Difference between revisions of "Expand Access to MAT/MAR for Pregnant People"
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= Relevant Research = | = Relevant Research = | ||
<div class="_">A 2012 study of medical students in an obstetrics and gynecology rotation found that when students are placed in a residential treatment center for pregnant women (i.e. specialized training) they showed greater comfort in assessing and educating patients about substance abuse during pregnancy compared to those in a regular rotation.<sup> <ref>http://www.usatoday.com/story/news/nation/2014/06/15/drug-dependent-babies-challenge-doctors-politicians/10526103/</ref></sup>PCCS MAT<ref>http://pcssmat.org/ Provider's Clinical Support System</ref> provides many free online trainings and resources to help address the opioid crisis, including Opioid Dependence in Pregnancy: Clinical Challenges.<ref>http://pcssmat.org/ Provider's Clinical Support System</ref></div> | <div class="_">A 2012 study of medical students in an obstetrics and gynecology rotation found that when students are placed in a residential treatment center for pregnant women (i.e. specialized training) they showed greater comfort in assessing and educating patients about substance abuse during pregnancy compared to those in a regular rotation.<sup><ref>http://www.usatoday.com/story/news/nation/2014/06/15/drug-dependent-babies-challenge-doctors-politicians/10526103/</ref></sup>PCCS MAT<ref>http://pcssmat.org/ Provider's Clinical Support System</ref> provides many free online trainings and resources to help address the opioid crisis, including Opioid Dependence in Pregnancy: Clinical Challenges.<ref>http://pcssmat.org/ Provider's Clinical Support System</ref></div> | ||
== New 2018 Clinical Guide by SAMHSA == | == New 2018 Clinical Guide by SAMHSA == |
Revision as of 18:20, 31 March 2022
Introductory Paragraph
Maintenance Therapy Drugs
Medically supervised tapering of opioids in pregnant women is associated with high relapse rates as compared to methadone maintenance.
Women who need maintenance therapy drugs often struggle to get them. To get buprenorphine, they must go to one of the state's few doctors with a special license. To get methadone, they must go regularly to a clinic — in Middle Tennessee there's one in Nashville and one in Columbia. Women must often pay out of pocket. And many women of child-bearing age don't qualify for TennCare until they find themselves pregnant. That makes it difficult for an addict to access family planning or mental health preventive care before becoming pregnant.
Tennessee's three managed care companies — Amerigroup, UnitedHealthcare's Medicaid subsidiary and BlueCross BlueShield's BlueCare program — are trying to reach these women earlier to ensure that more babies are born healthy. All have flagged drug-dependent babies as a major cost issue. BlueCross, for example, covered 775 such babies in 2013 [must be nationwide]. [at $50,000 each, which is a low estimate of incremental cost over a normal birth, that cost BlueCross about 38 million.] All three have launched efforts to help expectant mothers beat their addictions. [1][2]
Key Information
- There are often long waiting periods to get women into treatment.[3]
- Although pregnant women actually receive priority for methadone treatment, once they are not pregnant they return tot the long waiting periods and the motivation to pursue treatment may be deterred by these waits[4]
- Women often experience anxiety about what will happen if they can no longer pay for their methadone treatments
- There is a need for increased grant funding to help women stay in treatment once they are enrolled[6]
- Women have misconceptions about methadone and are unclear about the treatment process[7]
- 13 states give pregnant women priority access to general programs for drug treatment.[8]
- 4 states protect pregnant women from discrimination in publicly funded programs.[9]
- 18 states consider substance abuse during pregnancy to be grounds for child abuse. [10]
Relevant Research
New 2018 Clinical Guide by SAMHSA
Split Dosing to Reduce Risk
Impactful Federal, State, and Local Policies
Available Tools and Resources
TR - Expand Access to MAT for Pregnant Women
Promising Practices
- What to expect in regards to pain management
- Infant withdrawal symptoms
- CPS involvement
- Treatment approaches for withdrawing infants
- How to work with doctors and nurses to help the process go smoothly
- Advice for comforting methadone-exposed babies once they come home
Sources
- ↑ ACOG Committee on Health Care for Underserved Women; American Society of Addiction Medicine. ACOG committee opinion no. 524: opioid abuse, dependence, and addiction in pregnancy. Obstet Gynecol 2012;119:1070–6
- ↑ https://www.usatoday.com/story/news/nation/2014/06/15/drug-dependent-babies-challenge-doctors-politicians/10526103/
- ↑ https://healthandjusticejournal.springeropen.com/articles/10.1186/s40352-015-0015-5
- ↑ https://healthandjusticejournal.springeropen.com/articles/10.1186/s40352-015-0015-5
- ↑ https://healthandjusticejournal.springeropen.com/articles/10.1186/s40352-015-0015-5/
- ↑ https://healthandjusticejournal.springeropen.com/articles/10.1186/s40352-015-0015-5
- ↑ http://www.washingtonexaminer.com/west-virginia-tackles-opioid-abuse-during-pregnancy/article/2610403
- ↑ http://www.washingtonexaminer.com/west-virginia-tackles-opioid-abuse-during-pregnancy/article/2610403
- ↑ http://www.washingtonexaminer.com/west-virginia-tackles-opioid-abuse-during-pregnancy/article/2610403
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/23154692
- ↑ http://www.usatoday.com/story/news/nation/2014/06/15/drug-dependent-babies-challenge-doctors-politicians/10526103/
- ↑ http://pcssmat.org/ Provider's Clinical Support System
- ↑ http://pcssmat.org/ Provider's Clinical Support System
- ↑ https://store.samhsa.gov/shin/content//SMA18-5054c/SMA18-5054.pdf Clinical Guidance for Treating Pregnant Women with OUD and their Infants