Year of Publication

2018

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. Robin Vanderpool

Committee Member

Dr. Christina Studts

Committee Member

Dr. Richard Crosby

Abstract

The Kentucky River Area District Health Department proposes implementation of CHARM-Kentucky, a treatment program for pregnant women with opioid use disorder (OUD), in eastern Kentucky. Over 115 Americans die each day from an opioid overdose, resulting in approximately 42,000 deaths in 2016. In addition to an overall increase in opioid use in recent years, the use of opioids in pregnancy has also increased from 1.19 per 1,000 hospital births in 2000 to 5.63 in 2009. Opioid use during pregnancy results in poor neonatal outcomes including: low birth weight, preterm delivery, small head circumference, increased child maltreatment, and risk for long-term foster care. There are many different professionals, both medical and nonmedical, that may be involved in the treatment, care, and decision-making surrounding a woman with OUD and her baby. The CHARM program combines medication-assisted therapy (MAT) with early access to prenatal care, counseling, early child welfare involvement prior to birth, parenting education, nutrition support, and social services support. Participants in the program receive prenatal care, access to MAT, participate in mandatory substance abuse counseling, submit mandatory urine drug testing, attend group educational sessions relating to addiction and parenting, and have coordination of services by a case manager. The original CHARM program in Vermont has been shown to increase the number of women receiving treatment, move women into treatment earlier in their pregnancy, increase infant birth weights, and have more infants remain in the care of their mothers. CHARM-Kentucky will operate from the Primary Care Centers of Eastern Kentucky Clinic in Hazard, a clinic serving communities significantly burdened by the opioid epidemic in Kentucky.

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