Society guideline links: Substance misuse in pregnancy

Introduction — 

This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.

The recommendations in the following guidelines may vary from those that appear in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.

Links to related guidelines are provided separately. (See "Society guideline links: Fetal alcohol spectrum disorder".)

International

●World Federation of Societies of Biological Psychiatry (WFSBP) and International Association for Women's Mental Health (IAWMH): Guidelines for the treatment of alcohol use disorders in pregnant women (2019)

●Academy of Breastfeeding Medicine (ABM): Clinical protocol #21 – Guidelines for breastfeeding and substance use or substance use disorder, revised (2015)

●World Health Organization (WHO): Guidelines for the identification and management of substance use and substance use disorders in pregnancy (2014)

●WHO: Recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy (2013)

●WFSBP: Guidelines for the biological treatment of substance use and related disorders – Opioid dependence (2011)

Canada

●Canadian Paediatric Society (CPS): Position statement for managing newborns at risk for neonatal abstinence syndrome (NAS)/neonatal opioid withdrawal syndrome (NOWS) – Updates and emerging best practices (2025)

●CPS: Position statement on tobacco use and misuse among Indigenous children and youth in Canada (2017, reaffirmed 2024)

●Society of Obstetricians and Gynaecologists of Canada (SOGC): Clinical practice guideline on screening and counselling for alcohol consumption during pregnancy (2020)

●SOGC: Alcohol use and pregnancy consensus clinical guidelines (2017)

●SOGC: Clinical practice guideline on substance use in pregnancy (2017)

●SOGC: Adolescent pregnancy guidelines (2015)

United States

●American College of Obstetricians and Gynecologists (ACOG): Committee opinion on prepregnancy counseling (2019, reaffirmed 2024)

●ACOG: Committee opinion on reproductive health care for incarcerated pregnant, postpartum, and nonpregnant individuals (2021, reaffirmed 2024)

●ACOG: Committee opinion on tobacco and nicotine cessation during pregnancy (2020, reaffirmed 2023)

●ACOG: Committee opinion on substance abuse reporting and pregnancy – The role of the obstetrician-gynecologist (2011, reaffirmed 2022)

●ACOG: Committee opinion on alcohol abuse and other substance use disorders – Ethical issues in obstetric and gynecologic practice (2015, reaffirmed 2021)

●ACOG: Committee opinion on at-risk drinking and alcohol dependence – Obstetric and gynecologic implications (2011, reaffirmed 2021)

●ACOG: Committee opinion on marijuana use during pregnancy and lactation (2017, reaffirmed 2021)

●ACOG: Committee opinion on methamphetamine abuse in women of reproductive age (2011, reaffirmed 2021)

●ACOG: Committee opinion on opioid use and opioid use disorder in pregnancy (2017, reaffirmed 2021)

●US Preventive Services Task Force (USPSTF): Final recommendation statement on interventions for tobacco smoking cessation in adults, including pregnant persons (2021)

●American Academy of Pediatrics (AAP): Clinical practice policy to protect children from tobacco, nicotine, and tobacco smoke (2015, reaffirmed 2020)

●AAP: Clinical report on neonatal opioid withdrawal syndromes (2020)

●AAP: Public policy for protecting children from tobacco, nicotine, and tobacco smoke (2015, reaffirmed 2020)

●American Society of Addiction Medicine (ASAM): Clinical practice guideline on alcohol withdrawal management (2020)

●ASAM: National practice guideline for the treatment of opioid use disorder, focused update (2020)

●USPSTF: Final recommendation statement on illicit drug use in children, adolescents, and young adults – Primary care-based interventions (2020)

●USPSTF: Final recommendation statement on unhealthy drug use – Screening (2020)

●American Psychiatric Association (APA): Practice guideline for the pharmacological treatment of patients with alcohol use disorder (2018)

●Substance Abuse and Mental Health Services Administration (SAMHSA): Clinical guidance for treating pregnant and parenting women with opioid use disorder and their infants (2018)

●USPSTF: Final recommendation statement on unhealthy alcohol use in adolescents and adults – Screening and behavioral counseling interventions (2018)

●AAP: A public health response to opioid use in pregnancy (2017)

●AAP: Clinical report on neonatal drug withdrawal (2012, reaffirmed 2016)

United Kingdom

●National Institute for Health and Care Excellence (NICE): Guideline on tobacco – Preventing uptake, promoting quitting, and treating dependence (2021, updated 2025)

●NICE: Quality standards on tobacco – Treating dependence (2022)

●NICE: Clinical guideline on antenatal and postnatal mental health – Clinical management and service guidance (2014, updated 2020)

●Scottish Intercollegiate Guidelines Network (SIGN): A national clinical guideline on children and young people exposed prenatally to alcohol (2019)

●British Association for Psychopharmacology (BAP): Consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum (2017)

●United Kingdom Department of Health (DH): Drug misuse and dependence – UK guidelines on clinical management (2017)

●Royal College of Obstetricians and Gynaecologists (RCOG): Green-top guideline for the investigation and management of the small-for-gestational-age fetus, 2nd edition (2013, revised 2014)

●BAP: Evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity – Recommendations, update (2012)

●NICE: Clinical guideline on pregnancy and complex social factors – A model for service provision for pregnant women with complex social factors (2010)

Australia–New Zealand

●Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG): Clinical guideline on substance use in pregnancy (2024)

●New Zealand Ministry of Health: The New Zealand guidelines for helping people to stop smoking, update (2021)

●Australian Department of Health: National guidelines for medication-assisted treatment of opioid dependence (2014)