PPW Project ECHO – February 21, 2017Pat Stilen & Lonnetta Albright, ATTC CoE PPW

PPW Field

• Family-centered Framework (Pat)

SUD Field

• Recovery Principles (Lonnetta)

Healthcare

• Cascade of Care (Lonnetta)

An Integrated Framework

PPW Field

• Family-centered Framework

SUD Field

• Recovery Principles

Healthcare

• Cascade of Care

Integrated Framework

APPROACH

This Framework Draws on Previous Work in the Field

1960 - 1980

• Neonatal narcotic addiction (1960s – 1970s)

• Methadone used to treat opioid addiction during pregnancy (1973)

• Fetal Alcohol Syndrome first described (1973)

• In the 1970s, women-specific services emerged

• Research on differences between men’s and women’s SUD was the centerpiece of a women’s alcoholism movement (late 1970s – early 1980s)

• Organizationally, this movement included the National Council on Alcoholism, National Women’s Congress on Alcohol and Drug Problems (1980)

• Sensationalist reports on cocaine exposed infants (1985) led to expansion of treatment resources for women and specialized programs to treat women involved in the child protection system

This Framework Draws on Previous Work in the Field

1980 - 2010

• Women-only treatment units triple as NIAAA and NIDA focus attention on the special needs of women with substance use disorders

• Women’s Movement - Coalition on Alcohol and Drug Dependent Women and Their Children; National Association of Women in Alcoholism and Drug Dependencies (1988)

• 3x number of women incarcerated (1980 -1992) “for delivering drugs to their infants through pregnancy” (Immarigeon and Chesney-Lind, 1992)

• Specialized services for women with federal “set-aside” funding (1982-1995)

• Methadone benefits for both mother and infant confirmed (Finnegan & Kandall, 1992)

• September 1991 - 214,000 women were enrolled in addiction treatment in US (27% of all clients receiving treatment)

• CSAT expands treatment capacity – 65 demonstration projects to serve women with substance use disorders and their children (1993)• Between 1993 and 1995, the Center for Substance Abuse Treatment (CSAT) awarded a

series of 5-year grants under the Residential Women and Children (RWC) and Pregnant and Postpartum Women (PPW) Demonstration Program.

This Framework Draws on Previous Work in the Field

2010-2017

• By 2011, 609,000 women admitted to specialty addition treatment in US (33% of all clients receiving treatment)

SAMHSA Block Grants Prioritizing PPW (2011–2016) • Served >21,000 pregnant women per year• Revised grant reporting to strengthen capacity to deliver care• Request to states to identify geographic areas that do not adequately meet the

treatment needs of pregnant women with opioid use disorders (Dr. Kim Johnson, Dec 2016)

PPW Field

• Family-centered Framework

SUD Field

• Recovery Principles

Healthcare

• Cascade of Care

Integrated Framework

FRAMEWORK

What Does Recovery Mean to You?

PPW Field

• Family-centered Framework

SUD Field

• Recovery Principles

Healthcare

• Cascade of Care

Integrated Framework

1. Increase Access

2. Retention & Treatment

Completion

3. Sustainability

How do we make sure PPW & their families who need treatment can access treatment?

• Assertive outreach & engagement

How do we improve our capacity to retain PPW & their families who access treatment through to completion of treatment?

• Team expands to include peers and recovery coaches

How do we increase the capacity for follow-up care so that PPW & their families who complete treatment will sustain their recovery?

• Community supports• Natural Supports

Cascade of Care: Building on a CDC Model for HIV/AIDS

FRAMEWORK