Inside Family Medicine

IFM | FASDs in Primary Care: Recognition, Prevention, and Support


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AAFP Chief Medical Officer and Senior Vice President of Education, Inclusiveness and Physician Well-Being Margot Savoy, MD, MPH, FAAFP, welcomes back Jeffrey Quinlan, MD, FAAFP, a family physician and University of Iowa department leader with a 28-year US Navy career, to discuss his AAFP work on fetal alcohol spectrum disorders (FASDs) and substance use in pregnancy. He emphasizes that alcohol is a teratogen with no safe amount or timing in pregnancy and outlines associated neurodevelopmental, craniofacial, organ, growth and behavioral effects.

The conversation covers primary care screening and early identification using exposure history and clinical signs, common diagnostic frameworks (COFASP and the University of Washington 4-digit code), multidisciplinary care coordination and prevention through routine screening (AUDIT-C or NIAAA single-question), preconception counseling and stigma reduction. For longitudinal care, Quinlan highlights early intervention, individualized care plans, family support and training, school accommodations, behavioral therapies, nutrition support and medications for comorbid conditions, all using a strength-based approach.

Topics by Timestamp

00:00 Welcome and Guest Intro

00:51 Clinical Background and Exposure

01:55 No Safe Alcohol in Pregnancy

04:02 Screening and Diagnosis Basics

06:46 Building the Care Team

09:05 Preventing Alcohol Exposed Pregnancy

12:38 Long Term Care and Interventions

20:13 Key Takeaways and Closing

Additional Resources

Clinician Resources

  • Substance use disorders: Clinical guidance and practice resources from the AAFP
  • Alcohol use during pregnancy and fetal alcohol spectrum disorders: Educational supplement on improving screening, diagnosis and treatment of children and families with FASDs, and improving support services and access to care for impacted women and families
  • IFM | Medical insights on cannabis and alcohol use during pregnancy: Jeffrey Quinlan, MD, FAAFP, addresses alcohol and cannabis use during pregnancy in primary care
  • Treating excessive alcohol use: Guidance for screening, diagnosing and treating excessive alcohol use in primary care settings
  • Tobacco and nicotine use | Prevention and cessation resources: Comprehensive toolkit to assist in helping patients stop smoking or prevent them from starting

Patient Resources

  • Substance use disorder: Evidence-based patient educational resource
  • Opioid addiction: Evidence-base patient educational resources

Related AAFP CME Activities

  • Substance Use Disorders Edition 2: CME meeting DEA-mandated eight hours of Medication Access and Training Expansion (MATE) Act
  • Addiction Treatment and Care CME for Family Physicians: Free, on-demand CME to gain deeper understanding of the neurobiology and psychosocial dimensions of substance use disorders, and learn practical strategies to integrate harm reduction, trauma-informed approaches and culturally responsive care into your practice

Funding Statement: This activity is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,219,331 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

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Inside Family MedicineBy American Academy of Family Physicians

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