This CDC guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. Additional CDC resources for applying this guideline are available.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has a shared decision-making tool for Medication-Assisted Treatment (MAT) and Opioid Use Disorder.

The American Academy of Pediatrics has extensive resources for pediatricians on caring for the parent-infant dyad, including opioid use during pregnancy, planning for birthing parent and infant discharge, and community care coordination.

An American Academy of Pediatrics has a free online course.  Pediatricians working with young children and families affected by opioid use often encounter challenges when initiating successful and sustainable practices in coordinating care for postpartum people with opioid use disorder (OUD), and infants diagnosed with neonatal opioid withdrawal syndrome (NOWS). This course aims to support community pediatricians and their teams in implementing recovery-friendly approaches and environments within the patient- and family-centered medical home framework.

The American Society of Addiction Medicine has an extensive online education platform with over 300 hours of accredited education. Courses are available that address the stigma affecting pregnant people with substance use disorder (SUD). Some courses relevant to substance use during pregnancy include:

• ASAM Fundamentals of Addiction Medicine
  This 8-hour on-demand workshop is designed for providers relatively new to the field of addiction medicine, such as primary care physicians, clinicians, nurse practitioners, physician assistants, and behavioral health specialists, who see patients at risk for or with addiction.
• Treatment of Opioid Use Disorder: OB/GYN Focus
  This 8-hour, online course provides the education that is essential for providers to identify, assess, diagnose, and manage pregnant and postpartum patients with opioid use disorder (OUD).
• Moving Beyond the Barriers of Treating Opioid Use Disorder
  Moving Beyond the Barriers of Treating Opioid Use Disorder provides a deep dive into implementing office-based treatment for opioid use disorder. This case-based, interactive, on-demand course addresses moving beyond common barriers that prevent qualified clinicians from successfully treating patients with OUD.
• Pregnancy and Newborns: Considerations from Science to Systems
  This 30-minute, on-demand session from the ASAM 2023 Review Course discusses substance-related treatment for pregnant or post-partum patients and newborns.
• Supporting Birthing People and Families During COVID; Tools for Buprenorphine and Methadone

This 1-hour, on-demand session from the ASAM 53rd Annual Conference discusses opioid use disorder treatment during pregnancy and in the post-pregnancy period.

• March of Dimes COMPASSION Supportive Group Model for Birthing People with SUD
  This 1-hour, on-demand session from the ASAM 53rd Annual Conference discusses the new Supportive Pregnancy Care Model COMPASSION and opportunities for providers to be a champion for the health of parents with SUD and their babies.
• Assessing Stigma Towards Substance Use in Pregnancy: A Randomized Study Testing the Impact of Stigmatizing Language and Type of Opioid Use on Attitudes Toward Mothers With Opioid Use Disorder
  This one hour on-demand journal article examines about stigma towards substance use in pregnancy.
• Substantial Harm: Thinking Critically about Child Welfare Referrals for Parents with SUD
  This 75-minute on-demand session from the ASAM 54th Annual Conference addresses how the medical system interacts with the child welfare system.
• Sex, Substance Use, & Stigma: Reproductive Justice, Contraception, and Substance Use
  This 1-hour on-demand session from ASAM Virtual 2021 addresses patient’s reproductive health as there are an increasing number of reproductive age patients with SUDs who are having higher rates of unintended pregnancy and lower rates of contraception use.
• Methamphetamine Use Disorder in Pregnancy
  This 1-hour, on-demand session from the ASAM 53rd Annual Conference discusses care and outcomes in pregnant and postpartum individuals using methamphetamines in pregnancy.
• Cannabis Use in Pregnancy: Person-Centered Perspectives
  This 1-hour, on-demand session from the ASAM 53rd Annual Conference provides a person-centered perspective on the current evidence and evidence gaps about cannabis use in pregnancy.
• Ethics and the Law: Principles and Treatment Implications
  This 45-minute, on-demand session from the ASAM 2022 Review Course provides an overview of complex ethical and legal issues when treating substance use disorder and other co-occurring disorders as well as issues surrounding criminal justice, impaired professionals, minors, and pregnant women.

The Alliance for Innovation on Maternal Health (AIM) has developed patient safety bundles for specific clinical conditions to support best practices that make birth safer. Patient safety bundles are collections of evidence-informed best practices, developed by multidisciplinary experts, which address clinically specific conditions in pregnant and postpartum people. Bundles encompass a variety of conditions, including one on the Care for Pregnant and Postpartum People with Substance Use Disorder.

The American Academy of Pediatrics has developed communication tools and infographics centering on provider education, including infographics for pediatrician FAQs on the Plan of Safe Care and partnering with birthing parents to support their recovery.

KQPC has assembled resources on breastfeeding and medication/substance use, caring for the infant at risk for NAS, and caring for birthing parents/family with substance use. There are resources to describe best practices for identifying infants at risk for NAS, evaluating those infants for NAS, best practices for treatment of the dyad, and standardizing safe discharge and follow up.

MHA has created a roadmap to provide hospitals and health systems with evidence-based recommendations and standards for the development of perinatal substance use prevention and quality improvement programs.

In this episode Kenneth Zoucha, MD, FAAP, a recognized leader in addiction medicine for the state of Nebraska, talks about the stigmas around substance use disorder and neonatal opioid withdrawal syndrome. Hosts David Hill, MD, FAAP, and Joanna Parga-Belinkie, MD, FAAP, also talk to Tamela Milan-Alexander, MPPA, about her history with opioid use disorder, which led to a high-risk pregnancy, and her subsequent advocacy for mothers and their babies.

Coverage for newborns and Medicaid-eligible birthing parents of newborns with NAS is described in this informational bulletin. Some pregnant people and newborns may have private insurance coverage that covers all of their care and others may be underinsured and have the benefit of dual coverage. In the event the birthing parent of a newborn with NAS is not Medicaid-eligible, the newborn and, in some cases, the birthing parent of the newborn, may be eligible for certain services under the Early Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. As of 2020, CMS coverage policies ensure some form of MAT across all CMS programs.