Substance Use Treatment During Pregnancy in the Rural Primary Care Setting: Putting the Puzzle Together

This session will identify and discuss the unique barriers of the rural pregnant and substance use disorder (SUD) population. The most evident barriers are the same across all SUD populations in a rural area: access to care, transportation to care and support programs, stable housing, and financial/employment limitations. However, within the pregnant population, this is compounded with the additional need for time-sensitive medical testing, potential medication changes for appropriateness during pregnancy, hormonal changes contributing to increase in frequency and intensity of mental health symptoms, and the abundance of prenatal need. Providing medication assisted treatment services in a primary care setting that also provides pregnancy specific mental health services, targeted case management, master’s level therapy services, prenatal care, and general medical care in a one stop setting improves the overall progress and positive outcomes for mother and infant. Mountain Comprehensive Health Corporation's Neonatal Abstinence Prevention Program began collecting data in June 2016. The data indicated delivery of multifaceted services across all domains of treatment, provided from a treatment team collaborative, improved health outcomes. This method of service delivery allows the patients to receive unfettered access to all identified medical and mental health needs, including community connections, support, and basic life needs. Services provided in this modality also allow a reduction of stressors within the home environment, promoting a healthier pregnancy and a reduction of medically indicated treatment for Neonatal Opioid Withdrawal Syndrome.