Navigating Opioid Use Disorder in Pregnant and Perinatal Women

Addressing the Unique Needs of a Vulnerable Population

Pregnancy is supposed to be one of life’s most magical times. But for women struggling with opioid use disorder (OUD), it can be a scary and lonely journey. As an obstetrician-gynecologist with extensive experience in this field, Dr. Sura Edmond has witnessed firsthand the complexities and nuances of caring for this vulnerable population.

According to Dr. Edmond, the needs of pregnant women with OUD are unique and require a tailored approach to care. This includes expanded screening for sexually transmitted infections, as well as close collaboration with a multidisciplinary team of specialists, including anesthesiologists, maternal-fetal medicine experts, pediatricians, and behavioral health professionals. By leveraging this team-based approach, healthcare providers can ensure that the patient receives comprehensive, individualized care that addresses their physical, mental, and social needs.

One of the significant challenges in treating pregnant women with OUD is managing their pain, particularly during labor, delivery, and the postpartum period. Due to their increased drug tolerance and hypersensitivity, these patients often require higher doses of opioids to achieve adequate pain control. Dr. Edmond emphasizes the importance of working closely with anesthesiologists and pharmacists to develop a pain medication regimen that balances the patient’s need for pain relief with the preservation of their sobriety and the well-being of the fetus.

The Safety and Efficacy of Medication-Assisted Treatment

When it comes to the treatment of OUD in pregnant women, Dr. Edmond strongly advocates for the use of medication-assisted treatment (MAT), such as methadone or buprenorphine. According to the American College of Obstetricians and Gynecologists (ACOG), MAT is recommended and preferred over supervised medical withdrawal, as it helps prevent withdrawal symptoms, cravings, and the risk of overdose. While there are no known increased risks of birth defects with MAT, experts are still studying the potential for developmental issues in infants.

One of the biggest challenges facing pregnant and postpartum women with OUD is the pervasive stigma and legal barriers that can prevent them from seeking and receiving the care they need. Dr. Edmond emphasizes the importance of breaking down these stigmas and addressing the fear of legal consequences, such as the potential loss of child custody. By providing a compassionate, non-judgmental approach and ensuring access to comprehensive support services, healthcare providers can help these women overcome the barriers to care and prioritize their health and the well-being of their families.

The Critical Role of Community and Family Support

Beyond the healthcare system, Dr. Edmond stresses the vital role that community and family support can play in the recovery and well-being of pregnant and postpartum women with OUD. By educating themselves, offering a supportive and non-judgmental presence, and connecting these women with resources and services, loved ones can make a significant difference in their lives. By building a strong “village” of support, these women can navigate the challenges of pregnancy, childbirth, and postpartum recovery with greater resilience and hope.

Caring for pregnant and postpartum women with OUD requires a multifaceted approach that prioritizes compassion, collaboration, and a deep understanding of the unique challenges they face. By fostering a healthcare environment that is free from stigma, providing comprehensive, evidence-based treatment, and leveraging the support of the broader community, we can empower these women to overcome the obstacles and reclaim their health, their families, and their futures.

Want to learn more about how to support a loved one with OUD? Check out our resources all about supporting pregnant and perinatal women with opioid use disorder.

Life Support Podcast: Dr. Sura Edmond

Can you imagine a medical condition that would get between you and your children? Host Rachel Blanton sits with Sura Edmond to discuss Opioid Use Disorder amongst pregnant and postpartum women, the stigma that surrounds these women, and how to enhance access to treatment for all who are dealing with this circumstance. To find more resources, you can visit https://www.acog.org/topics/opioids

Anthony LeonNavigating Opioid Use Disorder in Pregnant and Perinatal Women

Addressing Workforce Shortages in Central Oregon

One of the most pressing issues in the healthcare industry is the shortage of qualified professionals, especially in rural areas. In Central Oregon, the need for behavioral health practitioners is particularly acute. To tackle this challenge, the Central Oregon Behavioral Health Consortium has developed novel strategies to address workforce shortages in the region. In this blog, we will explore the unique approach taken by the Central Oregon Behavioral Health Consortium and how it is making a difference in the community. 

An Introduction to the Consortium

The Central Oregon Behavioral Health Consortium is a program sponsored by the Oregon Health Authority and the Central Oregon Health Council. Its primary aim is to train and retain the local behavioral health workforce in the region. The program focuses on supporting the needs of the three counties in Central Oregon: Deschutes, Jefferson, and Crook.

The consortium was formed through a collaborative effort between healthcare professionals, community partners, and East Cascade Works, a workforce investment board. The goal was to develop a comprehensive workforce training program that addresses the specific mental health needs of the region.

The Unique Challenges of Central Oregon

Central Oregon is a region characterized by its rural and frontier spaces. While the cities of Bend and Redmond have a larger population, the neighboring towns and counties are more sparsely populated. This presents unique challenges in terms of access to healthcare services, especially behavioral health services.

According to a study conducted by the consortium, there is less than one therapist per 1,000 people in the rural areas of Central Oregon. This limited access to mental health professionals has a significant impact on the community’s well-being. It also creates a need for local clinicians who understand the unique challenges faced by rural communities.

Innovative Solutions for Workforce Shortages

The Central Oregon Behavioral Health Consortium has implemented several innovative strategies to address workforce shortages and improve access to care in the region. These strategies include:

  • Next-Generation Collaboration: The consortium adopts a collaborative approach, involving healthcare professionals and community members in identifying the specific needs of the region. By gathering input from those directly involved in providing healthcare services, the consortium can allocate resources more effectively.
  • Apprenticeship Model: Unlike traditional internships, the consortium’s program offers paid apprenticeships for master’s level students. By providing financial support during their training period, the consortium aims to reduce burnout and increase retention rates among new clinicians.
  • Focus on Stigma and Cultural Competence: The consortium recognizes the importance of addressing stigma and promoting cultural competence in the delivery of behavioral health services. By training clinicians to be sensitive to the unique cultural contexts of rural communities, the consortium aims to improve the quality of care provided.

The Impact of the Consortium

Since its formation, the Central Oregon Behavioral Health Consortium has made significant progress in addressing workforce shortages and improving access to care in the region. By bringing together 26 agencies and fostering collaboration among healthcare professionals, the consortium has created a united front in tackling the challenges faced by the community.

Through their training program, the consortium has provided essential knowledge and skills to a new generation of behavioral health practitioners. These clinicians are now better equipped to serve the specific needs of rural and frontier communities. The consortium also focuses on expanding the network of supervisors, ensuring that there are enough qualified professionals available to mentor and support new clinicians.

Additionally, the consortium has developed a range of evidence-based training opportunities for clinicians in the region. These trainings cover various areas, including cognitive processing therapy for PTSD, gender-diverse youth therapy, motivational interviewing for co-occurring disorders, and pain care management. By equipping clinicians with the necessary tools and knowledge, the consortium aims to improve the quality of care provided to the community.

The Future of the Consortium

The Central Oregon Behavioral Health Consortium has ambitious plans for the future. One of their goals is to establish a PTSD-focused clinic in Central Oregon. This clinic would provide specialized care and evidence-based treatments for individuals with PTSD, addressing a significant need in the community. 

Another exciting prospect is the establishment of an APA-accredited psychology internship program in the region. Currently, most psychology internships are concentrated in urban areas, such as Portland. By creating internship opportunities in Central Oregon, the consortium aims to attract and retain the next generation of psychologists who are specifically interested in working in rural settings. 

By continuing to prioritize collaboration, innovation, and community involvement, the Central Oregon Behavioral Health Consortium is paving the way for improved access to behavioral health services in the region. Their holistic approach to addressing workforce shortages serves as a model for other communities facing similar challenges.

Need help creating a website like COBHC’s? Contact us to get started.

Life Support Podcast: Transforming Mental Health in Central Oregon

We speak with Dr. Adam Dickey to explore the innovative solutions transforming mental health in Central Oregon! Discover how the Central Oregon Behavioral Health Consortium is reshaping mental health with groundbreaking strategies to address workforce shortages, dive into the unique mental health needs of Central Oregon, navigating rural spaces and limited resources, and explore the Consortium’s impactful initiatives, quarterly training sessions, and their exciting plans for the future, including a PTSD-focused clinic and the dream of an APA-accredited psychology internship.

Anthony LeonAddressing Workforce Shortages in Central Oregon

Finding Pride in Rural Healthcare

In a world where LGBTQ+ healthcare can be a struggle, especially in rural areas, Dr. Anthony Carney stands as a beacon of hope. This dedicated nurse practitioner provides affirming primary care for LGBTQ+ patients in a small town clinic at the University of Kentucky. We recently had the pleasure of speaking with Dr. Carney on the Life Support Podcast, and his insights are a must-read for anyone passionate about inclusive healthcare.

Following a Passion to Provide Care

Dr. Carney’s journey to becoming an affirming care provider wasn’t a straight line. It all began with his desire to focus on LGBTQ+ health during his graduate studies. This passion led him to connect with mentors and clinics that specialized in this area. Eventually, his skills and dedication landed him a position at a small-town clinic, allowing him to bring much-needed affirming care directly to a rural community.

What Makes Care Affirming?

But what exactly does affirming care look like? Dr. Carney explains it as recognizing and addressing the unique needs of LGBTQ+ patients. This can range from creating a welcoming and safe environment to using the correct pronouns and offering comprehensive sexual health screenings. Additionally, affirming care provides mental health services specifically tailored to those transitioning genders.

Challenges and Triumphs in Rural Communities

Dr. Carney sheds light on the challenges faced by LGBTQ+ individuals in rural areas. Limited access to affirming services and a constant fear for safety are just a few of the hurdles they encounter. However, Dr. Carney highlights the power of word-of-mouth referrals. By creating a safe space and providing exceptional care, his clinic has attracted patients through positive experiences shared within the community.

Learning Beyond Textbooks

Dr. Carney emphasizes the importance of real-world experience when providing affirming care. Textbooks offer valuable knowledge, but it’s the lived experiences of patients that truly shape a provider’s understanding. Dr. Carney stresses the need to be aware of the social determinants of health and the impact of violence on LGBTQ+ individuals. This allows him to provide holistic care that addresses not just medical issues, but also the social factors that influence well-being.

Making Affirming Care a Reality for All

The interview concludes with Dr. Carney offering valuable advice for healthcare providers who want to create more inclusive environments. He encourages them to:

  • Seek additional training on LGBTQ+ health
  • Utilize online resources
  • Prioritize creating a safe space for patients to express themselves freely

A Brighter Future for LGBTQ+ Healthcare

Dr. Carney’s vision for the future of LGBTQ+ care is one filled with hope. He dreams of a world where more healthcare providers are trained to offer affirming care, LGBTQ+ health topics are a standard part of medical education, and barriers to healthcare access for LGBTQ+ patients are broken down.

Dr. Carney’s dedication and passion are truly inspiring. By sharing his story and insights, he empowers others to advocate for change and create a healthcare system that welcomes and supports everyone, regardless of sexual orientation or gender identity. Let’s continue this conversation and work towards a future where LGBTQ+ healthcare thrives in all communities, big and small.

Life Support Podcast: Gender Affirming Practices in Rural Areas

Elise Winbrock joins Rachel Blanton in a talk with Dr. Anthony about his motivation for practicing LGBTQ+ affirming care in a small town, the importance of affirming care for individuals, and how to create LGBTQ+ friendly healthcare spaces.

Anthony LeonFinding Pride in Rural Healthcare

The Importance of Youth Mental Health

Mental health has become a constant topic of discussion in recent times, especially when it comes to youth mental health. The Surgeon General of the United States has stated that mental health challenges are the leading cause of disability and life outcomes for young people. Unfortunately, there has been a significant increase in certain mental health disorders in youth, including depression, anxiety, and suicidal ideation. This issue has been further amplified by the COVID-19 pandemic.

The American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, and the Children’s Hospital have declared the decline in child and adolescent mental health due to the pandemic as a national emergency. These leading health agencies are urging the rest of the country and the world to take immediate action.

The Impact of the Pandemic on Youth Mental Health

The pandemic has had a profound impact on the mental health of youth. According to the American Psychological Association, there has been a 25% increase in emergency room visits for mental health issues among children from March to October 2020. Additionally, a survey conducted among parents showed that over 70% of them believed that the pandemic had taken a toll on their children’s mental health. Approximately 69% of parents considered it to be the worst thing that had ever happened in their children’s lives.

The increase in mental health issues among youth is not limited to the pandemic alone. Even before the pandemic, CDC statistics showed that one in five adolescents would experience some form of mental health issue. However, only 20% of them were receiving treatment. The pandemic has only exacerbated this existing problem.

The Role of Mental Health Professionals

In order to address the increasing mental health needs of youth, mental health professionals must play a crucial role. Clinical and health psychologists, licensed clinical social workers, and other professionals have seen a significant increase in their workload. They have observed higher levels of depression, anxiety, and social isolation among their young patients.

One of the challenges in working with youth is that they require a different approach compared to adults. Mental health professionals need to consider the developmental context of children and adolescents. They must meet them where they are in terms of their cognitive, social, and emotional development. Additionally, the family context must also be taken into account, as it plays a vital role in a child’s mental health.

The Importance of Family Support

Parents and families have a crucial role in supporting the mental health of their children. One of the most important things parents can do is to listen to their children. By providing a safe space for children to express their feelings and concerns, parents can help them navigate the challenges they face.

Parents should also lead by example and provide positive role models for their children. By being open about their struggles and demonstrating healthy coping mechanisms, parents can instill hope and resilience in their children.

It is also important for parents to be aware of any changes in their child’s behavior or mood. If they notice any significant changes, such as sleep disturbances, irritability, or changes in academic performance, they should reach out for professional help. Early intervention can make a significant difference in a child’s mental well-being.

The Role of the Community

The community, including neighbors, friends, and other individuals, also has a responsibility to support youth mental health. One way to do this is by becoming a mentor to young individuals. Becoming a trusted adult in their lives can provide them with an additional support system outside of their immediate family.

Volunteering and getting involved in youth programs and organizations is another way to make a positive impact on the mental health of young individuals. By providing them with opportunities for engagement and connection, we can help them develop healthy relationships and interests.

For those who are not parents or mental health professionals, increasing awareness and education about youth mental health is essential. Understanding the signs and symptoms of mental health issues and knowing how to provide support can make a significant difference in a young person’s life.

The Role of Schools

Schools play a critical role in addressing youth mental health. They provide a unique opportunity to reach all children, as every child attends school. Schools can start by incorporating mental health education into their curriculum, teaching students about the importance of mental well-being and providing them with tools to cope with stress and emotions.

Schools can also integrate mental health professionals into their system, ensuring that students have access to the support they need. This includes school counselors, psychologists, and therapists. By providing on-site mental health services, schools can eliminate barriers to access and ensure that students receive timely and appropriate care.

Prevention is key when it comes to youth mental health. Schools can implement preventive measures by promoting healthy lifestyles, encouraging physical activity, and educating students about mental health from an early age. By fostering an environment that supports positive mental health, schools can create a foundation for lifelong well-being.

Addressing youth mental health is essential for the well-being of our future generations. By listening to children, providing support and resources, and creating a community that values mental health, we can make a significant impact on their lives. Mental health professionals, parents, schools, and the community must all work together to ensure that young individuals receive the care and support they need to thrive.

Remember, mental health is just as important as physical health. Let’s prioritize the mental well-being of our youth and create a world where everyone has the opportunity to live a happy and healthy life.

If you would like to help us support Idaho’s youth, you can donate to our Youth Mental Health Scholarship Fund. Your contribution will provide vital mental health support to young people facing challenges like anxiety and depression. Together, we can create a brighter future for Idaho’s youth.⁠

Life Support Podcast: Youth Mental Health and How Families Can Support It

Learn more about the importance of youth mental by listening to our Life Support Podcast episode with guests Amy Walters and Maria Torres. 

Anthony LeonThe Importance of Youth Mental Health

Pacing with Our Patients: Recovery & Opioid Use Disorder

Pacing with Our Patients: Recovery & Opioid Use Disorder

By Sabrina Sherwood, Pharmacy Consultant

I recently ran my first half marathon and have my first full marathon in one month. I wouldn’t call myself a “runner”, but I find myself like a moth drawn to flame of the running community. The grit, the perseverance, the preparation. After finishing a race, I like to sit at the finish line.

It’s easy to get caught up in cheering for the first-place finisher but I find the real awe in seeing how many people cross the finish line with grimacing eyes, subpar posture, and sweat stains that will take weeks to resolve.

These are the runners who run not to get first place, but to accomplish their goal of finishing – and the running community has stepped up to help the majority. How? Race pacers.  A race pacer is a runner that keeps a consistent pace throughout a run. These are usual veteran runners – experts who can easily maintain a run speed for a long duration of time. Often, large groups of runners will find their pacer at the start line and run alongside them for the entirety of the race to ensure they achieve the goal time they seek.

Healthcare teams are in a strategic position to pace with patients in many ways – but particularly as it relates to opioid use. Over 27 million people were reported to be suffering from opioid use disorder in 2016. Of those suffering, few have the resources to seek help, and even less are receiving treatment. Providers (including partners such as behavioral health specialists and pharmacists) are highly skilled members of the healthcare team. Pacers are experts of running, and similarly, our healthcare partners are experts in therapy management.   

Like a marathon, our patients with opioid use disorder are not looking to secure the single first-place title of “best sober person to exist”. They just want to cross the finish line. There are a few ways that we can pace with them:   

Visualize   

Helping our patients develop and adhere to a plan that will maximize potential to reach their goals. Patient with opioid use disorder may have competing psychosocial and health related needs that should be factored in before setting up a “training” plan. Let’s help them see the path of least resistance to their finish line.  

Bring them into the Network   

We do better together. Studies show that running persistence improves in those who have a running social network. Pacers bring encouragement and motivation to runners when they’re tempted to quit. Similarly we can support our patients by providing them with their own healthcare partner “pacer” and other resources.

Match the Cadence    

Let’s pace with our patients to meet them where they are at. As a provider, it is easy to sprint to the finish line and waiting for our patient to catch up. We are tempted to tell the patients exactly what needs to be done for them to improve their health and expect them to adhere to our plan. Our patients aren’t robots – they need water breaks, and they need time to tie their shoes occasionally. Let’s pace by continually assessing their progression and helping them move closer to their goal.   

  • pharmacy
  • opioids
  • opioid use disorder
  • recovery
  • opioid epidemic
  • substance use disorder
  • healthcare
Linda CardwellPacing with Our Patients: Recovery & Opioid Use Disorder

Project rEASON

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Anthony LeonProject rEASON

Opioid Use Disorder Community Response

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Title: Opioid Use Disorder Community Response

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URL: https://www.c-who.org/opioid-use-disorder-community-response/

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Anthony LeonOpioid Use Disorder Community Response

Southwest District – Drug Overdose Prevention

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URL: https://swdh.id.gov/healthy-living/drug-overdose-prevention-program/

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Anthony LeonSouthwest District – Drug Overdose Prevention

PHINCD – Drug Overdose Prevention Program

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Title: Drug Overdose Prevention Program

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Anthony LeonPHINCD – Drug Overdose Prevention Program
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