Psych CASC / OSCE · Addiction psychiatry — perinatal substance use
Explain OAT and NAS in pregnancy — CASC communication station
MRCPsych/FRANZCP-style communication station: non-punitive explanation of OUD in pregnancy, OAT rationale, NAS as expected/treatable, reject forced detox, outline postpartum safety plan.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes after reading. You are the psychiatry/addiction registrar. The examiner may play the patient and/or her mother. [3]
Candidate instructions. Explain why medication treatment (OAT) is recommended in pregnancy. Contrast forced detox with methadone/buprenorphine. Explain neonatal abstinence in plain language without stigma. Address child-protection fears honestly. Agree a collaborative plan including postpartum continuity. [2][3][4]
References5ShowHide
- [1]Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure N Engl J Med, 2010.PMID 21142534
- [2]Minozzi S, Amato L, Jahanfar S, et al. Maintenance agonist treatments for opiate-dependent pregnant women Cochrane Database Syst Rev, 2020.PMID 33165953
- [3]American College of Obstetricians and Gynecologists Committee Opinion No. 711 Summary: Opioid Use and Opioid Use Disorder in Pregnancy Obstet Gynecol, 2017.PMID 28742670
- [4]Klaman SL, Isaacs K, Leopold A, et al. Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance J Addict Med, 2017.PMID 28406856
- [5]American Society of Addiction Medicine The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update J Addict Med, 2020.PMID 32511106