Evidence-Based Practice Proposal - Section E: Implementation Plan In 1,000-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following: 1.

1

Does Lack of Prenatal and/or Medical Care with Expectant Mothers Increase or Contribute to Developmental, Physiological, Biological and Mental Impairments from Infancy to Childhood and Possibly Adulthood?

Does Lack of Prenatal and/or Medical Care with Expectant Mothers Increase or Contribute to Developmental, Physiological, Biological and Mental Impairments from Infancy to Childhood and Possibly Adulthood?

Introduction

Research has shown that drug addiction is a complex illness with even more devastating consequences for pregnant women and their unborn child (National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health and Human Services, 2018). There is still much to be learned about long term side effects of prenatal drug exposure. Research studies have stated there are some common and cognitive and behavioral issues across the wide spectrum of different types of drugs (Addiction Campuses Editorial Team, 2019).

Proposal Solution

Drug addiction is considered a brain disease. This addiction can be exacerbated by genetic make-up, age of exposure and environmental influences. Drug addiction can lead to mental and physical illness, harm to self and others and even death (National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health and Human Services, 2018 ).

Treatment for drug addiction is not simple. Most treatment programs are a combination of several components to treat the person not the addiction. The beginning of most treatment programs provide individualize care help stop using drugs while educating to maintain a drug free lifestyle and eventually develop coping skills to function with family, work and society. Drug addiction is a brain disease that can require long-term or relapsed episodes of care. Long-term care can advance to integrating residential and community setting care (National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health and Human Services, 2018).

Treatment Interventions for pregnant woman should include drug screening in the first trimester of pregnancy. If the expectant mother test positive for illicit drug use; mothers should be advised of any possible criminal and/or punitive civil child welfare actions with if treatment is not started immediately. Many pregnant women are afraid of incarceration so they do not seek medical care during pregnancy. On a yearly average it cost approximately four thousand seven hundred dollars to treat drug addiction as opposed spending twenty-four thousand dollars a year keep someone imprisoned (Jessup, 2019). Research studies have shown that combining criminal justice sanctions with substance abuse treatment programs can be effective with decreasing substance abuse. Individuals who are legally bound to drug treatment programs will stay in the treatment program longer and do as well or better than those not under legal pressure (National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health and Human Services, 2018).

Treatment Interventions should be evidence-based with the most effective being behavioral counseling with brief interventions and motivational interviews which could incorporate telephone-based brief interventions. Research studies have shown these interventions are just as effective as in person interventions (Forray, 2016).

According to the National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health and Human Services (2018), there are approximately fourteen thousand evidence-based long term facilities in the United States. These treatment centers begin with detoxification and evaluation for long-term residential treatment. Depending on the length of drug abuse some abusers can be evaluated for short-term residential treatment and possible outpatient treatment, which focuses on individualized counseling transitioning into group therapies. Individualize counseling and group therapies using incorporate pharmacotherapies and behavioral treatment. There are other effective treatment interventions such as cognitive-behavioral therapy, contingency management, community reinforcement, twelve step facilitation therapy and family behavioral therapy.

Organization Culture

Many states and legislative bodies are recognizing that addiction should be treated and not punished. Approximately, in the United States, nineteen states participate in drug and alcohol treatment program funded and created pregnant women. Research states ten to eleven states in the United States give pregnant women priority access to state or public funded dependency treatment program and an additional four states in the United States forbid discrimination against pregnant women seeking addiction treatment (Pregnancy And Drug Abuse, 2020).

Expected Outcomes

Evidence-based research has shown drug interventions and treatment programs during pregnancy and postpartum have been powerfully effective with reducing and stopping drug abuse during pregnancy and continuing with long term treatment after birth of the child. The longer the mothers remain in treatment the higher the abstinence rates, seeking and finding employment, limiting time spent in the justice criminal system. Mothers are being offered specialized programs that include child care and child protection (National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health and Human Services, 2018 ).

Method to Achieve Outcomes

1. Brain Chemistry-Brain Disease

1. Genetic Make up

2. Age of Exposure to Drugs

3. Environmental Influences

4. Engaging Brain Function with Ability to Choose or Not Choose

1. Individualized Treatment Including Co-curing Disorders

2. Easily Accessible Treatment

3. Treat the Whole Individual not just the Disease

4. Provide Treatment Program Appropriate for Individual

1. Long-Term Care

2. Behavioral Therapy

3. Cognitive Therapy

4. Pharmacotherapy

1. Legal ramification for continuation of drug use

2. Appropriate Screenings and Interventions

3. Routine Evaluations and Modifications to Treatment

4. Evidence-Base Treatment Programs for Continuation of Drug Free Lifestyle (National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health and Human Services, 2018)

Outcome Impact

Evidence-based research has proven that with appropriate interventions along with medical care and the de-escalation of possible imprisonment, expectant mothers can become drug free while pregnant and postpartum to decrease the number of babies born addicted to drugs (Addiction Campuses Editorial Team, 2019). Decreases in hospital cost for treating babies born addicted to drugs. Offering more public assistance to pregnant mothers and improve affordable health insurance coverage for low-income women before pregnancy which would expand access to substance use disorder treatment programs and in return reduce NAS related morbidity and mortality. This could also decrease or prevent cognitive impairment and development, behavioral issues, physiological and neurological deficiencies with babies (Winkelman et al., 2018).

References

Addiction Campuses Editorial Team. (2019, October 4). Drug Addiction And Babies: Long

Term Effects [Blog Post]. Retrieved from

https://www.addictioncampuses.com/blog/drug-addiction-and-babies/

Forray, A. (2016). Substance use during pregnancy. F1000Research, 5. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4870985

Jessup, M. (2019, June 4). Pregnant women with substance use disorders need treatment not

Prison. STAT, Retrieved from

https://www.statnews.com/2019/06/04/pregnant-women-substance-use-diso...

National Institute on Drug Abuse, National Institutes of Health & U.S. Department of Health

and Human Services. (2018). Principles of Drug Addiction Treatment: A Research-Based

Guide (Third Edition). Retrieved from https://www.drugabuse.gov

Pregnancy And Drug Abuse. (2020). Retrieved from

https://blackbearrehab.com/substance-abuse/pregnancy/

Winkelman, T.N.A., Villapiano, N., Kozhimanni, K.B., Davis, M.M., & Patrick, S.W. (2018).

Incidence and Costs of Neonatal Abstinence Syndrome Among Infants with Medicaid:

2004-2014. Pediatrics, 141(4), e20173520. doi: https://doi.org/10.1542/peds.2017-3520