![Page 1: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/1.jpg)
Tough Love is for Your Mama
STIGMA IN TREATING SUD DURING PREGNANCY
![Page 2: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/2.jpg)
Brooke Schaefer MSN, FNP-C, RN
Director Perinatal Substance Use
Disorder Program
Nurse Practitioner for the CHOICE
Program (East, Anderson, Kokomo)
Wife, mother, hippy, terrible
CrossFitter, gardener, succulent
obsessed
![Page 3: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/3.jpg)
Disclosures:
None
![Page 4: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/4.jpg)
Bias Inevitable
Can be for or against a group or person
Occurs in all aspects of life
Controllable
Can be subconscious
![Page 5: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/5.jpg)
•Hidden
•SneakyImplicit
Bias
•Loud
•Active intentExplicit
Bias
![Page 6: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/6.jpg)
“Compared to white patients, black
patients were 40% less likely to receive
medication to ease acute pain and
Hispanic patients were 25% less likely”
Implicit bias – an example
https://www.physiciansweekly.com/nonwhite-patients-get-less/
![Page 7: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/7.jpg)
Being AWARE of our
biases help us fight
them
![Page 8: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/8.jpg)
Trauma and it’s link to SUD -
https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-
it-does-and-doesnt-mean
![Page 9: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/9.jpg)
https://www.cdc.gov/violenceprevention/acestudy/resources.html?CDC_AA_refVal=https%3A%2F
%2Fwww.cdc.gov%2Fviolenceprevention%2Fchildabuseandneglect%2Facestudy%2Fresources.htm
l
![Page 10: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/10.jpg)
https://www.cdc.gov/violenceprevention/acestudy/resources.html?CDC_AA_re
fVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Fchildabuseandne
glect%2Facestudy%2Fresources.html
![Page 11: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/11.jpg)
Let’s dive in to SUD
![Page 12: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/12.jpg)
Addiction vs. Dependency
Addiction:
-Use of substance
regardless of harm and
consequences
Dependency:
-Physical need
-Tolerance and
withdrawal potential
![Page 13: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/13.jpg)
Why should you care?
Because:
You have to, even if you don’t like it
Tell the fart story
It is the right thing to do
You like people or you wouldn’t be here
![Page 14: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/14.jpg)
Why would people not get
treatment?
![Page 15: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/15.jpg)
Two main rules:
BE NICE
and…
![Page 16: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/16.jpg)
IF YOU SAY IT OUT LOUD AND IT
SOUNDS STUPID,
IT IS STUPID,
DON’T DO THAT
![Page 17: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/17.jpg)
Relapse/Set Back? Not a failure!
○ AND usually because they stopped therapy or treatment
https://pubmed.ncbi.nlm.nih.gov/11015800/
![Page 18: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/18.jpg)
If you can’t get people to care for
the right reasons…
![Page 19: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/19.jpg)
Results from our program:
$764K in savings over two years
39.9% reduction in neonatal length of stay
Babies whose mothers took buprenorphine had a
25% lower incidence of neonatal abstinence
syndrome (NAS) than babies whose mothers took
methadone and spent 15.5 fewer days in the
hospital.
![Page 20: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/20.jpg)
Questions?
![Page 21: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/21.jpg)
Books worth reading
Dreamland
Hillbilly Elegy: A Memoir of a Family and Culture in Crisis
Chasing the Scream: The First and Last Days of the War on Drugs
Evicted: Poverty and Profit in the American City
American Pain: How a Young Felon and His Ring of Doctors Unleashed America's
Deadliest Drug Epidemic
![Page 22: Tough Love is for Your Mama stigma.pdf · 2020. 11. 17. · Tough Love is for Your Mama Author: Schaefer, Brooke Created Date: 11/17/2020 8:09:20 AM](https://reader033.vdocument.in/reader033/viewer/2022061005/60b31f8379069b4e8f3af1ad/html5/thumbnails/22.jpg)
References
https://www.healthcatalyst.com/success_stories/neonatal-abstinence-syndrome-
chnw
Luty J, Nikolau V, Bearn J. Is opioid detoxification unsafe in pregnancy? J Subst Abuse Treat. 2003;24:363–
7. https://www.sciencedirect.com/science/article/pii/S0740547203000357?via%3Dihub
Bell J, Towers CV, Hennessy MD, Heitzman C, Smith B, Chattin K. Detoxification from opioid drugs during
pregnancy. American J of Obstet & Gynecol. 2016;: p. Proof Pending.
https://www.sciencedirect.com/science/article/abs/pii/S0376871618300231
https://www.cdc.gov/violenceprevention/childabuseandneglect/aces/fastfact.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917415/