Substance Use, Pregnancy, and Stigma
Pregnant women dealing with substance use disorders (SUD) often find themselves feeling alone, fearful, and overwhelmed. The stigma attached to their situation can prevent them from seeking the vital care they need. Families might also worry about mandatory reporting systems involving law enforcement or child welfare, which can lead to custody issues when they try to get help. Providing non-judgmental, compassionate support, along with evidence-based practices, can help ensure the best outcomes for both mothers and their babies.
The Maricopa County Shift initiative promotes a collaborative approach, aiming to build a network of programs that support pregnant and postpartum women and families impacted by SUD. The objective is to offer high-quality, human-centered care—this includes prenatal care during pregnancy as well as treatment for SUD. Maricopa plans to recruit and train a large group of partners who can work together to address stigma associated with SUD during pregnancy.
Essentially, the key aspect of Maricopa Shift is engaging with families early in the pregnancy. This early involvement can help identify any prenatal substance exposure, making it easier for parents and infants to access services quickly. It can enhance cross-system adjustments and ultimately help keep families safe. By planning for safe care ahead of birth, the chances of a newborn returning home with their parents can significantly increase.
I was struck by the challenges surrounding substance use, and honestly, I felt a bit helpless. It’s tough not knowing where to turn for help. I sure don’t want other families to feel the same way. When a family is hurting, we all feel it. Healing one family can often mean healing for us all.
– Shift team members
Step up to support your family
The collaboration of Maricopa Shift will model initiatives like Vermont’s charm program, which began in 2003 aiming to improve collaboration and outcomes for families affected by SUD.
The partners involved in this effort include:
Additionally, the Maricopa Shift team consists of peer mentors who have personal experiences with substance use and recovery during pregnancy. What started with 10 stakeholders has now expanded to 123 organizations.
Shift creates connections and nurtures communities
The Shift initiative focuses on educating everyone who interacts with families affected by SUD, ensuring that mothers are treated with respect and provided with compassionate care. Integrated case management is a central focus.
Establishing a shift-like care system needs bold optimism from various leaders, along with support from their organizations. As Shift’s leadership states, “This is achievable today. Our community is waiting. Our families are calling out. Our babies deserve healthy parents to raise them.”
The future of Arizona’s shift
Four of Arizona’s 15 counties have initiated shift collaborations aimed at a unified goal throughout the state. Each county’s shift brings diverse strengths and expertise. Collaborative success within these areas is shared with the statewide Shift Leadership team, encouraging innovative practices and fostering a wide range of integrated systems. Given that Maricopa County is the state’s most populous, five regional Shift Partnership Teams are being developed to serve its various regions.
Impact
Since 2019, Maricopa County has trained 3,800 professionals on the shift approach, tackling the complex myths and facts surrounding SUD during pregnancy. This includes best practices aimed at improving outcomes and altering negative attitudes and behaviors.
When fully implemented, the Maricopa Shift approach is projected to deliver significant cost savings for care systems, including Medicaid. For instance, the average cost for treating newborns exposed to opioids or other substances exceeds $30,000, with an average hospital stay of 20 days. In contrast, the Shift Collaborative model reduces the average stay to just six days at a cost of $3,000 per newborn. This model also lessens trauma for families and alleviates compassion fatigue and burnout among social workers.
