Link to video: https://www.gochromacreative.com/forestforthetrees

Additional Resources:

v  Strategies to reduce the stigma of substance use disorder

Ø Changing language

§  https://www.recoveryanswers.org/addiction-ary/

Ø  Respectful maternity care

§ https://www.awhonn.org/birthequity/

§ **Respectful maternity care is an approach that emphasizes treating all women, regardless of their mental health or substance use struggles, with respect, compassion, and encouragement during their pregnancy to improve pregnancy outcomes.

 v International and national guidelines on managing substance use in pregnant/postpartum women

Ø  Substance Abuse and Mental Health

Services Administration (SAMHSA)

§  https://store.samhsa.gov/product/Clinical-Guidance-for-Treating-Pregnant-and-Parenting-Women-With-Opioid-Use-Disorder-and-Their-Infants/SMA18-5054

Ø  World Health Organization (WHO)

§  https://www.who.int/publications/i/item/9789241548731

v  Screening measures for pregnant women

Ø  Tobacco, Alcohol, Prescription

Medication, and Other Substance Use (TAPS) Online Screening Tool; https://nida.nih.gov/taps2/

§  **Recommended universal screening (yet

to be validated with pregnant patients) to identify problematic use of

nicotine, alcohol, and illegal drugs. This is a user-friendly

computer-administered test that patients can complete on their own or a

clinician can administer. It takes about 1 to 8 minutes to complete, depending

on which substances are endorsed. Responses are immediately scored, risk levels

are calculated, and detailed resources and recommendations for treatment are

offered for each substance use problem that is indicated.

§  **Recommended universal screening for

all pregnant patients to identify who may be at risk of and need further

assessment of alcohol and drug use. This is a 5-question paper and pencil

screener that asks about substance use (in general, not broken down by

substance type) by a woman’s parents, peers, partner, as well as in her past

and currently during pregnancy. It takes about 1 minute to complete, although

positive responses will require additional assessments.

Ø  Adverse Childhood Experiences (ACES)

§  **Paper and pencil questionnaire (that could be made into an online survey to facilitate completion), which patients can complete on their own or can be administered by a clinician. Higher ACE scores indicate higher risk for physical and mental health problems, substance use, and other poor outcomes during pregnancy, and referrals to mental health services should be considered.

 v  Substance use treatment services for pregnant women

Ø 

MOM Power

§  https://familiesfree.com/mom-power-a-therapeutic-intervention-for-mothers-of-young-children/

§ **MOM

Power is an evidence-based group therapy for pregnant/postpartum women with substance use disorder and other mental health concerns. Groups teach skills for coping with strong emotions and healing from past trauma. Currently offered by the organization, Families Free, this program has rolling admissions and provides childcare so that mothers can engage in and benefit from treatment. Located in Johnson City, TN.

Ø  Baby Steps Clinic

§ https://www.etsu.edu/com/pediatrics/babystepsclinic.php

§ **Babysteps supports families with a child who has been exposed to substances before birth. Babysteps offers wraparound services from birth until age 5, and their team includes a care coordinator, audiologist, speech-language pathologist, occupational therapist, physical therapist, registered dietician, and

board-certified pediatrician. The team works with families to make sure

children get the support they need to thrive, and that parents get access to

the mental health and substance use treatment they may need. Located in Johnson City, TN.

Ø  ETSU Family Medicine Clinic

§  https://www.etsuhealth.org/locations/family-medicine-jc.php

§  **ETSU’s family medicine clinic is led

by Dr. Joyce Troxler, who also leads the Addiction Medicine Fellowship and

trains physicians to care for people with substance use disorders. The clinic

provides care for the whole family, including obstetrics,  so you can see a primary care doctor and receive behavioral health or medication services if needed during pregnancy and beyond. Located at 917 W Walnut St, Johnson City, TN 37604

Ø East Tennessee Children’s Hospital, Grow With Me Clinic

§ https://www.etch.com/medical-services/nicu/grow-with-me-clinic/

§ **The Grow with Me Clinic is an outpatient service for at-risk children who were

diagnosed with neonatal abstinence syndrome (NAS) or were exposed to substances before birth. Grow with me provides medication and other supports to babies experiencing withdrawals after birth and continues to provide services that address medical, developmental, and emotional needs through age 5.

Ø Strong Futures, Ballad Health

§  https://www.balladhealth.org/locations/behavioral-health/strong-futures-greeneville

§  **Strong Futures coordinates care for expectant or current parents of children under the age of 18 who are struggling with substance use problems in Carter, Cocke, Greene, Hamblen, Hancock, Hawkins, Johnson, Sullivan, Unicoi and Washington counties. This program offers a variety of services for parents so that they can be healthy and stable for their children. Located in Greeneville, TN.

Ø  Tennessee Recovery-Oriented Compliance

Strategy (TN-ROCS)

§  https://tnsmartjustice.org/tn-rocs/

§  **TN-ROCS is a program for people who have been arrested and determined to have a substance use problem that would benefit from treatment. TN-ROCS operates in 14 Tennessee counties (Cannon, Grainger, Hickman, Jefferson, Lewis, McMinn, Monroe, Perry, Rutherford, Sevier, Sullivan, Van Buren, Warren, and Williamson), and involves close coordination between a judge, probation officer, mental health service provider, and others in order to ensure people, including pregnant and parenting women, receive effective treatment for substance use disorder.

Ø  Additional treatment programs across the state may be found through the Department of Mental Health and Substance Abuse Services resources

§  https://www.tn.gov/content/dam/tn/mentalhealth/documents/Listing_of_Women_and_Pregnant_Women_(2).pdf

§  https://www.tn.gov/behavioral-health/substance-abuse-services/treatment---recovery/treatment---recovery/treatment-for-pregnant-women-abusing-substances.html

Ø Select clinics providing medication for opioid use disorder that will treat pregnant women

§  Cedar Recovery, Knoxville (https://www.cedarrecovery.com/)

§  Catalyst Health Solutions, Johnson City

(https://catalysthealth.org/home-patient/)

§  Overmountain Recovery, Johnson City (https://www.overmountainrecovery.org/)

§  ReVida Recovery, multiple locations (https://www.revidarecovery.com/)

Ø  State-wide Opioid Treatment Program Locator

§ https://www.tn.gov/content/dam/tn/mentalhealth/documents/TN_OTP_Map_4-4-22.pdf

   More educational resources for healthcare workers

Ø  Tennessee Initiative for Perinatal Quality Care (TIPQC)

§  https://tipqc.org/educationalvideos/

§  **Under the OUD/OEN Series, find videos

about opioid use disorder, medication treatment for OUD during pregnancy,

caring for opioid-exposed newborns, safe baby courts, pain management, the

eat-sleep-console method, videos of how providers can interact with patients to

decrease stigma, and more.

Ø  ETSU Interdisciplinary Addiction Medicine ECHO (I AM ECHO)

§  https://www.etsu.edu/com/cme/iamecho.php

§  **I AM ECHO is a virtual meeting that is

open to health professionals who serve individuals with substance use disorder,

such as Family Medicine Physicians, Physicians, APNs, PAs, Residents/Fellows,

Pharmacists, and Psychologists. The goal of I AM ECHO is to 1) provide brief

educational presentations on the latest research and clinical skills for

working with addiction (e.g., harm reduction, managing co-occurring diagnoses,

neuroscience of addiction, withdrawal) and 2) facilitate discussions around how

to better treat patients struggling with substance use disorder. Health

professionals can attend just to listen and learn, or they can submit case

presentation information for discussion amongst the group. Sessions occur on

select Wednesdays from 12:15-1:15pm EST.

Ø  Substance Misuse and Addiction Resource for Tennessee

§  https://smart.ips.tennessee.edu/

§  **SMART is a group of academics,

researchers, and other professionals who aim to address the opioid epidemic in

the state of Tennessee. SMART offers consultation to organizations, publishes

best practices and policy briefs around the treatment of opioid use disorder,

and records a podcast with some of our local thought leaders trying to mitigate

the impacts of the opioid epidemic.

 v  General information about substance use disorder, recovery, and treatment

Ø  The impact of ACES

§ https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime?language=en

§ **This video breaks down how ACES put people at risk for issues like substance use later in life.

Ø  What is addiction?

§ https://www.youtube.com/watch?v=M5Mky3Jr960

§ **This video breaks down what happens to the brain when people develop an addiction to alcohol or drugs.

Ø  What does recovery look like?

§ https://www.recoveryanswers.org/recovery-101/brain-in-recovery/

§  **Harvard’s Recovery Research Institute

offers a variety of resources about the science behind recovery from substance

use disorder, including studies about how the brain changes during recovery,

different pathways to recovery, and more.

Ø  Why do we stigmatize addiction?

§  Stigma and the Toll of Addiction

§ https://www.nejm.org/doi/pdf/10.1056/NEJMp1917360?articleTools=true

§  **This is a brief article written by Dr. Noral Volkow, Director of the National Institute on Drug Abuse, who has been a strong advocate for the effective treatment of substance use disorder.

Ø  Why should we connect with people in recovery?

§  The opposite of addiction is connection

§  https://www.youtube.com/watch?v=PY9DcIMGxMs

§  **This is a popular TED Talk by Johann Hari, a former journalist who speaks about substance use disorder

No content or comments made in any TIPQC Healthy Mom Healthy Baby Podcast is intended to be comprehensive or medical advice. Neither healthcare providers nor patients should rely on TIPQC’s Podcasts in determining the best practices for any particular patient.  Additionally, standards and practices in medicine change as new information and data become available and the individual medical professional should consult a variety of sources in making clinical decisions for individual patients. TIPQC undertakes no duty to update or revise any particular Podcast. It is the responsibility of the treating physician or health care professional, relying on independent experience and knowledge of the patient, to determine appropriate treatment.