Substance Abuse among Perinatal - PowerPoint Presentation

Slide1

Substance Abuse among Perinatal Women

Rebecca Hebner Roppolo, MPHSubstance Abuse Prevention Systems Coordinator Violence and Injury Prevention-Mental Health Promotion BranchSlide2

Welcome and Introductions Warm Up Share Name, Agency and Role

What makes you interested in substance abuse prevention among pregnant and breastfeeding women?What is your comfort level working on this topic? (“Not at All,” “Kind Of,” or “Really”) Slide3

Overview of Today’s PresentationBackground on Substance Abuse Priority: Marijuana and Prescription Drug Misuse

Data on substance abuse among pregnant/postpartum women and women of reproductive age (18-44)State-level Strategies: Logic Model + Action PlanLocal-level Strategies: Logic Model + Action PlanFuture Opportunities

Discussion: Questions, Feedback, Ideas

Next StepsSlide4

BackgroundBad for Mom

Addiction, mental health disorders, organ damage, overdose and deathBad for BabyPreterm birth, stillbirth, fetal and childhood developmental problemsSlide5

Marijuana & Prescription DrugsPrenatal Marijuana Exposure

Executive functioning, impacts attention, flexible problem solving, and working memory abilities- may interfere with intellectual development and academic achievementPrescription DrugsFew studies have examined the impact of prescription drug abuse on fetal development, Neonatal Abstinence Syndrome (NAS) is complication from opioidsRisks for pregnancies include an elevated risk for obstetric complications, such as premature birth, stroke, and drug withdrawalSlide6

Data National Survey on Drug Use and Health (NSDUH)Colorado Pregnancy Risk Assessment Service (PRAMS)

Behavioral Risk Factor Surveillance System (BRFSS)Slide7

National Survey on Drug Use & Healthillicit drug use

Pregnant women use any illicit drugs (including marijuana and misuse of prescription drugs) less often in past 30 days than women of reproductive age (ages 15-44).

Marijuana

is the most commonly used illicit drug among pregnant women (2002-2007 data).

Prescription drugs

are second most commonly used illicit drug.

Use declines as pregnancy progresses.

http://archive.samhsa.gov/data/NSDUH/2013SummNatFindDetTables/NationalFindings/NSDUHresults2013.pdf

Past

30 day illicit drug use

Pregnant

Not Pregnant

2011 data

4.4%

10.9%

2012-2013

data5.4%11.4%Slide8

National Survey on Drug Use & Healthdemographics

Use of any illicit drugs (including marijuana and misuse of prescription drugs) during pregnancy is more common among younger women.

Use of any illicit drugs by pregnant women

varies by race/ethnicity

(2002-2010 data).

http://www.samhsa.gov/data/sites/default/files/Spot062PregnantRaceEthnicity2012/Spot062PregnantRaceEthnicity2012.pdf

Black

White

Hispanic

Use during pregnancy

7.7%

4.4%

3.1%Slide9

Concerning Issue, Scarce CO DataColorado Pregnancy Risk Assessment Monitoring Service (PRAMS):

1998-2011 (most recent year) = no questions on marijuana or prescription drug misuse, only tobacco and alcohol.  PRAMS data on marijuana forthcomingBehavioral Risk Factor Surveillance Survey (BRFSS): Only one year of data on marijuana

use among women of reproductive age, no data on prescription drugs.

 BRFSS data on prescription drugs forthcomingSlide10

BRFSS women of reproductive age (15-44)

Current use (past 30 day) data reflects overall Colorado trends for age, education, income, and race.Highest among younger and lower income adults.Whites more likely than other races.

n/a

Special data request: 2013 BRFSS. Slide11

State-Level StrategiesOVERVIEWSlide12

Processes UsedNew Priority!

 Examined existing activities for synergy, opportunitiesViolence and Injury Prevention – Mental Health Promotion branch Environmental HealthSubstance Exposed Newborns commission, Colorado Alliance for Drug Endangered Children Slide13

State StrategiesMass-reach health education campaigns

to women of reproductive ageAccess to safe disposal for prescription drugsHealth care provider education on risks from substance misuse while pregnant or breastfeeding

Promote prescription drug monitoring program (

PDMP

) use

Expand data and surveillance

efforts to better understand scope of issueSlide14

State Logic ModelSlide15

State Action PlanHealth education campaigns

Develop and implement marijuana education campaign targeting pregnant and post partum women, including consultation and/or focus groups with indicated populationsCoordinate messaging and outreach efforts with state-wide partner organizations to

promote mass reach health education campaign materials

with substance abuse (marijuana and non-medical use of prescription drugs) messagingSlide16

State Action PlanSafe disposal

Partner with Environmental Health to recruit law enforcement, pharmacies or hospitals to host permanent prescription drug take-back receptaclesSlide17

State Action Plan3. Health care provider education

Provide trainings, clinical guidance documents, and webinars to healthcare providers on risks of marijuana use for pregnant or postpartum women

Promote resources

for both marijuana and prescription drug misuse prevention

Develop

evaluation tool

to measure capacity of health care providers who participate in CDPHE trainings, webinarsSlide18

State Action Plan4. Prescription Drug Monitoring Program (PDMP)

Conduct public health surveillance with PDMP for women age 18-44 and/or prescribers that provide care to pregnant or postpartum womenPublically disseminate findings to raise awareness

among prescribers of the risks of misuse among women of reproductive age

Promote use of PDMP

for women age 18-44 among prescribersSlide19

State Action Plan5. Data and surveillance

Identify data sources, explore non-traditional data sources, and collaborate with existing groups (PDMP workgroup, Maternal Mortality Review, Birth Defect Registry, Substance Exposed Newborn Commission) to understand scope of prescription drug use by pregnant and post-partum women and suggest recommendations for improvements to data collection and surveillance at CDPHE, specifically for

Neonatal Abstinence Syndrome: emerging issue

Maternal Mortality: Rx is second leading causeSlide20

Local-Level StrategiesOVERVIEWSlide21

Process UsedNew Priority!

 Thank you, December LPHA Summit Participants!GOALSAlign local and state efforts

Feasibility

SustainabilitySlide22

Pardon our appearance…New MCH priority

 no established local activities, no expectation of expertiseNew LPHA priority  currently limited to no funding from CDPHE for local public health activitiesNew CDPHE priority  only since July 2014 has there been any funding, efforts for marijuana; limited prescription drug workSlide23

Local StrategiesREQUIRED

Identify key partners, stakeholders, responsible parties and resources in community Expand local use of substance abuse data for women of reproductive age, pregnant or postpartum

OPTIONAL

3.

Leverage and support community-level strategies

that impact women of reproductive age

4.

Disseminate

mass reach substance abuse prevention social

norming

campaigns from state agencies Slide24

Local Logic ModelSlide25

Notez Bien!Local action plans are customizable. Slide26

Required Strategy1. Identify Key Partners to Leverage Resources

Tracking: Community Substance Abuse Resource Environmental ScanIdentify potential or existing partners, organizations and businesses, community substance abuse prevention coalitions

Consolidate in written

substance abuse community resource environmental scan

Share

the community resource directory among stakeholders and MCH

Assist existing coalitions to

identify new coalition members

identified in environmental scan to represent MCH concernsSlide27

Required Strategy2. Expand Use of Local Data

Tracking: Community Substance Abuse Data Profile & PresentationCollect data from CDPHE on local BRFSS results: marijuana use (2013-2015), prescription drug misuse (2015) among WRA optional: Birth Defects Registry for NAS; hospitalization/ED data from CHA; PDMP prescribing patterns; other local sources

Create and share Community Substance Abuse Data Profile

& Presentation with coalitions, stakeholders and CDPHE

Partner with existing coalitions

to identify SMART

objectives

based on community data and needs that will impact pregnant/postpartum women.Slide28

Optional Strategy3. Partner with Local Communities that Care (CTC) Substance Abuse Coalitions to Represent MCH populations

Tracking: Action plan w/ SMART objectives to reduce substance misuse among local pregnant and breastfeeding womenJoin local CTC substance abuse prevention coalition and help identify ways to leverage resources to achieve shared goals among coalition members.

Select community-level strategies

from CTC menu that impact pregnant/postpartum women

Complete

a written community-specific action plan

to prevent substance use among pregnant and breastfeeding women in collaboration with CTC Slide29

Optional Strategy4. Disseminate Mass-Reach Substance Abuse Prevention Social

Norming Campaigns from State Agencies Tracking: # of local outlets disseminating materialsSocial

norming

:

Speak Now, Good to Know/Marihuana en Colorado, Take Meds Seriously, other materials developed and provided by CDPHE disseminated

Health care provider resources

: promote trainings on substance abuse prevention- SBIRT/PDO/MJ – to partnersSlide30

Future OpportunitiesIn addition to current local-level prevention efforts…Slide31

Potential Substance Abuse Funding Opportunities for LPHAs

Prescription Drug Abuse Prevention: CDC funding to… Enhance and maximize PDMPImplement community interventions for high-burden communities

Youth Substance Abuse Prevention:

Communities that Care model includes…

Coalition

for youth substance abuse prevention

Community-level

environmental strategiesSlide32

DiscussionSlide33

Questions:What community and agency-level strengths need to be in place or obtainable?

(feasible as is, need training, unrealistic)Who are the key partners & coalitions needed to champion and implement the priority? (identified in community resource directory)What resources are needed in order to effectively achieve the stated outcomes?

(

disseminate

campaign materials + community resource directory + data presentation)

What skills are needed to lead implementation of the action plan?

(

request campaign materials +

i.d

. partners + data request + objectives)Slide34

Next StepsSlide35

FY16 Planning Process (March-May)Generalist Consultants (Julie and Isabel) will work with each of their agencies to schedule planning meetings.Rebecca

Roppolo (rebecca.roppolo@state.co.us) is available to consult with LPHA staff to draft customized local action plans.Ongoing Technical Assistance is Available! Depending on the number of LPHAs that select this priority, I will be reaching out via conference calls, webinars, or in-person technical assistance. Slide36

Thank you!