Manejo de psicofármacos en los trastornos por uso de sustancias durante el embarazo y la lactancia

A review is presented on the consequences of substance abuse and the safety of the drugs indicated for the treatment of alcohol, nicotine, and opioid use disorders during pregnancy and lactation. Drugs of abuse cause damage to the foetus and the infant. Despite this, a significant number of women still use them. Treatments may not be easily accessible, and women may hide their addiction, as they fear stigma or legal consequences. Knowledge and proper use of indicated psychoactive drugs during pregnancy and breastfeeding can help reduce damage. It is recommended to discontinue the use of alcohol at any time during pregnancy, and to prevent withdrawal symptoms with benzodiazepines. Although higher quality studies are desirable, there is evidence to consider Nicotine Replacement Therapy and opioid agonists as effective and safe medications. Breastfeeding is recommended in most cases.