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Women who abuse these substances are more likely to have untreated depression and anxiety and are at higher risk for intimate partner violence, homelessness, incarceration, infectious disease, and unplanned pregnancy. Substance abuse during pregnancy places both mother and fetus at risk for adverse perinatal outcomes. Data regarding the prevalence of substance abuse in women are conflicting and difficult to interpret. On the clinical level, strong arguments exist against routine urine drug testing and in favor of the use of validated instruments to screen women for drug and alcohol use both in primary women's health care and during pregnancy. A number of sex\u2010specific screening tools are available for clinicians, some of which have also been validated for use during pregnancy. Given the risks associated with untreated substance abuse and dependence in women, the integration of drug and alcohol screening into daily clinical practice is imperative. This article reviews screening tools available to providers in both the prenatal and primary women's health care settings and addresses some of the challenges raised when women screen positive for drug and alcohol abuse.<\/jats:p>","DOI":"10.1111\/jmwh.12035","type":"journal-article","created":{"date-parts":[[2013,4,30]],"date-time":"2013-04-30T16:49:38Z","timestamp":1367340578000},"page":"278-287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Screening for Substance Abuse in Women's Health: A Public Health Imperative"],"prefix":"10.1111","volume":"58","author":[{"given":"Daisy J.","family":"Goodman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina B.","family":"Wolff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,4,30]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Tenth Special Report to the U.S. Congress on Alcohol and Health","author":"Department of Health and Human Services","year":"2000"},{"key":"e_1_2_9_3_1","volume-title":"Agenda for Research on Women's Health for the 21st Century","author":"National Institutes of Health","year":"1999"},{"key":"e_1_2_9_4_1","volume-title":"SBIRT: Screening, Brief Intervention, and Referral to Treatment, Issue Brief","author":"Substance Abuse and Mental Health Services Administration Center for Integrated Health Solutions","year":"2011"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/1064-1297.15.5.411"},{"key":"e_1_2_9_6_1","volume-title":"Treating Tobacco Use and Dependence: 2008 Update","author":"Agency for Healthcare Research and Quality","year":"2008"},{"key":"e_1_2_9_7_1","volume-title":"Data Report: Maine Women Entering Substance Abuse Treatment 1997\u20102007","year":"2009"},{"key":"e_1_2_9_8_1","first-page":"55","article-title":"Demographic and psychosocial characteristics of substance\u2010abusing pregnant women","volume":"26","author":"Hans S","year":"1999","journal-title":"Prenat Drug Expo Child Outcome."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.07.010"},{"key":"e_1_2_9_10_1","volume-title":"Opioid Abuse, Dependence, and Addiction in Pregnancy","author":"Committee on Health Care for Underserved Women and the American Society of Addiction Medicine","year":"2012"},{"key":"e_1_2_9_11_1","volume-title":"At\u2010Risk Drinking and Alcohol Dependence: Obstetric and Gynecologic Implications","author":"Committee on Health Care of Underserved Women","year":"2011"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2008.06.001"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2011.01664.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892-0362(97)00091-3"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2009\/596149"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ntt.2005.03.010"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2010.147876"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3212"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.01.017"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-005-0083-y"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890423349"},{"key":"e_1_2_9_22_1","volume-title":"NSDUH Series H\u201041","author":"Substance Abuse and Mental Health Services Administration","year":"2011"},{"key":"e_1_2_9_23_1","volume-title":"Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010","author":"Centers for Disease Control and Prevention","year":"2012"},{"key":"e_1_2_9_24_1","first-page":"534","article-title":"Alcohol use and binge drinking among women of childbearing age\u2014United States, 2006\u20132010","volume":"28","author":"Centers for Disease Control and Prevention","year":"2012","journal-title":"MMWR Morb Mortaly Wkly Rep."},{"key":"e_1_2_9_25_1","unstructured":"Centers for Disease Control and Prevention.Available from Alcohol and Public Health: frequently asked questions. 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