Resource manual for pregnant or postpartum women using opioids

Profile of an outstanding post-master's DNP project

Virginia Reising

Clinical Issue/Practice Problem: Opioid use among pregnant women is on the rise both nationally and in the state of Illinois. Exact maternal opioid use prevalence in Illinois is not currently known, however, nationally the rate of opioid use in pregnancy is 0.8% . In Illinois, the Neonatal Abstinence Syndrome (NAS) rate increased 53% over a 5-year period to 2.7% with significantly higher rates occurring in rural populations (5.1%) and public/uninsured populations (5.1%).

Summary of Supporting Literature: The American College of Obstetricians & Gynecologists recommends universal screening for opioid use throughout prenatal care, brief intervention at time of screening and referral to Medication Assisted Treatment (MAT) and behavioral therapy. Pregnancy and the postpartum period is a time of great risk for women using substances related to overdose and relapse into drug use, thus comprehensive care is necessary. Integrated prenatal and substance use is the gold standard of treatment. Improving rates of adherence to both prenatal and substance use care impacts positive health outcomes for mom and baby.

Project Implementation: The goal of this initiative was to develop an opioid use treatment resource manual for pregnant women in Illinois to be used by medical providers as a referral tool. A manual was developed using evidence-based resources relevant to Illinois residents: national treatment directories, county public health departments and the Illinois Department of Human Services Division of Alcohol and Substance Abuse Opioid Treatment Program. All resources included in the manual verified treatment of pregnant women and acceptance of Medicaid insurance.

Outcomes: After analysis of findings, 90 total resources were found in Illinois, 67 of these resources offered MAT, and two provided integrated prenatal care and substance use treatment. An electronic resource manual was developed using these treatment referral resources. The Opioid Use Treatment Resources for Pregnant Women with Medicaid in Illinois manual is available to all healthcare providers on the Illinois Department of Public Health website.

Implications for Practice and Next Steps: Areas in Illinois are opioid-use disorder treatment deserts, as resources exist in only 36% of Illinois counties and only 24% of counties have access to MAT resources. This initiative raises awareness of treatment options for pregnant women with Medicaid. It is vital for the state to invest in increasing the availability of resources for areas of Illinois not currently supported by treatment programs.