April 18, 2014

The World Health Organization (WHO) has released the first evidence-based global guidelines to prevent and treat substance use by pregnant women. The plain language recommendations also can be used to help pregnant women and their family members make healthy decisions about alcohol, tobacco, and illicit drug use. Designed for use in both low- and high-resource countries, the document identifies principles and best practices in six areas:

  • Screening and brief intervention
  • Psychosocial interventions
  • Detoxification
  • Dependence management
  • Infant feeding
  • Management of infant withdrawal.

The guidelines evolved from a 2009 NIDA International Program meeting, Treating Addiction During Pregnancy: Exploring Multinational Perspectives To Build a Treatment Approach Consensus. Invitees completed a premeeting survey that attracted enthusiastic responses from researchers in 22 different countries on six continents. Participants identified experts and stakeholders to develop a draft consensus statement and asked WHO to consider developing the guidelines.

In mid-2012, the WHO departments of Mental Health and Substance Abuse and the Tobacco Free Initiative began coordinating the guidelines development process, which was funded by the U.S. and Norwegian governments. NIDA and the National Institute of Alcohol Abuse and Alcoholism provided additional support for evidence reviews and planning meetings.

Former NIDA INVEST Fellow Guilherme Borges, Sc.D., Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico, co-chaired the guidelines development group, and NIDA Distinguished International Scientist Irma Kirtadze, M.D., Alternative Georgia Addiction Research Center, Republic of Georgia, served as an external peer reviewer. NIDA grantee Hendrée Jones, Ph.D., University of North Carolina at Chapel Hill, who chaired the 2009 NIDA meeting, also served on the WHO guidelines development group. Dr. Jones led the NIDA-funded Maternal Opioid Treatment: Human Experimental Research (MOTHER) study that found buprenorphine maintenance treatment safe for opioid-dependent pregnant women and their babies. NIDA International Program Director Steven W. Gust, Ph.D., Division of Clinical Neuroscience and Behavioral Research Behavioral and Brain Development Branch Chief Cheryl Anne Boyce, Ph.D., and Women and Sex/Gender Differences Research Program Deputy Coordinator Samia Dawud Noursi, Ph.D., participated in the guidelines development group meetings. Download the WHO Guidelines for the Management of Substance Use and Substance Use Disorders in Pregnancy