Video: A virtual training, including examples of brief interventions for marijuana, alcohol, and opioid use during pregnancy
Ordean A, Wong S, Graves L. SOGC guideline No. 349: substance use in pregnancy. J Obsted Gynaecol Can 2017; 39:922–937.
Ordean A, Forte M, Selby P, Grennell E. Screening, Brief Intervention, and Referral to Treatment for Prenatal Alcohol Use and Cigarette Smoking: A Survey of Academic and Community Health Care Providers. J Addict Med. 2020 Jul/Aug;14(4): e76-e82. Free article.
Wouldes TA, Crawford A, Stevens S, Stasiak K. Evidence for the Effectiveness and Acceptability of e-SBI or e-SBIRT in the Management of Alcohol and Illicit Substance Use in Pregnant and Postpartum Women. Front Psychiatry. 2021 May 5; 12:634805. Free article.