Reference Guide for Reproductive Health Complicated by Substance Use

Provider guide toolkit

Download Reference Guide for Reproductive Health Complicated by Substance Use (Revised April 2021)

Substance misuse, dependency, and substance use disorders (SUDs), including opioid use disorders (OUDs) are common among Nevada adult populations. These issues are also occurring during pregnancy at an alarming rate with far reaching effects on both mother and infant. To date, the single best strategy we have to identify and help those that want assistance is adding screening and referral to treatment, known as Screening, Brief Intervention and Referral to Treatment (SBIRT), into the clinical setting. Medical professionals are often the first line to aid in this effort. Note that this document uses the term “medical professional” to be inclusive of doctors and advanced practitioners. The intention for this guide is to provide basic directives for successfully implementing Screening, Brief Intervention and Referral to Treatment (SBIRT), into the clinical setting. SBIRT, specifically how to apply it to pregnant and non-pregnant women of reproductive age populations.

Reference Guide for Labor and Delivery Complicated By Substance Use

sor patient

Download the Reference Guide for Labor and Delivery Complicated by Substance Abuse (Revised April 2021)

Substance misuse, dependency, and substance use disorders (SUDs), including opioid use disorder (OUD), are prevalent among Nevada adult populations, including among individuals of reproductive age. Subsequently, OUD also occurs during pregnancy at an alarming rate with far reaching effects on both the parent and infant. SUD is a primary chronic disease similar to diabetes and hypertension, not a moral failure or character weakness, and should be treated as such by the medical professionals who care for pregnant patients and their infants. Currently, pregnant patients with SUD who present to Labor & Delivery (L&D) units, may receive significant variation in services. These differences include identification and treatment of SUD, identification and treatment for the infant(s), reproductive planning, and care coordination. Practice variance without the use of common generally accepted expert guidelines may potentially lead to parental and/or neonatal complications before, during, and/or after delivery. This reference guide aims to address some of these variances and provide a resource with best practices, guidelines, and protocols for medical professionals involved in the care of pregnant patients with OUD who are admitted to L&D units for delivery and their infants up until discharge.

Introduction to SBIRT  Both Reference Guides provide basic directives for successfully implementing Screening, Brief Intervention and Referral to Treatment (SBIRT) into the clinical setting, specifically how to apply it to pregnant and non-pregnant women of reproductive age populations.

  • What are we doing?
    Performing Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use in every pregnant woman and non-pregnant woman of reproductive age.
  • Why are we doing SBIRT?
    Drug-related deaths contribute to pregnancy associated deaths, with substance use being a preventable causal or correlating factor in maternal mortality. SBIRT for substance use needs to be done as part of your duty as a medical professional. It is the standard of care.
  • Where are we supposed to do this?
    In all settings where a pregnant woman or non-pregnant woman of reproductive age seeks services.
  • Who can do this?
    A wide variety of health care staff can perform SBIRT, including physicians, nurses, nurse practitioners, physician assistants, licensed midwives, and licensed clinical social workers.
  • When are we supposed to do this?
    All Physicians, Advanced Practitioners and Nurses: When a pregnant woman or non-pregnant woman of reproductive age is being seen for the first time (first contact). – or – When you first recognize a pregnancy. Additionally, on an annual basis, if you are providing continuous care for a pregnant woman or nonpregnant woman of reproductive age.
  • How do I do this?
    The Adopt SBIRT team at CASAT/UNR serves Nevada with expertise and key resources to assist organizations to promote, prepare, adopt, and implement SBIRT. Please complete the Online Training Readiness Form (see link above) to get started today

2021 Media Toolkit: #PerinatalHealthSBIRT

To help with patient substance misuse and dependency screening and referral, two Perinatal Health Reference Guides have been developed and are available for Medical professionals to aid in this effort. To raise awareness of these resources and the use of Screening, Brief Intervention and Referral to Treatment (SBIRT), we have launched the 2021 Media Toolkit: #PerinatalHealthSBIRT

Read more and Download Media Toolkit Here

Screening, Brief Intervention and Referral to Treatment (SBIRT) Training & Technical Assistance

This brief virtual presentation will provide a guide through several Screening, Brief Intervention and Referral to Treatment (SBIRT) training and technical assistance options  that are available to medical professionals licensed  to practice in the state of Nevada (including physicians, nurses, nurse practitioners, physician assistants, licensed midwives and licensed clinical social workers) to learn about strategies to implement SBIRT within your women’s health or OBGYN setting.

Online Training Readiness Form – Download PDF

SBIRT Application

  • Max. file size: 16 MB.
For more information regarding SBIRT training and technical assistance, contact: wwoods@casat.org


Reference Guide for Labor and Delivery Complicated by Substance Use Contributors:
Developed by Farzad Kamyar MD under contract with Social Entrepreneurs, Inc., with assistance from Core Team members:
Brent Bartholomew MD, FACOG Women’s Health Associates of Southern Nevada
Brian Iriye MD, Managing Partner High Risk Pregnancy Center, MOTHER Program Co-Director
Deepa Nagar MD, NICU Medical Director, Co-Director, EMPOWERED Dignity Health
Andria Peterson PharmD, NICU/Pediatric Clinical Pharmacist, Co-Director EMPOWERED Dignity Health
Stephanie Woodard PsyD, Senior Advisor on Behavioral Health Nevada Division of Public and Behavioral Health

Reference Guide for Reproductive Health Complicated by Substance Use Contributors:
Brent Bartholomew MD, FACOG Women’s Health Associates of Southern Nevada
Brian Iriye MD, Managing Partner High Risk Pregnancy Center, MOTHER Program Co-Director
Farzad Kamyar MD, Director of Collaborative Care High Risk Pregnancy Center, MOTHER Program Co-Director
Deepa Nagar MD, NICU Medical Director, Co-Director, EMPOWERED Dignity Health
Andria Peterson PharmD, NICU/Pediatric Clinical Pharmacist, Co-Director EMPOWERED Dignity Health
Stephanie Woodard PsyD, Senior Advisor on Behavioral Health Nevada Division of Public and Behavioral Health

Acknowledgment:
Members of the Nevada Opioid Use Disorder, Maternal Outcome, Neonatal Abstinence Syndrome Initiative (OMNI) supported by the Association of State and Territorial Health Officials (ASTHO) Core Team and Provider Education and Practice Standards Workgroup.

Standard Meeting Times for Workgroups:
• Core Team: Monthly on the 4th Friday of the month, 1:30-3:00 PM
• CARA Plan of Care Workgroup: Monthly on the 2nd Wednesday of the month, 12:00-1:00 PM
• Reproductive Health Network: Quarterly Meetings (November, February, May, August), typically on the 4th Friday of the month, 9:30-10:30 AM

For more information regarding workgroups or questions about this project, please email: nevadaperinatalhealth@gmail.com

Contact Us

Please send us an email and we'll get back to you ASAP.

Not readable? Change text. captcha txt