There has been a five-fold increase in babies born with Neonatal Abstinence Syndrome (NAS) from 2000 to 2012. These babies are a part of why HHS has made addressing the opioid epidemic a Department-wide priority.
In collaboration with partners across federal government, SAMHSA is sharpening its focus on opioid-dependent pregnant women. And with a $1 billion, two-year investment of new, mandatory funding in the President’s Fiscal Year (FY) 2017 Budget proposal to bolster our efforts, we’re expanding and intensifying our work to prevent and treat opioid dependence, including identification and treatment of NAS.
Expanding access to life-saving treatment.
Medication-Assisted Treatment, or MAT, is the standard of care for pregnant women with opioid use disorders because it provides the most stable conditions for mother and baby. We’re working hard to ensure that women with opioid dependence have access to optimal treatment.
Through our Pregnant and Postpartum Women’s (PPW) initiative, we’ve provided family-centered, residential substance use disorder treatment services for more than 7,500 women and their minor children. In recent years, many of the PPW treatment providers have begun administering MAT onsite to the opioid-dependent women admitted to their programs. I’m happy to say that progress is being made. Substance use decreased in both pregnant and postpartum women who participated in the program. The number of women in the program who reported no substance use increased. And, because their mothers are getting treatment, the PPW program also improved birth outcomes for babies. The President’s proposed FY 2017 Budget would extend the reach of this program, with a 25 percent set-aside to provide more flexibility in where and how these services are provided to women and their children.
Our Substance Abuse Prevention and Treatment block grants continue to prioritize treatment for pregnant women with substance use disorders. From 2011 through 2016, we served more than 21,000 pregnant women per year through these grants. We’ve recently revised our block grant reporting and discretionary grant requirements to strengthen capacity to deliver MAT. SAMHSA asks states to track the number of programs that serve pregnant women and their infants, and those that offer MAT. We’re also asking states to identify geographic areas that do not adequately meet the treatment needs of pregnant women with opioid use disorders.
SAMHSA’s Medication-Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA) program supports 11 states, three of which — Kentucky, Massachusetts, and New Jersey — focus specifically on pregnant women. We’re excited that the 2017 Budget proposes an additional $25.1 million to support 23 new MAT-PDOA grants.
Building capacity in local communities.
Through the National Center on Substance Abuse and Child Welfare (NCASCW), a technical assistance center we co-fund with the Administration on Children, Youth, and Families (ACYF), we’re providing in-depth technical assistance to help states and local jurisdictions to improve the safety, health, and well-being of substance exposed infants. With an emphasis on recovery for pregnant and parenting women and their families, we’re supporting the development of policies and guidelines to address the full spectrum of intervention opportunities—from pre-pregnancy, prenatal and postpartum treatment, and continuing throughout a child’s development.
Encouraging collaboration to meet complex needs.
Because pregnant and parenting women with opioid use disorders and their infants are touched by so many systems, a coordinated, multisystem approach is essential. SAMHSA is issuing two reports on the best approaches for optimizing outcomes for pregnant and parenting women with opioid use disorders and their infants. Both reports are aimed at helping these woman gain greater access to this effective treatment and other important services.
One report, entitled Advancing the Care of Pregnant and Parenting Women with Opioid Use Disorder and their Infants: A Foundation for Clinical Guidance, summarizes the evidence review and rating processes SAMHSA used to establish appropriate interventions for the treatment of pregnant and parenting women with opioid use disorder and their infants.
The other report, A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice and Policy Considerations for Child Welfare and Collaborating Service Providers, completed together with ACYF, is a guide aimed at promoting collaborative efforts among agencies and providers serving pregnant and post-partum women with opioid dependence and their infants.
With the collaborative energy and efforts of partners across government, we can and will reduce the incidence of opioid misuse during pregnancy, reduce the incidence of NAS, and help mothers and their babies live healthier and happier lives.