Project Description
Provider Response to Prenatal Substance Exposure
PI: Gail Zellman
Funded by: National Institute on Drug Abuse
Prenatal exposure to drugs and alcohol can have devastating effects on a developing fetus. State laws to limit such exposure range from prioritizing drug treatment for pregnant women to imposing criminal sanctions. However, little is known about the role of health care providers in the prevention or early detection of prenatal substance exposure. RAND examined how health care providers respond when they suspect their pregnant patients of substance abuse and assessed whether hospital policies influence the providers' actions. Results from a nationwide survey of physicians, nurse managers, and hospital administrators revealed that while most physicians who suspect substance abuse act on their suspicions, a large number appear not to recognize its signs. Furthermore, physicians who believe their hospital has a protocol for dealing with prenatal substance exposure are more likely than others to respond to their suspicions. However, fewer than half the hospitals surveyed reported having such a protocol. The study suggests that while most physicians appear to be reacting appropriately to suspicions of prenatal substance exposure, substantial gaps exist in recognition and response.
Related Publications:
Zellman, Gail L., Peter D. Jacobson, Helen DuPlessis, and Robin DiMatteo, Health Care System Response To Prenatal Substance Use: An Exploratory Analysis, RAND, N-3495-DPRC, 1992. Shorter version published as "Detecting Prenatal Substance Exposure: An Exploratory Analysis and Policy Discussion," Journal of Drug Issues, 23(3):375-387, 1993. (RAND Reprint RP-225.)
Zellman, Gail L., Robert M. Bell, Carol Archie, Helen DuPlessis, Jill Hoube, and Angela Miu, "Physician Response to Prenatal Substance Exposure," Maternal and Child Health Journal, 3(1):29-38. 1999. (RAND Reprint RP-868.)
Zellman, Gail L., Peter D. Jacobson, Robert M. Bell, "Influencing Physician Response to Prenatal Substance Exposure Through State Legislation and Work-Place Policies," Addiction, 92(9):1123-1131. 1997. (RAND Reprint RP-669.)
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