Adding to Our Practice Toolkit: Using the ACTS Script to Address Stigmatizing Peer Behaviors in the Context of Maternal Substance Use

Infants with neonatal abstinence syndrome (NAS) are a growing population in the NICU setting, and nurses report that caring for families can be challenging. Women who are pregnant and newly parenting who use drugs and alcohol typically face significant negative attitudes, judgment, and stigma within their communities and from providers when they access health care. When nurses witness biased behavior or communication from their peers, they may feel distressed and unprepared to address the situation. Using script guides or structured communication frameworks (e.g., SBAR) is one helpful strategy for rehearsing actions and responses. The ACTS script was developed specifically to address peer attitudes and stigma in relation to substance use during pregnancy.