8/9/2019 PQCNC: Pregnancy and Opiod Exposure

1/11

Pregnancy and Opioid Exposure

Melissa L. Godwin, LCSWUNC School of Social Workmgodwin@email.unc.edu

NC Division of Menal !ealh, Develo"menalDisa#iliies and Su#sance $#use Services

mailto:mgodwin@email.unc.edumailto:mgodwin@email.unc.edu

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

2/11

Opioids Prescribed in NC

Mepheridine

Codeine

HydromorphoneBuprenorphine

Morphine

Methadone

Hydrocodone

OxycodoneFentanyl

   L  e  a  s   t

    M  o  s   t

   P  r  e  s  c  r   i   b  e   d

   P  r  e  s  c  r   i   b  e   d

The

Most

Common

Opioids

Prescrib

ed

in North

Carolina

2010. 

Adapted from Modarai, F. et al

%&&' o ()%), he *ederal D+$ recordedan 839 increase in sales of he o"ioid

o-codone in NC

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

3/11

Opioid Exposed People

RX• Large aaila!ility of "u!"tance

Opioid #"e$i"order"

MA%  • %reatment

• Geneic vulnera#ili-

•Naure of su#sancecreaes eu"horia,akes awa- "ain

•  rauma hisor-, oher$C+/s

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

4/11

NC Pregnancy and Opioid Exposure

Stakeholder Workgroup

$i"cipline" repre"ented include&

OB'()*", pediatrician", nur"e", "ocial +orer", "u!"tance a!u"e

treatment proider", pharmaci"t" and pu!lic health profe""ional".

(oal"&Education and collaboration

• -dentify !e"t practice continuum of care for range of complex need" for

+omen +ho are pregnant, opioid taing and their infant".

• $eelop and di""eminate educational tool" for proider"

• -dentification of "erice" for +omen and their infant"

• -mproe colla!oration of proider"

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

5/11

NC Pregnancy and Opioid Exposure

Stakeholder Workgroup

(oal" continued

Infants

• /arly identification and management of infant" !orn experiencing

 *eonatal A!"tinence 0yndrome 1*A02.

• Longitudinal re"earch of infant" !orn +ith *A0 due to opioid expo"ure.

Policy and legislation

• 3ropo"e pre"cri!ing regulation", to include informed con"ent re4uiring

education of +omen prior to pre"cri!ing, regarding impact on ne+!orn

if "he +ere to !ecome pregnant.

• 0upport increa"ed u"e of Controlled 0u!"tance Reporting 0y"tem

1C0R02 !y proider"

Grant funding capacity

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

6/11

Messaging

5orgroup mem!er" !uilt con"en"u" around ey me""age" related to

opioid u"e in pregnancy.

• 6ey me""age" +ere deeloped +ith a focu" on

72 +omen of child!earing age +ho are taing opioid" 8 pregnant

+omen +ith opioid dependence,

92 proider" +ho care for the"e +omen, and

:2 proider" +ho care for opioid;expo"ed ne+!orn" and their

familie".

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

7/11

NC Pregnancy and Opioid Exposure Professional Education Needs Survey

• 0no+!all "ampling targeting medical, !ehaioral health,

 = re"pondent" completed, from =: of 7>> *C countie"

• Accurate no+ledge of re"pondent" +a" uneen

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

8/11

Cau"e of *A0

3ain management and pregnancy

$etox " medication a""i"ted treatment during pregnancy

A!"tinence ". medication a""i"ted treatment

 *A0 i" treata!le

#"e of opioid" in pregnancy can re"ult in child a!u"e coniction

Brea"tfeeding and methadone

3o"tpartum management of medication a""i"ted treatment

(enetic ulnera!ility for addiction

>? 7>? 9>? :>? @>? >? >?

:?9?

@?

@D?

@?

:D?:?

9?

7D?

6no+ledge of 3rofe""ional"

? Correct

N=909

NC Pregnancy and Opioid Exposure

Professional Education Needs Survey

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

9/11

Pregnancy and Opioid: uidance for North

Carolina

• Adapted from exi"ting material" from Eermont

• -nterdi"ciplinary "taeholder input

• -ntended for !road audience of profe""ional"

• /lectronically aaila!le ncpoep.org

http://www.ncpoep.org/http://www.ncpoep.org/

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

10/11

nc"oe".org

•  *C 3regnancy and Opioid /xpo"ure (uidance $ocument

• Me""aging for multiple audience"

• 0erice locator 

• Brief -nterention ideo

• -ntroduction ideo to 3erinatal 0u!"tance #"e 0peciali"t and

related program"

• Related re"ource" and training eent"

8/9/2019 PQCNC: Pregnancy and Opiod Exposure

11/11

!esources

3MH Care 3ath+ay on the Management of 0u!"tance #"e in3regnancy

http"&''+++.communitycarenc.org'population;management'pr 

egnancy;home'pmh;path+ay"'pmh;care;path+ay";management;"

u!"tance;u"e;pregnan'

 *C 0B-R%

+++."!irtnc.org

 *C 3erinatal, Maternal and CA0A5OR60 for Familie"

http&''ncpregnancy.org're"ource;directory'treatment'

 

https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/http://www.sbirtnc.org/http://ncpregnancy.org/resource-directory/treatment/http://ncpregnancy.org/resource-directory/treatment/http://www.sbirtnc.org/https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/https://www.communitycarenc.org/population-management/pregnancy-home/pmh-pathways/pmh-care-pathways-management-substance-use-pregnan/