New clinical resources are available to better support British Columbians during pregnancy, while reducing harms related to substance use.

The British Columbia Centre on Substance Use (BCCSU) has developed a new clinical guideline supplement to care for pregnant people who use alcohol and has expanded the 24/7 Addiction Medicine Clinician Support Line for midwives in B.C. Supporting clinicians with specific tools and knowledge to approach substance-use care for clients during pregnancy will improve overall health outcomes and a better likelihood of longer-term engagement in care.

“This vulnerable time for new parents and their babies is made even more difficult by the stigma that still surrounds substance use,” said Sheila Malcolmson, Minister of Mental Health and Addictions. “This expansion of support will help foster a healthier environment at a time when new parents and their babies need it most.”

Stigma associated with substance use and pregnancy have created barriers for pregnant people. A lack of knowledge around appropriate screening and treatment options create additional barriers to evidence-informed care.

Both the guideline supplement and the expansion of the support line will help reduce those barriers, providing supports for clinicians to address substance use safely and effectively with their patients during pregnancy and post-partum periods.

“Pregnancy is a critical time to engage patients in care, and screen for substance use, yet there are often barriers to screening and gaps in knowledge among health-care providers on how to manage ongoing substance use among pregnant patients,” said Samantha Robinson, interim clinical director, BCCSU. “These new resources will fill critical gaps by providing health-care providers with the tools and information they need to best support their clients who use substances during pregnancy and in the immediate post-partum period.”

The new clinical guideline is a supplement to the Provincial Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder. It was developed by BCCSU in collaboration with Perinatal Services BC to provide population-specific treatment recommendations and care principles for pregnant and post-partum individuals who may continue to engage in high-risk drinking and those with alcohol-use disorder. The guideline supplement includes current research and outlines steps for routine and repeat screening for alcohol use and alcohol-use disorder, brief counselling interventions and clinical management options for alcohol-use disorder in pregnancy. Approaches that support immediate post-partum care and breastfeeding are also included.

The expansion of BCCSU’s 24/7 Addiction Medicine Clinician Support Line was completed in partnership with the Midwives Association of British Columbia (MABC). Midwives play a unique role in establishing a trusting relationship with a patient that otherwise may have little to no contact with medical professionals. They also offer a critical opportunity to connect the patient with the health-care system and to offer evidence-based treatment and care for patients using substances. With the expansion of the support line, midwives will now be able to access the expertise and knowledge of an addiction medicine specialist any day and time of the week.

The Provincial Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder was released in December 2019 to provide evidence-informed recommendations to health-care providers on how to treat and support people struggling with alcohol use, ensuring that people receive the care they need and deserve. In January 2021, Health Canada announced new funding for the BCCSU to adapt this work and develop the first National Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder.

Quotes:

Jana Encinger, director of acute care, Perinatal Services BC –

“Perinatal Services BC values culturally safe, trauma informed, gender affirming and harm reducing care to optimize pregnancy and birth outcomes as a foundation for a healthy population across the continuum of care.”

Lehe Spiegelman, president, MABC –

"We are pleased to learn that B.C. midwives will be able to provide this expanded service to our patients. Having access to these additional resources will help ensure birthing families in B.C. receive the best evidence-based treatment and care when substance use is disclosed. Midwives may be the only contact a client has with the health-care system, representing a singular and vital care role for a person with a substance-use disorder. Having access to a medical specialist with expertise and knowledge in addiction medicine will help midwives better support birthing families across B.C.”

Learn More:

24/7 Addiction Medicine Clinician Support Line: www.bccsu.ca/24-7

Pregnancy Supplement – Provincial Guideline for the Clinical Management of High-Risk Drinking and Alcohol Use Disorder: www.bccsu.ca/alcohol-use-disorder