Conference Coverage

Substance use increases likelihood of psychiatric hold in pregnancy


 

REPORTING FROM THE AAPL ANNUAL MEETING


The third question introduced a positive pregnancy test for the woman, but none of the respondents said they would cancel the psychiatric hold. Most were split between proceeding with a hold (42.6%) or proceeding with a discharge (47.1%), though 10.3% would cancel the discharge and place the patient on a hold. Ultimately, respondents were no more likely to put the woman on a hold whether she was pregnant or not.

Then the survey repeated the scenario, but instead of a positive pregnancy test, the question asked what clinicians would do if her drug screen were positive after she had refused admission. In that scenario, the woman reported daily methamphetamine use to the emergency physician.

Among respondents, 48.5% would proceed with a psychiatric hold, 42.6% would proceed with a discharge, and 8.8% would cancel the discharge and put the patient on a hold.

The final question asks clinicians’ course of action if the woman’s pregnancy test were positive after the positive drug screen. Now, only a little over a quarter of respondents (26.5%) would proceed with a discharge and follow-up. More than half (57.4%) would proceed with a hold, and 16.2% would cancel the discharge and place a psychiatric hold.

Therefore, 73.6% of clinicians would place a pregnant woman with a history of substance use on a psychiatric hold, compared with 52.9% if the woman were pregnant but not using methamphetamine.

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