11
Pregnant and Postpartum Patients
Stimulant use can pose significant risk during pregnancy. It can
lead to pregnancy complications as well as miscarriage, premature
delivery, fetal growth restriction, maternal death, and fetal death.
• Treatment for stimulant use disorder should be initiated as
early in the pregnancy as possible.
• It is important for the pregnant patient to get regular prenatal
care.
• Contingency management (CM, described earlier) may be
used to encourage prenatal care as well as stimulant use
disorder treatment.
• Clinicians treating the stimulant use disorder and clinicians
providing prenatal care should work together.
• Clinicians should ask for patient consent before drug testing
and explain the potential consequences of a positive drug test
during pregnancy.
• Patients may need extra support for their stimulant use
disorder after the birth of the baby.
• Breastmilk can contain high levels of stimulants. People who
are currently using stimulants should not breastfeed.
Lesbian, Gay, Bisexual, Transgender, and Questioning
(LGBTQ+)
Individuals who identify as LGBTQ+ have a high risk of developing
a substance use disorder. They are also more likely to have mental
health concerns. Some addiction treatment programs offer services
designed for LGBTQ+ patients. Some patients may be more
comfortable engaging in treatment with others who are LGBTQ+.
The clinician should consider the patient's unique experiences and
needs when recommending a treatment program.
