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‘Don’t Quit the Quit’ program helps area moms in recovery

By Sue Sitter - | Oct 10, 2020

Pregnant and new moms working to stay healthy as they recover from opioid use disorder now have help from a local program through Heart of America Medical Center and the University of North Dakota.

The program, called “Don’t Quit the Quit” includes emotional support, medication and health advice for obstetric and post-partum patients in rural communities such as Rugby.

“The program is developed to empower women who are in recovery from opioid use disorder,” said Maridee Shogren, a nurse midwife and clinical professor of nursing at UND.

“Basically, the idea behind it is if they’ve entered into recovery, we don’t want them to quit the good work they’re doing to make healthy life choices and stay in recovery,” Shogren added.

Rugby’s Heart of America Medical Center and Dunseith Clinic are part of a network of clinics that Shogren is building to participate in the program.

“We were trying to think about what was specifically needed in our rural areas,” Shogren noted. “We are specifically working with an eight-county region in North Dakota. We included Bottineau, Rolette, Towner, Cavalier, McHenry, Pierce, Benson and Ramsey Counties.”

“Right now, Heart of America (Medical Center) is participating, Presentation Medical Center is participating and we hope we have other clinics that are getting ready to be oriented in October. So, every time we get a participating provider ready to go, we put them on our website,” Shogren said.

“Our goal is to try to increase the number of providers by eight in our eight-county region, so that moms don’t have to travel so far. Because we know winters are terrible and it’s hard to get places. It’s hard when you have a family and a job and then you travel two hours to get care.”

Shogren added, “The grant program is funded through the Foundation for Opioid Response Efforts (FORE).”

“One of the first things we’re trying to do with our grant is increase access to providers who will prescribe medications for opioid use disorder, especially for women who are either pregnant, post-partum and if they happen to be breastfeeding,” Shogren said. “So, our grant is looking to try to increase services and increase care for women who are in that perinatal period which includes the pregnancy and up to one year post-partum. That was the first arm of the grant.”

“The second arm is education and community awareness. In order to do that, we have done trainings with all the WIC agencies that are in the eight-county region. We’ve done trainings this summer for them, then we are continuing to stay connected with them. We’re hoping to bring in a nutritionist,” Shogren said. “We’re going to just talk about all things healthy – recovery and nutrition. Then we invite them to participate in our webinars, so we can continue to grow community support and education.”

Shogren added, “We also offer free monthly webinars to any moms who wish to participate in this program – providers, community members, families, WIC agencies, counselors – anybody who’s interested. These are standing webinars that are available the first Thursday evening of each month. We’re getting ready to start our first one. They’re held at 7 p.m. and they’re held on Zoom.”

“Then the third part of our program is focused on community support. We’re trying to develop a network of post-partum doulas who live in and can serve this eight-county region,” Shogren said.

“Post-partum doulas are trained professionals who develop expertise in that post-partum area to help families as they transition to parenthood,” Shogren explained.

Shogren said the program trains the doulas to offer support to patients as they parent their infants.

Health care providers in the program have the ability to prescribe medications to help withdrawl symptoms in patients dealing with opioid use disorder.

Nicole Lemieux, a physician’s assistant in HAMC’s Rugby and Dunseith Clinics, provides care to OB and post-partum patients in recovery from opioid dependency.

“Buprenorphine is the medication that can be used to help treat opioid addiction. Unfortunately, it’s not a medication that just anyone can prescribe. It takes a special training and the provider must apply to be waivered,” Lemieux wrote in an email. “I had done the training and gotten waivered, but had never actually pulled the trigger to start treating patients. This program came along looking for providers in our area to one, become waivered and two, treat this special subset of pregnant and post partum women. I thought to myself, ‘Well you’re already waivered and if you’re going to do this, what patient population is going to be more rewarding to treat and provide that support to? You’re not just helping pregnant and post partum women, you’re helping their children and their families.”

Lemieux added, “Being involved in this program, I also have the support of other providers who have used this medication and have worked with pregnant and post partum women previously.”

“One thing I really hope to see come out of this is to help stop the stigma,” Lemieux added. “Every mother wants what is best for their child, but I’ve seen too many times where a mother is afraid to come into the clinic for basic care because they have a history of drug use. They’re afraid providers won’t give them prenatal care because of that drug use and so instead they don’t come in at all. I want mothers to know they are welcome in the clinic and that I’m here to help them through this time, not judge them.”

Lemieux added, “As a family practioner, I provide care for the entire family. In these particular cases, I provide medication-assisted treatment, known as buprenorphine, to help patients stay sober. But I also provide prenatal care (up to 32 weeks), post partum care, and general women’s health. I’m here to provide treatment and support for whatever their health care needs be, not just treatment for opioids.”

“I see patients at both our Rugby and Dunseith locations,” Lemieux said. “I’m typically in the Dunseith clinic Monday, Tuesday, and Thursday 830-4:30 while in Rugby Wednesday and Friday 9-5.”

“I just want our women in need to know that it’s OK to come in for care,” Lemieux added. “As a healthcare provider, I want you to be healthy. I want you to have a healthy pregnancy. I want you to have healthy kids. I want you to feel comfortable coming in for medical care without concern of labels or fear. I’m here to support patients reach their goals and be the best they can be.”

More information on the Don’t Quit the Quit program, including a link to webinars can be found at cnpd.und.edu/research/dqtq/.

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