Specific roles of the obstetrician-gynecologist

A wide pattern of licit and illicit substance use occurs in our society. The vast majority of obstetrician-gynecologists see patients who use legal substances in social and nonabusive ways; however, life stresses and social situations move some of these patients to patterns of drug use that are destructive for themselves and others, which may result in short- or long-term social and health consequences. As primary health care providers to women, obstetrician-gynecologists need to consider these risks at every patient encounter. Many routinely provide varying levels of screening, advice, and prevention services on a regular basis. These have become known as brief interventions, and they serve as future substance abuse prevention as well as a foundation for progressive steps in substance use and abuse therapies. Brief intervention has had well-documented efficacy with patients who are problem alcohol drinkers [1]. This technique is probably also useful for patients with other types of substance abuse. When well planned and consistently administered, it can have an overall impact comparable to more extensive counseling. The emphasis of this strategy is on multiple brief sessions that can be incorporated into the course of a routine office visit. The technique takes between 1 and 5 minutes. The key is to continue to use brief intervention over several office visits until the patient is motivated to take definite action to change their addictive behavior. Often this means following through with a referral to a specific substance abuse program.