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States Tackle Substance Use Disorder in Pregnant Women

States are developing and implementing strategies to promote early identification and treatment of substance use disorder (SUD) in pregnant women, according to an issue brief from the National Academy for State Health Policy.

Rates of SUD and overdoses among pregnant women have increased in recent years, along with poor birth outcomes, including neonatal abstinence syndrome (NAS) and neonatal opioid withdrawal syndrome (NOWS).

In the face of this epidemic, states are leveraging financial incentives, quality measures, waivers, and public-private partnerships to improve outcomes and control costs associated with SUD.

Some states, including Tennessee, leverage data and Medicaid managed care organizations to perform outreach to women of childbearing age who might be at risk for developing SUD or having a child with NAS or NOWS. In Tennessee, officials also worked to increase the number of medication-assisted treatment (MAT) providers.

Vermont has used its Section 1115 demonstration waiver to facilitate a multifaceted approach to the opioid epidemic that includes prevention efforts and creating a continuum of care for patients.

In Montana, the state Medicaid program works collaboratively with a private health care foundation to form the Perinatal Behavioral Health Initiative (PBHI), which aims to improve access to care and outcomes for pregnant and postpartum women with behavioral health needs.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Rachel Schwartz is a former policy associate at America's Essential Hospitals.

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