Reducing Fear to Help Build Healthy Families: Investing in Non-Punitive Approaches to Helping People with Substance Use Disorder

• Published in: Maternal and child health journal Vol. 27; no. Suppl 1; pp. 177 - 181
• Main Authors: Scott, Karen A., Shogren, Maridee, Shatzkes, Kenneth
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-12-2023; Springer Nature B.V
• Subjects: Analgesics, Opioid; Child; Child Welfare; Children; Commentary; Community organizations; Crises; Drug overdose; Drug use; Drugs; Families & family life; Family Health; Fear; Female; Gynecology; Health care industry; Health services; Humans; Maternal and Child Health; Maternal mortality; Medicine; Medicine & Public Health; Morbidity; Mortality rates; Mothers; Narcotics; Opioid-Related Disorders - therapy; Opioids; Organizational effectiveness; Overdose; Parents & parenting; Pediatrics; Perinatal care; Philanthropy; Population Economics; Pregnancy; Public Health; Rehabilitation; Sociology; Substance abuse treatment; Substance use; Substance use disorder; United States > US; Philanthropy; Maternal mortality; Treatment; Stigma; Child welfare reporting; Opioids
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-023-03772-8

Background
Many pregnant and parenting people with substance use disorders (SUD) refrain from seeking perinatal care or treatment for their SUD for fear of being treated poorly by health care providers and/or triggering a child welfare investigation. For those who do seek treatment, there are relatively few clinicians willing and able to prescribe medications for opioid use disorder (MOUD) to pregnant people. Both stigma and lack of access to treatment put many pregnant and parenting people at risk. Drug-related deaths contribute significantly to U.S. maternal mortality rates, with people at especially high risk of drug overdose in the months following delivery.
Methods
The Foundation for Opioid Response Efforts (FORE) is a national philanthropy focused on finding and fostering solutions to the opioid crisis. We draw lessons from our grantees’ efforts to expand access to substance use treatment and recovery supports for pregnant and parenting people.
Results
To build systems of care that ensure more pregnant people get timely perinatal care, we need to expand training for perinatal providers on how to provide OUD treatment, clarify child welfare reporting rules, and engage and support trusted organizations and community-based services.
Conclusions
In addition to changes to our systems of SUD treatment and recovery, we need greater philanthropic investment in efforts to combat the public health crisis of substance use and overdose among pregnant and parenting people. Private funders have the leeway to act quickly, take risks, and demonstrate the effectiveness of new approaches, building the case for investment of public resources in such initiatives.
Significance
The continuing high rates of overdose deaths in the U.S. intersect with maternal mortality and morbidity, as well as family health. Private foundations along with public agencies have significant opportunities to align work on both issues to save lives.