Something for the Pain Season 2
Season 2: Perinatal Substance Use Disorder
Listen to recorded lectures from ECHO Idaho’s Perinatal Substance Use Disorder series to enhance your understanding of treating pregnant and post-partum patients with co-occurring mental health and substance use disorders.
Whether you work in health care and want claim continuing education credit, or live in Idaho and want to educate yourself about this patient population, Something for the Pain has a little something for everybody.
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Something for the Pain is considered an enduring material jointly by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE) and the American Nurses Credentialing Center (ANCC).
ECHO Idaho uses eeds software to manage our continuing education (CE). To claim CE for listening to an episode of Something for the Pain, please navigate to the eeds website.
Questions? Email us at wwami-ce@uidaho.edu, or call 208-364-4072.
Episode 21 – Alyson Smith – Recovery and Parenting
Featuring: Alyson Smith, M.D., addiction medicine specialist, Director of Mental Health, Delta Airlines
Featuring: Alyson Smith, M.D., FASAM, addiction medicine physician and family medicine physician, Director of Mental Health at Delta Airlines
Didactic Presentation Details
- Didactic Presenter: Alyson Smith, M.D., addiction medicine physician and family medicine physician, Director of Mental Health at Delta Airlines
- Didactic Presentation Title: “Postpartum Consideration: SUD Treatments, Recovery and Parenting”
- Didactic Presentation Date: July 28, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- AMA
- CDC
- ACLU
- Drugpolicy.org
- Womenshealth.gov
- Planagainstpain.com
- Steven Allan Sumner, Melissa C. Mercado-Crespo, M. Bridget Spelke, Leonard Paulozzi, David E. Sugerman, Susan D. Hillis & Christina Stanley (2016) Use of Naloxone by Emergency Medical Services during Opioid Drug Overdose Resuscitation Efforts, Prehospital Emergency Care, 20:2, 220- 225, DOI: 10.3109/10903127.2015.1076096
- Haight SC, Ko JY, Tong VT, Bohm MK, Callaghan WM. Opioid Use Disorder Documented at Delivery Hospitalization — US, 1999–2014. MMWR Morb Mortal Wkly Rep 2018;67:845–849. DOI
- https://www.healthaffairs.org/do/10.1377/hblog20180426.63403/full/
- https://news.vumc.org/2019/07/15/parental-substance-use-linked-to-increase-in-infants-in-foster-care/
- Forray A, Merry B, Lin H, Ruger JP, Yonkers KA. Perinatal substance use: a prospective evaluation of abstinence and relapse. Drug Alcohol Depend. 2015;150:147-155. doi: 10.1016/j.drugalcdep.2015.02.027
- Rossen L, Mattick RP, Wilson J, et al. Mother-Infant Bonding and Emotional Availability at 12-Months of Age: The Role of Early Postnatal Bonding, Maternal Substance Use and Mental Health. Matern Child Health J. 2019;23(12):1686-1698. doi:10.1007/s10995-019-02809-1
- Holmes AP, Schmidlin HN, Kurzum EN. Breastfeeding Considerations for Mothers of Infants with Neonatal Abstinence Syndrome. Pharmacotherapy. 2017;37(7):861-869. doi:10.1002/phar.1944
- Mahoney K, Reich W, Urbanek S. Substance Abuse Disorder: Prenatal, Intrapartum and Postpartum Care. MCN Am J Matern Child Nurs. 2019;44(5):284-288. doi:10.1097/NMC.0000000000000551
- https://www.thelily.com/opioid-overdoses-among-women-have-increased-dramatically-but-treatment-centers-are-still-designed-for-men/
- “Your Words Matter – Language Showing Compassion and Care for Women, Infants, Families, and Communities Impacted by Substance Use Disorder” – Article from National Institute on Drug Abuse
- Idaho Breastfeeding Coalition
- Project Nurture
- “Trauma, ACEs and Substance Use Disorder” – ECHO Session from June 26, 2020 by Thomas Patterson, M.D
- The Deepest Well: Healing the Long-Term Effects of Childhood Adversity by Nadine Burke Harris, M.D.
- “The Rise of Methamphetamine: New Risks, Current Treatments” – ECHO session from Jan. 28, 2021 by Jacob Harris, M.D.
- Postpartum Support International
- Nurse Family Partnership
- Friends of Children and Families
- Office Based Addiction Treatment Training and Technical Assistance
Speaking Credits
- Narrator/Host: Sam Steffen, Digital Media/Communications Specialist, ECHO Idaho, Boise
- Speaker: Alyson Smith, MD, addiction medicine specialist, family medicine physician, director of mental health, Delta Airlines
- Speaker: Stacy Seyb, MD, maternal fetal medicine, St. Luke’s Health System, Boise
- Speaker: Rachel Root, PhD, PMH-C, Psychologist, Treasure Valley Psychology, Boise
- Speaker: Jerri Woodworth, OB Nurse, St. Luke’s Health System, Boise
- Speaker: Lachelle Smith, former ECHO Idaho Director
- Speaker: Bari Laskow, ECHO participant
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
Episode 20 – Nicole Fox – Marijuana Use in the Perinatal Period
Featuring: Nicole Fox, M.D., M.P.A., Psychiatrist, St. Luke’s Health System, Boise
Featuring: Nicole Fox, M.D., M.P.A., Psychiatry, St. Luke’s Health System
Didactic Presentation Details
- Didactic Presenter: Nicole Fox, M.D., M.P.A., Psychiatry, St. Luke’s Health System
- Didactic Presentation Title: “Marijuana Use in the Perinatal Period”
- Didactic Presentation Date: July 14, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- Fox, Hayey. “Weed and Pregnancy: How Cannabis Laws Are Hurting Mothers.” Rolling Stone Magazine. Nov. 17, 2018
- Oster, Emily. “New Evidence on Pot During Pregnancy.” The Atlantic. July 8, 2019
- CDC: “Marijuana Use and Pregnancy"
- “Surgeon General’s Advisory: Marijuana Use and the Developing Brain”
- “Marijuana”
- “The Effects of Marijuana on Fetal Development”
- Prozac
- Zoloft
- Sertraline
- Fluoxetine
- Friedrich, J., Khatib, D., Pars, K. et al. “The Grass Isn’t Always Greener: the Effects of Cannabis on Embryological Development.” BMC Pharmacoll Toxicol 17, 45 (2016)
Speaking Credits
- Narrator/Host: Sam Steffen, Digital Media/Communications Specialist, ECHO Idaho, Boise
- Speaker: Nicole Fox, MD, MPA, Psychiatrist, St. Luke’s Health System, Boise
- Speaker: Stacy Seyb, MD, maternal fetal medicine, St. Luke’s Health System, Boise
- Speaker: Jerri Woodworth, OB Nurse, St. Luke’s Health System, Boise
- Speaker: LaResa Janousek, NNP, Neonatal Nurse Practitioner, NICU, St. Luke’s Health System, Boise
- Speaker: Lachelle Smith, former ECHO Idaho Director
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
Episode 19 – Rachel Root – Perinatal Anxiety Disorders
Featuring: Rachel Root, Ph.D., PMH-C, psychologist at Treasure Valley Psychology in Boise
Featuring: Rachel Root, Ph.D., PMH-C, Psychologist, Treasure Valley Psychology, Boise
Didactic Presentation Details
- Didactic Presenter: Rachel Root, Ph.D., PMH-C, Psychologist, Treasure Valley Psychology, Boise
- Didactic Presentation Title: “Perinatal Anxiety Disorders”
- Didactic Presentation Date: June 9, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- PMADS, shorthand for Perinatal Mood and Anxiety Disorders
- OCD, shorthand for Obsessive Compulsive Disorder
- PTSD, shorthand for Post-Traumatic Stress Disorder
- Edinburgh Postnatal Depression Scale (EPDS)
Speaking Credits
- Narrator/Host: Sam Steffen, Digital Media/Communications Specialist, ECHO Idaho, Boise
- Speaker: Rachel Root, PhD, PMH-C, Psychologist, Treasure Valley Psychology, Boise
- Speaker: Jerri Woodworth, OB Nurse, St. Luke’s Health System, Boise
- Speaker: Nicole Fox, MD, MPA, Psychiatrist, St. Luke’s Health System, Boise
- Speaker: Alyson Smith, MD, addiction medicine specialist, family medicine physician, director of mental health, Delta Airlines
- Speaker: Haley Brown, ECHO participant
- Speaker: Lachelle Smith, former ECHO Idaho Director
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
Episode 18 – Nicole Fox – Perinatal Mood Disorders
Featuring: Nicole Fox, M.D., M.P.A., Psychiatrist, St. Luke’s Health System, Boise
Featuring: Nicole Fox, M.D., M.P.A., Psychiatrist, St. Luke’s Health System, Boise
Didactic Presentation Details
- Didactic Presenter: Nicole Fox, M.D., M.P.A., Psychiatrist, St. Luke’s Health System, Boise
- Didactic Presentation Title: “Perinatal Mood Disorders”
- Didactic Presentation Date: May 26, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- FDA A-B-C-D-X category system
- Edinburgh Postnatal Depression Scale
- Zoloft
- Sertraline
- Fluoxetine
- Citalopram
- Celexa
- ECT, stands for “electroconvulsive therapy”
- Paroxetine
- Paxil
- Venlafaxine
- Buproprion
- Carbamazepine
- Depakote
- Lamotrigine
- Lamictal
- Haldol
- Quetiapine
- Seroquel
- Olanzepine
- Zyprexa
- Risperidone
- Risperdal
- American Psychiatric Association: Diagnostic Statistical Manual, 5th Edition. American Psychiatric Association, Arlington, VA. 2013.
- Cohen LS, Altshuler LL, Harlow BL, Nonacs R, Newport DJ, Viguera AC, Suri R, Burt VK, Hendrick V, Reminick AM, Loughead A, Vitonis AF, Stowe ZN. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA 295(5):499-507, 2006.
- Jones I, Chandra P, Dezzan P and Howard L. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet 2014; 384; 1789-99.
- Miller ED, Hoxha D, Wisner KL, Gossett DR. The impact of perinatal depression on the evolution of anxiety and obsessive compulsive symptoms. Arch Womens Ment Health 2015.
- MGH Center for Women’s Health Online Reproductive Psychiatry Resource and Information Center.
- Nonacs R, Cohen LS. Depression during pregnancy: diagnosis and treatment options. J Clin Psychiatry. 2002;63. Suppl 7:24-30.
- Reefhuis J, Devine O, Friedman J et al. Specific SSRIs and birth defects; Bayesian analysis to interpret new data in the context of previous reports. BMJ 2015; 350-h3190.
- Robakis T and Williams K. Atypical Antipsychotics during pregnancy. Current Psychiatry 2013; 12 (7): 12-18
Speaking Credits
- Narrator/Host: Sam Steffen, Digital Media/Communications Specialist, ECHO Idaho, Boise
- Speaker: Nicole Fox, MD, MPA, Psychiatrist, St. Luke’s Health System, Boise
- Speaker: Alyson Smith, MD, addiction medicine specialist, family medicine physician, director of mental health, Delta Airlines
- Speaker: Jerry Wilmes, ECHO participant
- Speaker: Lachelle Smith, former ECHO Idaho Director
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
Episode 17 – LaResa Janousek – Neonatal Opioid Withdrawal Syndrome
Featuring: LaResa Janousek, Neonatal Nurse Practitioner at the NICU, St. Luke’s Health System, Boise
Featuring: LaResa Janousek, Neonatal Nurse Practitioner at the NICU, St. Luke’s Health System, Boise
Didactic Presentation Details
- Didactic Presenter: LaResa Janousek, Neonatal Nurse Practitioner at the NICU, St. Luke’s Health System, Boise
- Didactic Presentation Title: “Neonatal Abstinence Syndrome: Identification and Treatment”
- Didactic Presentation Date: April 28, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- NOWS: Neonatal Opioid Withdrawal Syndrome (formerly NAS, neonatal abstinence syndrome)
- Loretta Finnegan
- American Academy of Pediatrics (AAP)
- Meconium refers to the early stool passed by a newborn soon after birth, before the baby starts to feed and digest milk or formula.
- The Center for Child Health Policy
- National Institute on Drug Abuse
- HCUP Fast Stats. Healthcare Cost and Utilization Project (HCUP). Agency for Healthcare Research and Quality, Rockville, MD
- Eat, Sleep, Console (Matthew Grossman)
- St. Luke’s Neonatology Algorithms
- FNAS
Speaking Credits
- Narrator/Host: Sam Steffen, Digital Media/Communications Specialist, ECHO Idaho, Boise
- Speaker: LaResa Janousek, NNP, Neonatal Nurse Practitioner, NICU, St. Luke’s Health System, Boise
- Speaker: Stacy Seyb, MD, maternal fetal medicine, St. Luke’s Health System, Boise
- Speaker: Alyson Smith, MD, addiction medicine specialist, family medicine physician, director of mental health, Delta Airlines
- Speaker: Jerri Woodworth, OB Nurse, St. Luke’s Health System, Boise
- Speaker: Lachelle Smith, former ECHO Idaho Director
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
Episode 16 – Alyson Smith – MOUD in Pregnancy
Featuring: Alyson Smith, M.D., family medicine physician and addiction medicine specialist, Director of Mental Health, Delta Airlines
Featuring: Alyson Smith, M.D., Family Medicine Physician, Addiction Medicine Specialist, Director of Mental Health, Delta Airlines
Didactic Presentation Details
- Didactic Presenter: Alyson Smith, M.D., Family Medicine Physician, Addiction Medicine Specialist, Director of Mental Health, Delta Airlines
- Didactic Presentation Title: “MAT in Pregnancy”
- Didactic Presentation Date: April 14, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- MAT stands for “Medications for Addiction Treatment”
- MOUD stands for “Medications for Opioid Use Disorder”
- MAUD stands for “Medications for Alcohol Use Disorder”
- Methadone
- Buprenorphine
- Naltrexone
- Vivtrol
- Finnegan Neonatal Abstinence Scoring Tool (FNAST)
- Drug Addiction Treatment Act of 2000 (DATA 2000)
- Promise Study (2005)
- MOTHER Trial
- Subutex
- Society for Maternal Fetal Medicine
- American College of Obstetricians and Gynecologists (ACOG)
- American Society of Addiction Medicine (ASAM)
- NOWS: abbreviation for Neonatal Opioid Withdrawal Syndrome (or NAS, Neonatal Abstinence Syndrome)
- Hendrée Jones, PhD - content from MOTHER study used with Dr. Jones’ permission
- PCSS buprenorphine waiver program
- SAMHSA
- Resource for patients
Speaking Credits
- Narrator/Host: Sam Steffen, Digital Media/Communications Specialist, ECHO Idaho, Boise
- Speaker: Alyson Smith, MD, addiction medicine specialist, family medicine physician, director of mental health, Delta Airlines
- Speaker: LaResa Janousek, NNP, Neonatal Nurse Practitioner, NICU, St. Luke’s Health System, Boise
- Speaker: Lachelle Smith, former ECHO Idaho Director
- Speaker: Neil Ragan, ECHO participant
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
Episode 15 – Stacy Seyb – Medications and Substances in Pregnancy
Featuring: Stacy Seyb, M.D., maternal-fetal medicine physician at St. Luke's Health System in Boise
Featuring: Stacy Seyb, M.D., Maternal Fetal Medicine, St. Luke’s Health System
Didactic Presentation Details
- Didactic Presenter: Stacy Seyb, M.D., Maternal Fetal Medicine, St. Luke’s Health System
- Didactic Presentation Title: “Medications and Substances in Pregnancy: Exposure and Risk”
- Didactic Presentation Date: March 24, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- James G. Wilson
- Six Rules of Teratology
- Teratogen: meaning, “structural defects”
- Phenylephrine
- FDA Pregnancy Categories
- 2014 FDA change
- 3 categories of FDA change
- Abruption: the separation of the placenta from the wall of the uterus.
- Apgar Score
- Paroxetine
- Seroquel
- Trazadone
- Ritalin
- Lamotrigine
- Topiramate
- Keppra
- Mother-to-Baby
Speaking Credits
- Narrator/Host: Sam Steffen, Digital Media/Communications Specialist, ECHO Idaho, Boise
- Speaker: Stacy Seyb, MD, maternal fetal medicine, St. Luke’s Health System, Boise
- Speaker: Nicole Fox, MD, MPA, Psychiatrist, St. Luke’s Health System, Boise
- Speaker: LaResa Janousek, NNP, Neonatal Nurse Practitioner, NICU, St. Luke’s Health System, Boise
- Speaker: Rachel Root, PhD, PMH-C, Psychologist, Treasure Valley Psychology, Boise
- Speaker: Radha Sadacharan, MD, MPH, primary care physician, MOUD provider at Centurion, Idaho Department of Corrections
- Speaker: Alyson Smith, MD, addiction medicine specialist, family medicine physician, director of mental health, Delta Airlines
- Speaker: Jerri Woodworth, OB Nurse, St. Luke’s Health System, Boise
- Speaker: Lachelle Smith, former ECHO Idaho Director
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
Episode 14 – Katie Gray & Jerri Woodworth Introduce Perinatal Substance Use Disorder
Featuring: Jerri Woodworth, RNC-OB, at St. Luke's Maternal Fetal Medicine Clinic in Boise and Dr. Katie Gray, family medicine physician at Desert Sage Health Centers in Mountain Home, Idaho
Featuring: Katie Gray, M.D., Family Medicine physician at Desert Sage Health Centers in Mountain Home and Jerri Woodworth, OB-Nurse and director of the SUPPORT Clinic at St. Luke’s Health System in Boise
Didactic Presentation Details
- Didactic Presenter: Jerri Woodworth, OB-Nurse at St. Luke’s Health System in Boise
- Didactic Presentation Title: “Substance Use and Mental Health in Pregnancy: Overview and Screening”
- Didactic Presentation Date: March 10, 2021
- ECHO Idaho Series: Perinatal Substance Use Disorder series
- Didactic Presentation Video
Resources and Publications Mentioned
- Desert Sage Health Centers
- A,B,C,D,X FDA Medication Scoring Rubric
- American Society of Addiction Medicine (ASAM)
- National Institutes of Drug Abuse (NIDA)
- Diagnostic Statistical Manual of Mental Disorders (DSM-5)
- Edinburgh Post-natal Depression Screen (EPDS)
- American College of OB/GYNs (ACOG)
- The “5 Ps”
- Screening, Brief, Intervention, and Referral to Treatment (SBIRT)
- Postpartum Support International (PSI)
- Idaho Quitline: 1-800-QUIT-NOW (784-8669)
- Mass General Center for Women’s Health
Speaking Credits
- Narrator/Host: Sam Steffen, Project Coordinator, ECHO Idaho
- Speaker: Katie Gray, MD, Family Medicine, Desert Sage Health Centers, Mountain Home, ID
- Speaker: Jerri Woodworth, OB Nurse, St. Luke’s Health System, Boise
- Speaker: Nicole Fox, MD, MPA, Psychiatrist, St. Luke’s Health System, Boise
- Speaker: LaResa Janousek, NNP, Neonatal Nurse Practitioner, NICU, St. Luke’s Health System, Boise
- Speaker: Rachel Root, PhD, PMH-C, Psychologist, Treasure Valley Psychology, Boise
- Speaker: Radha Sadacharan, MD, MPH, primary care physician, MOUD provider at Centurion, Idaho Department of Corrections
- Speaker: Stacy Seyb, MD, maternal fetal medicine, St. Luke’s Health System, Boise
- Speaker: Alyson Smith, MD, addiction medicine specialist, family medicine physician, director of mental health, Delta Airlines
Music Contributions
- “ECHO Idaho Theme Song” written and performed by Sam Steffen
- Guitar instrumentals also provided by Sam Steffen
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Season 2 of Something for the Pain is supported by Grant No. 15 PBJA-21-GG-04557-COAP awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice's Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.