Substance Use Patterns in Pregnancy🔗

HBCD participants are relying on data users to be respectful and to minimize potential harms (such as stigmatization) when analyzing data and reporting analyses. For a brief discussion of how stigma and stereotyping affect people with substance use disorder, see this National Institute of Drug Abuse (NIDA) website: https://nida.nih.gov/research-topics/stigma-discrimination#address.

When using these data, please consider the context in which HBCD collected data on the use of substances. HBCD focuses on the impact of exposures on child development; therefore, substance exposure was assessed rather than the legality of the drug or its misuse. There is a significant difference between the “use” of a substance, which may or may not be legal, and the “misuse” of that substance. It is not, for instance, appropriate to describe participants who used substances as “addicts” or as having a “substance use disorder” because we did not collect information on such diagnoses. A number of drugs for which we gathered data, although open to misuse, could have been prescribed. These include methadone, buprenorphine, Adderall, and even certain cannabis products. While a participant’s use may or may not have been consistent with prescribed indications, we have not collected such information, nor have we collected information addressing the motivation for use.

For recommended language related to substance use, please see the NIDA website: Words Matter - Terms to Use and Avoid When Talking About Addiction.

We suggest that while designing and reporting analyses, users consider additional factors that may be more common among individuals with prenatal substance use and likely affect many outcomes of interest. Data users can minimize potential experimental biases by including appropriate additional variables that assess participants’ other relevant exposures and social contexts. HBCD has collected many such variables, some of which might serve as confounders or modifiers in analyses of substance use variables from this instrument.

Please take care not to overinterpret your results or to make assumptions about causation if your analysis is not designed for causal inference. We cannot control how other people, such as policy makers, educators, or clinicians, use the results of our research, but we can minimize risks of misuse by such non-scientist constituencies by being very clear, in papers and presentations, about the limits of our findings.