UNSW Embryology

Abnormal Development- Drug Use
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Introduction

These developmental abnormalities are maternal in origin and not congenital. Drug use also divides into those considered legal drugs (alcohol, tobacco, non-prescription and prescription) and illegal drug usage (see also alcohol, tobacco , Illegal drug issues). Legal drugs are usually classified by each country's appropriate regulatory body. These current notes do not cover either or tobacco issues. See also the page relating to the top 200 (by prescription number) drugs in the USA.

In Australia, drug usage is mainly regulated Federally by the Therapeutic Goods Administration (TGA, part of the Department of Health and Aged Care) and is covered by legislation in the Therapeutic Goods Act 1989. The TGA has an electronic document covering issues on Medicines and Pregnancy (medpreg.pdf 107 Kb).

In USA, drugs are classified by the Federal Drug Authority (FDA) into classes (A, B, C, D, and X) to define the safety of drugs during pregnancy. USA 1998 data on general prescription drug usage (Based On More Than 2.4 Billion US Prescriptions) is available as lists sorted either by usage or alphabetically. NIH-funded clinical trials findings are released as Clinical alerts.

WWW Links 

The Australian NHMRC (1988) recommends neonates be assessed for follow-up care under the following conditions.

(see the NHMRC WWW Page)

  • Birthweight less than 1500g or gestational age less than 32 weeks
  • Small-for-gestational-age neonates
  • Perinatal asphyxia
  • Apgar score less than 3 at 5 minutes
  • clinical evidence of neurological dysfunction
  • delay in onset of spontaneous respiration for more than 5 minutes and requiring mechanical ventilation
  • Clinical evidence of central nervous system abnormalities ie., seizures, hypotonia
  • Hyperbilirubinaemia of greater than 350umol/l in full term neonates
  • Genetic, dysmorphic or metabolic disorders or a family history of serious genetic disorder
  • Perinatal or serious neonatal infection including children of mothers who are HIV positive
  • Psychosocial problems eg., infants of drug-addicted or alcoholic mothers.

NHMRC (Australia) Publications

DS3 &endash; Published 1992

  • Is there a safe level of daily consumption of alcohol for men and women? (108 pages)
  • Cat. No. 9014225
  • Price: $8.95

DS4 &endash; Published 1987

  • Methadone programs (14 pages)
  • Free

The following statistics are based on the 1995 Australian National Drug Strategy Household survey.

  • Alcohol is one of the most widely used drugs in Australia.
    • 6% of the population aged 14 years or more are current drinkers, with just less than half of these drinking at least weekly
    • Males aged 14 to 24, and females aged 20-24, are more likely to drink to excess than males and females in other age groups.
  • Smoking is higher among young women than young men, although males tend to smoke more heavily.
    • Among 14-19 year olds
      • 13% are current regular smokers
      • 5% are occasional smokers
      • while 49% have never smoked.
  • Marijuana is the most commonly used drug after tobacco and alcohol.
    • 31% of persons aged 14 or more have tried it, and 13% have recently used marijuana.
    • Marijuana use is no higher in South Australia or the Australian Capital Territory, where its consumption has been decriminalised.
  • Analgesics is the next most frequently tried and used drug, with 12% having tried them, and 3% recently using them.
  • Hallucinogens, particularly LSD, come in next at 7% ever tried, and almost 2% have used in the past 12 months. Nearly all recent users are aged under 35.
  • Amphetamines have been tried by 6% of the population, and used in the past 12 months by 2%. Nearly all recent users are aged under 35.
  • Cocaine has been tried by 3% of the population, and 1% have used it in the past 12 months.
  • Designer drugs, particularly Ecstasy (MDMA) have been tried by nearly 3 % of the population, and used in the past 12 months by 0.8% of the population.
  • Inhalants have been tried by 4% of the population, and are currently used by 0.4%
  • Heroin has been tried by nearly 1% of the population, and is currently used by 0.4%.
  • Illegal drugs have been injected by nearly 1.5% of the population, and currently illegal drugs are injected by .5%.
  • Of the 26,355 deaths caused by drugs, 72% were due to tobacco, 25% to alcohol and 3% to illicit drugs. Alcohol is responsible for the majority of drug related deaths in persons aged 15 to 34.
  • In the 1994 Urban Aboriginal and Torres Strait Islander Peoples Household survey supplement, 62% of the Aboriginal and Torres Strait Islander community drink alcohol compared to 72% of the general urban population. Those who do drink alcohol, however, consume much higher quantities of alcohol than the general population.
  • 54% of urban Aboriginal and Torres Strait Islander people are current smokers, compared to 29% of the general population.
  • Illicit drug use is more widespread among the Aboriginal and Torres Strait Islander urban community than in the general population. 50% have tried an illicit drug compared with 38% in the general community. 24% are current users compared with 15% in the general population with marijuana being the most popular illicit drug.

For more information please email the CEIDA Information Centre

National Institute Drug Abuse (USA)

(NIDA Homepage)

NIDA Survey Provides First National USA Data on Drug Use During Pregnancy (September 1994)

  • More than 5 percent of the 4 million women who gave birth in the United States in 1992 used illegal drugs while they were pregnant, according to the first nationally representative survey of drug use among pregnant women. The NIDA sponsored survey, which was released last fall, provides the best estimates to date of the number of women who use drugs during pregnancy, their demographic characteristics, and their patterns of drug use.
  • The survey gathered self report data from a national sample of 2,613 women who delivered babies in 52 urban and rural hospitals during 1992. Based on these data, an estimated 22 1,000 women who gave birth in 1992 used illicit drugs while they were pregnant. Marijuana and cocaine were the most frequently used illicit drugs - 2.9 percent, or 119,000 women, used marijuana and another 1.1 percent, or 45,000 women, used cocaine at some time during their pregnancy.
  • The survey found a high incidence of cigarette and alcohol use among pregnant women. At some point during their pregnancy, 20.4 percent, or 820,000, pregnant women smoked cigarettes and 18.8 percent, or 757,000, drank alcohol.
  • The survey also uncovered a strong link between cigarette smoking and alcohol use and the use of illicit drugs in this population. Among those women who used both cigarettes and alcohol, 20.4 percent also used marijuana and 9.5 percent took cocaine. Conversely, of those women who said they had not used cigarettes or alcohol, only 0.2 percent smoked marijuana and 0. I percent used cocaine.
  • Besides providing the fist national estimates of drug use during pregnancy, the survey also examined differences in the amount and types of drugs used by several racial and ethnic groups of women. Overall, 11.3 percent of African-American women, 4.4 percent of white women, and 4.5 percent of Hispanic women used illicit drugs while pregnant. While African Americans had higher rates of drug use, in ten-ns of actual numbers of users, most women who took drugs while they were pregnant were white. The survey found that an estimated 11 3,000 white women, 75,000 African-American women, and 28,000 Hispanic women used illicit drugs during pregnancy.
  • The survey also described different patterns of licit and illicit drug use among white women and ethnic minorities. African-American women had the highest rates of cocaine use, mainly "crack," during pregnancy. About 4.5 percent of African-American women used cocaine compared with 0.4 percent of white women and 0.7 percent of Hispanic women who did so.
  • White women had the highest rates of alcohol and cigarette use. Nearly 23 percent of white women drank alcohol and 24.4 percent smoked cigarettes. By comparison, 15.8 percent of African-American women and 8.7 percent of Hispanic women drank alcohol and 19.8 percent of African-American women and 5.8 percent of Hispanic women smoked cigarettes. "These findings point to the importance of attending to cultural issues in drug abuse prevention and treatment efforts," said Dr. Finnegan.
  • Although women who used drugs during pregnancy generally decreased their rates of drug use throughout their pregnancy, they did not discontinue drug use.
  • NIDA's National Pregnancy and Health Survey reveals different patterns of substance use among black, white, and Hispanic women. The survey found that an estimated 113,000 white women, 75,000 African-American women, and 28,000 Hispanic women used illicit drugs during pregnancy.

Drug use During Pregnancy Among Racial and Ethnic Groups in the USA (NIDA Survey)

Percent of American women who gave birth in 1992 and used drugs during pregnancy.

Blacks

  • Any Illicit Drug 11.3%
  • Marijuana 4.6%
  • Cocaine 4.5%
  • Alcohol 15.8%
  • Cigarettes 19.8%

Whites

  • Any Illicit Drug 4.4%
  • Marijuana 3.0%
  • Cocaine 0.4%
  • Alcohol 22.7%
  • Cigarettes 24.4%

Hispanics

  • Any Illicit Drug 4.5%
  • Marijuana 1.5% n
  • Cocaine 0.7%
  • Alcohol 8.7%
  • Cigarettes 5.8%

Source: NIDA- Pregnancy and Drug Use Trends

For Normal Childhood Development see Publications (or NHMRC WWW Page)

About Notes

  • Notes from the Embryology Program compiled and written by Dr Mark Hill.
  • Note Links to OMIM Entries are copies of originals for computers without internet access. Computers with internet access can directly access the database.

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Date Last Modified: 19/3/99
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