{"id":15638,"date":"2020-04-09T16:31:42","date_gmt":"2020-04-09T21:31:42","guid":{"rendered":"https:\/\/blogs.und.edu\/und-today\/?p=15638"},"modified":"2020-09-29T15:13:15","modified_gmt":"2020-09-29T20:13:15","slug":"und-program-helps-pregnant-women-new-moms-maintain-recovery","status":"publish","type":"post","link":"https:\/\/blogs.und.edu\/und-today\/2020\/04\/und-program-helps-pregnant-women-new-moms-maintain-recovery\/","title":{"rendered":"&#8216;Don&#8217;t Quit the Quit&#8217;"},"content":{"rendered":"<h4>UND clinical professor of nursing nets part of $10M national grant for rural mothers in recovery from opioid use disorder<\/h4>\n<figure id=\"attachment_16710\" aria-describedby=\"caption-attachment-16710\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-16710 size-full\" src=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/190304-nursing-008-1.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/190304-nursing-008-1.jpg 800w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/190304-nursing-008-1-300x200.jpg 300w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/190304-nursing-008-1-768x512.jpg 768w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/190304-nursing-008-1-600x400.jpg 600w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/190304-nursing-008-1-75x50.jpg 75w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-16710\" class=\"wp-caption-text\">Maridee Shogren (above, right), a certified midwife and associate clinical professor of nursing at UND, is leading an effort, part of a $10.1 million national initiative, to support pregnant and postpartium women in rural North Dakota who are in recovery from opioid use disorder. Photo by Shawna Schill.<\/figcaption><\/figure>\n<p>Maybe she can\u2019t change the world. But UND\u2019s <a href=\"https:\/\/und.edu\/directory\/maridee.shogren\" target=\"_blank\" rel=\"noopener\">Maridee Shogren<\/a> hopes to change one corner of it \u2014 and thanks to a significant national grant, she\u2019s getting her chance.<\/p>\n<p>Shogren\u2019s Don\u2019t Quit the Quit program aims to support pregnant and postpartum women in rural North Dakota who are in recovery from opioid use disorder. Medications to treat opioid use disorder are safe and effective, but stigma and other barriers block many people from getting the medications they need, the National Academies of Sciences, Engineering, and Medicine has declared.<\/p>\n<p>One of those stigmatized populations is pregnant and postpartum women with opioid use disorder. Medications are available to help the soon-to-be and new moms quit opioid use. But many women are not aware of medication options or how to access those treatment medications (which include methadone and buprenorphine). This can be especially difficult for pregnant and postpartum women living in the most rural areas of North Dakota.<\/p>\n<p>\u201cThe \u2018Don\u2019t Quit The Quit\u2019 program supports and encourages mothers to maintain their recovery through these challenges,\u201d said Shogren, clinical associate professor of nursing at UND.<\/p>\n<p>\u201cIn other words, we\u2019re saying, \u2019Don\u2019t quit the hard work you\u2019re doing to maintain your healthy life choices and sobriety.\u2019\u201d<\/p>\n<figure id=\"attachment_15622\" aria-describedby=\"caption-attachment-15622\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15622\" src=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/181017-maridee-shogren-headshot-web2.jpg\" alt=\"\" width=\"800\" height=\"475\" srcset=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/181017-maridee-shogren-headshot-web2.jpg 800w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/181017-maridee-shogren-headshot-web2-300x178.jpg 300w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/181017-maridee-shogren-headshot-web2-768x456.jpg 768w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/181017-maridee-shogren-headshot-web2-600x356.jpg 600w, https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/181017-maridee-shogren-headshot-web2-200x118.jpg 200w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><figcaption id=\"caption-attachment-15622\" class=\"wp-caption-text\">Maridee Shogren<\/figcaption><\/figure>\n<h4>Nineteen out of 443<\/h4>\n<p>In March, the nonprofit <a href=\"https:\/\/forefdn.org\/\" target=\"_blank\" rel=\"noopener\">Foundation for Opioid Response Efforts (FORE)<\/a> announced $10.1 million in grants to 19 organizations on the frontlines of America\u2019s opioid crisis. The 19 were selected from among 443 organizations in 46 states, FORE said.<\/p>\n<p>And of the 19 recipients, only one was in the upper Midwest: Don\u2019t Quit the Quit at UND.<\/p>\n<figure id=\"attachment_15644\" aria-describedby=\"caption-attachment-15644\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15644\" src=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/180911-gayle-roux-2089-web.jpg\" alt=\"\" width=\"150\" height=\"200\" \/><figcaption id=\"caption-attachment-15644\" class=\"wp-caption-text\">Gayle Roux<\/figcaption><\/figure>\n<p>Shogren is a certified nurse midwife who continues to work in clinical practice while she teaches at UND. She&#8217;s working on Don&#8217;t Quit the Quit in tandem with <a href=\"https:\/\/und.edu\/directory\/gayle.roux\" target=\"_blank\" rel=\"noopener\">Gayle Roux<\/a>, professor and senior associate to the interim dean at UND&#8217;s College of Nursing and Professional Disciplines, and <a href=\"https:\/\/und.edu\/directory\/abby.moore.1\" target=\"_blank\" rel=\"noopener\">Abby Roach-Moore<\/a>, program manager at the Mountain Plains Addiction Technology Transfer Center.<\/p>\n<figure id=\"attachment_15643\" aria-describedby=\"caption-attachment-15643\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15643\" src=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/190116-abby-roach-moore-web.jpg\" alt=\"\" width=\"150\" height=\"200\" \/><figcaption id=\"caption-attachment-15643\" class=\"wp-caption-text\">Abby Roach-Moore<\/figcaption><\/figure>\n<p>\u201cOver the years, I\u2019ve seen an increase in substance abuse among women who are planning pregnancy, pregnant or postpartum,\u201d Shogren said.<\/p>\n<p>\u201cThere\u2019s a misconception out there that substance abuse in women is just either not occurring or is not a problem.\u201d<\/p>\n<p>Fortunately, medications have been found that can help those with opioid use disorders quit. The medications don\u2019t provide a high, but help prevent withdrawal symptoms and help people in recovery maintain normalcy and stability.<\/p>\n<p>And as the National Academies of Sciences, Engineering, and Medicine has reported, \u201cpatients who receive these medications are less likely to die from overdose or other causes related to their addiction, have higher treatment retention rates and better long-term outcomes.\u201d<\/p>\n<p>Those findings represent real progress in the treatment of opioid use disorder \u2014 and they apply to pregnant and postpartum women with the disorder, too. \u201cBut we have this awful perception that for some reason, women should not be able to use these medications while they&#8217;re pregnant or breastfeeding,\u201d Shogren said.<\/p>\n<p>\u201cI see the same thing happen if a woman presents with depression during pregnancy and wants to start an antidepressant; we immediately start thinking, \u2018But what&#8217;s it going to do to the baby?\u2019 What we forget is that we have a mother\/baby dyad here, and her quality of life is equally as important.\u201d<\/p>\n<p>With that in mind, health care providers balance medications\u2019 safety and effectiveness to provide both mom and baby a good quality of life. But in rural North Dakota and where opioid use disorder is concerned, that\u2019s complicated by not only stigma but also limited access to providers, Shogren said.<\/p>\n<h4>Four approaches<\/h4>\n<p>Don\u2019t Quit the Quit uses four approaches to overcome those hurdles.<\/p>\n<p>\u2022 The first is boosting the number of rural providers who have expertise in both obstetrics and in medications for opioid use disorder. That\u2019s a tall order, because healthcare providers who want to prescribe those medications must be \u201cwaivered\u201d \u2014 that is, complete additional education and training and apply for a special waiver under the Drug Addiction Treatment Act of 2000.<\/p>\n<p>Only about 100 of North Dakota\u2019s 1,600 practicing patient-care physicians have this waiver, the U.S. government reports. Nurse practitioners, physician assistants, certified nurse-midwives and a few other practitioners also can be waivered, but only about 90 in the state have secured the special waiver.<\/p>\n<p>\u201cDon\u2019t Quit the Quit is collaborating with the <a href=\"https:\/\/www.heartview.org\/\" target=\"_blank\" rel=\"noopener\">Heartview Foundation<\/a> out of Bismarck, and they are helping us with provider training,\u201d Shogren said.<\/p>\n<p>\u201cOur goal is to encourage more providers in rural North Dakota to either seek their waiver so they can prescribe for women who are pregnant or postpartum; or if they are already waivered, to give them additional clinical support and mentoring so they feel comfortable adding pregnant and postpartum women to their patient panels.\u201d<\/p>\n<figure id=\"attachment_15620\" aria-describedby=\"caption-attachment-15620\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15620\" src=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/KurtSnyder1-web.jpg\" alt=\"\" width=\"150\" height=\"200\" \/><figcaption id=\"caption-attachment-15620\" class=\"wp-caption-text\">Kurt Snyder<\/figcaption><\/figure>\n<p>Heartview is a nonprofit drug and alcohol treatment and education program. With the help of Kurt Snyder, executive director, and Dr. Melissa Henke, medical director, Heartview will offer the additional support and mentoring that newly waivered practitioners in rural ND need, Shogren said.<\/p>\n<figure id=\"attachment_15621\" aria-describedby=\"caption-attachment-15621\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15621\" src=\"https:\/\/blogs.und.edu\/und-today\/wp-content\/uploads\/sites\/7\/2020\/04\/MelissaHenke-web.jpg\" alt=\"\" width=\"150\" height=\"200\" \/><figcaption id=\"caption-attachment-15621\" class=\"wp-caption-text\">Melissa Henke<\/figcaption><\/figure>\n<p>\u2022 Don\u2019t Quit the Quit\u2019s second approach is collaborating with the <a href=\"https:\/\/www.health.nd.gov\/prevention\/wic\" target=\"_blank\" rel=\"noopener\">North Dakota Women, Infants, and Children or WIC program<\/a>. WIC is a critical resource for women and children who visit these agencies for health screenings and secure access to healthy foods. WIC staff can stay connected to rural families during the entire perinatal period and are an integral part of the public health model of care, Shogren noted.<\/p>\n<p>\u201cSo, by increasing WIC staffers\u2019 knowledge and having them learn about opioid use disorder during the perinatal period, we&#8217;re really trying to grow and enhance the whole community\u2019s knowledge base, as well as community support.\u201d<\/p>\n<p>\u2022 The project\u2019s third component is to introduce postpartum doulas into rural North Dakota. \u201cDoulas provide unbiased support to families during their transition to parenthood. They provide education about infant care and infant feeding, help new mothers with household tasks and healthy recovery, and ultimately increase the confidence of new mothers,\u201d Shogren said.<\/p>\n<p>\u201cIt&#8217;s very challenging to learn how to be a mother and how to care for another person, especially when you&#8217;re still trying to care for yourself. Our hope is that we would grow community experts, so we have local people who really understand postpartum, and whom women are comfortable asking questions of.\u201d<\/p>\n<p>\u2022 Last but not least, Don\u2019t Quit the Quit will offer a year of free monthly webinars to women who enroll in the program. \u201cWe are going to try to build their knowledge base and increase their awareness of opioid use disorder and optimal health,\u201d Shogren said.<\/p>\n<p>\u201cOur goal is to really empower these moms to maintain their recovery. They can invite their families, their friends, support people, anybody to listen in. And we&#8217;re going to use these webinars to help them gain that confidence while they are in treatment for opioid use disorder.<\/p>\n<p>\u201cI really think that adequate education is another key component that&#8217;s been missing from treatment.\u201d<\/p>\n<h4>Don\u2019t Quit the Quit<\/h4>\n<p>Integral to all of this is the understanding that addiction is a chronic disease. \u201cWhich means we need to start looking at addiction just as we look at diabetes,\u201d Shogren said.<\/p>\n<p>\u201cPeople who are have significant and severe diabetes take daily medication. It\u2019s no different if somebody has the chronic disease of addiction and is on a medication to help them achieve that normality and have a good quality of life.<\/p>\n<p>\u201cSo if a woman becomes pregnant, she should be able to stay on her medications for opioid use disorder through that pregnancy and through postpartum, in that same way as we would be prescribing insulin for her if she had diabetes.\u201d<\/p>\n<p>That&#8217;s how Don&#8217;t Quit the Quit came about, Shogren continued.<\/p>\n<p>\u201cThe woman has quit her substance use; she&#8217;s entered into recovery. And now we want her to not quit the amazing effort that she has already started. That\u2019s our goal.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>UND clinical professor of nursing nets part of $10M national grant for rural mothers in recovery from opioid use disorder<\/p>\n","protected":false},"author":16,"featured_media":16710,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[83],"tags":[23],"class_list":["post-15638","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-strategic-plan","tag-nursing"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>&#039;Don&#039;t Quit the Quit&#039; - UND Today<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.und.edu\/und-today\/2020\/04\/und-program-helps-pregnant-women-new-moms-maintain-recovery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"&#039;Don&#039;t Quit the Quit&#039; 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