Combination drug use and risk for fetal harm.

Alcohol and other drugs are frequently used in combination. Based on data from the National Epidemiologic Survey on Alcohol and Related Conditions, Falk and colleagues (2006, 2008) reported that 21.7 percent of the sampled population used both alcohol and tobacco and 5.6 percent used alcohol and another drug. Among women aged 18 to 24 the rates were 25.5 percent and 12.5 percent, respectively. Individually, alcohol, tobacco products, and a number of illicit drugs (such as cocaine or amphetamine) are known to be harmful to the developing fetus during pregnancy. Determining the additional harm resulting from polydrug use during pregnancy is an exceptionally challenging task. The unpredictable interactive (either additive or synergistic) effects of the drugs used simultaneously have far-reaching implications on child health and development given the pervasive use of multiple drugs in our society.