Local Initiatives Address Opioid Use Disorder (Pew Charitable Trust): Western North Carolina Initiative Integrates Obstetric and Gynecological Care With Substance Use Treatment

Article highlights Project CARA (Care that Advocates Respect, Resilience, and Recovery for All) which has supported over 800 pregnant and parenting people with substance use disorders (SUDs) since its launch in 2014. The Mountain Area Health Education Center (MAHEC) supports Project CARA, locating this program within a maternal-fetal medicine care network, to provide a hub-and-spoke approach by partnering with other prenatal care agencies to build similar, smaller-scaled models in other counties. In addition to the services offered at MAHEC (the “hub”), Project CARA partners with two clinics (the “spokes”) to provide substance use treatment integrated with obstetric clinical services. Project CARA provides three tiers of care. Under Tier 1, patients get a single SUD treatment consultation, but the rest of care is provided elsewhere. Tier 2 offers “shared care” so patients can receive their specialized SUD treatment from Project CARA and their obstetric care elsewhere. Tier 3 is meant for those who need Project CARA to provide all aspects of obstetric and SUD care. Additional strategies for successful wrap-around care are highlighted in this article. Strengths and patient outcomes are discussed.