Written by Suchi Tailor
On June 11, the North Carolina Department of Health and Human Services launched its Opioid Action Plan 2.0 at the NC Opioid Misuse & Overdose Prevention Summit. The new plan maintains the same goal of reducing expected opioid overdose deaths by 20% by 2021, but also seeks to identify additional strategies focused on preventing substance use. To meet this goal, the new plan integrated input from various partner initiatives across the state, including the Essentials for Childhood framework on child maltreatment prevention, to which the North Carolina Institute of Medicine (NCIOM) has contributed; the Perinatal Health Strategic Plan; and the NCIOM’s Task Force on Mental Health and Substance Abuse.
The following strategies were recommended as part of Opioid Action Plan 2.0:
Related NCIOM Work
Essentials for Childhood
In the revised Opioid Action Plan 2.0, Strategy 2 outlines steps to reduce youth misuse of drugs, prevent trauma and adverse childhood experiences, increase resilience to trauma, and improve prenatal, maternal, and infant care for women with substance use disorders.
As part of its work on Essentials for Childhood, in January 2019, the NCIOM convened two work group meetings in collaboration with NC DHHS to identify strategies related to childhood trauma, adverse childhood experiences, and supporting children and families to prevent substance use, for consideration in the revised Opioid Action Plan. The prevention strategies outlined in Opioid Action Plan 2.0 align with the Essentials for Childhood goals of supporting safe, stable, and nurturing relationships and environments for children and families.
Perinatal Systems of Care & Perinatal Health Strategic Plan
North Carolina’s Perinatal Health Strategic Plan 2016-2020 was developed by the North Carolina Division of Public Health with the vision of addressing infant mortality, maternal health, maternal morbidity, and the health of men and women of childbearing age. Goal 3 of the Perinatal Health Strategic Plan is to “improve the quality of maternal care” with the strategy to “ensure that pregnant women and high-risk infants have access to the appropriate level of care through a well-established regional perinatal system.” Recommendations on how to implement a regional perinatal system are being developed by the NCIOM’s Risk Appropriate Perinatal Systems of Care Task Force.
Recently, Melissa Godwin, a member of the NCIOM’s Perinatal System of Care Task Force, presented on the relationship between maternal health, child health, and substance use disorders. Among pregnant women in treatment for opioid use disorder nationally, 80% of pregnancies were unintended . While overall, unintended pregnancies are associated with poor health outcomes for women and children, for women with substance use disorders, appropriate prenatal care and treatment is instrumental in achieving maternal and child health.
Strategies from the NC Perinatal Health Strategic Plan were incorporated into Opioid Action Plan 2.0 through the emphasis on improving prenatal, maternal, and infant care for women with substance use disorders, addressing social determinants of health, and eliminating stigma.
Task Force on Mental Health and Substance Use
In 2015, with funding from the Kate B. Reynolds Charitable Trust, the NCIOM convened the Task Force on Mental Health and Substance Use, with the goal of developing recommendations to increase and improve community-based and evidence-informed prevention, treatment, and recovery services and supports for individuals with mental health and substance use disorders. The task force focused several recommendations on the unique needs of adolescents and older adults. Many recommendations from this task force align directly with those in Opioid Action Plan 2.0, specifically those that call for expanded availability of substance used services, improved cross-agency data sharing, and increased community partnerships to better meet the needs of people with substance use disorders.