Most Pregnant Cannabis Users Complete Substance Use Assessment When a Comprehensive Program Exists
In a Kaiser Permanente prenatal program, 80% of 20,398 pregnancies with positive cannabis screening completed substance use assessment, and 88% of those needing intervention attended counseling, showing comprehensive programs can effectively engage this population.
Quick Facts
What This Study Found
80.3% of cannabis-positive pregnancies completed assessment. Among 64% needing intervention, 88% attended counseling or treatment. Medicaid, anxiety, depression, and tobacco use disorders predicted higher odds of assessment. Older age (35+), greater parity, and later trimester assessment predicted lower odds. Nearly all psychiatric and substance use disorders predicted referral to addiction medicine treatment.
Key Numbers
17,782 individuals; 20,398 pregnancies; 80.3% completed assessment; 88% of those needing intervention attended; 64% needed intervention based on assessment.
How They Did This
Retrospective cohort using EHR data from Kaiser Permanente Northern California Early Start program. 17,782 individuals with 20,398 cannabis-positive pregnancies (2011-2021). GEE multinomial logistic regression for predictors.
Why This Research Matters
Prenatal cannabis use is rising, but engagement in assessment and counseling is poorly understood. This study shows a structured program can reach the vast majority of pregnant cannabis users, providing a model for other health systems.
The Bigger Picture
The high engagement rates suggest that barriers to prenatal substance use treatment are surmountable with systematic screening and integrated care. The lower engagement among older and multiparous women identifies specific groups needing targeted outreach.
What This Study Doesn't Tell Us
Single health system (Kaiser) may not represent other settings. Cannabis screening methods evolved over the study period. Outcomes limited to program attendance, not cannabis use reduction or pregnancy outcomes.
Questions This Raises
- ?Does Early Start program attendance improve pregnancy outcomes for cannabis users?
- ?Why are older and multiparous women less likely to complete assessment?
Trust & Context
- Key Stat:
- 80% of pregnant cannabis users completed substance use assessment
- Evidence Grade:
- Large cohort (20,398 pregnancies) over a decade with detailed EHR data. Single health system limits generalizability.
- Study Age:
- 2025 publication analyzing 2011-2021 Kaiser Permanente data.
- Original Title:
- Predictors of Participation in Prenatal Substance Use Assessment, Counseling, and Treatment Among Pregnant Individuals in Prenatal Settings Who Use Cannabis.
- Published In:
- Journal of addiction medicine, 19(2), 179-186 (2025)
- Authors:
- Lapham, Gwen T(10), Chi, Felicia W(6), Young-Wolff, Kelly C(42), Ansley, Deborah, Castellanos, Carley, Does, Monique B, Asyyed, Asma H, Ettenger, Allison, Campbell, Cynthia I
- Database ID:
- RTHC-06896
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Do pregnant cannabis users engage in treatment?
In this structured program, 80% completed assessment and 88% of those identified as needing help attended counseling or treatment.
Who is hardest to engage?
Older women (35+), those with more prior pregnancies, and those screened later in pregnancy were less likely to complete assessment.
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Cite This Study
https://rethinkthc.com/research/RTHC-06896APA
Lapham, Gwen T; Chi, Felicia W; Young-Wolff, Kelly C; Ansley, Deborah; Castellanos, Carley; Does, Monique B; Asyyed, Asma H; Ettenger, Allison; Campbell, Cynthia I. (2025). Predictors of Participation in Prenatal Substance Use Assessment, Counseling, and Treatment Among Pregnant Individuals in Prenatal Settings Who Use Cannabis.. Journal of addiction medicine, 19(2), 179-186. https://doi.org/10.1097/ADM.0000000000001399
MLA
Lapham, Gwen T, et al. "Predictors of Participation in Prenatal Substance Use Assessment, Counseling, and Treatment Among Pregnant Individuals in Prenatal Settings Who Use Cannabis.." Journal of addiction medicine, 2025. https://doi.org/10.1097/ADM.0000000000001399
RethinkTHC
RethinkTHC Research Database. "Predictors of Participation in Prenatal Substance Use Assess..." RTHC-06896. Retrieved from https://rethinkthc.com/research/lapham-2025-predictors-of-participation-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.