Polk-Dalton Substance Abuse in Pregnancy Program (SIP)

Grants and Contracts Details


The Substance Abuse in Pregnancy ("SIP") clinic through the University of Kentucky Department of Obstetrics and Gynecology was established in August, 2014 to address the growing needs of the opioid dependent pregnant population in the South East region of Kentucky. It is well known that the epidemic of Opioid Use Disorder is growing in this geographic area and (prior to the initiation of the SIP clinic) there have been limited options for comprehensive, evidence based substance abuse treatment for pregnant women. The SIP clinic is a pilot program designed to fill this void. Patients are followed through their pregnancies and into the postpartum period. The majority of patients undergo Opioid Maintenance Therapy (OMT) with buprenorphine mono-therapy. In addition, they participate in intensive psycho-social counseling though a combination of face-to-face psychotherapy with a social worker (Toni Webb, LCSW), 12-step programming and an online learning platform (Recovering(me)) that offers an education program on the disease of addiction. Recovering(me) is currently being provided by the company at no cost to our clinic and has been a helpful adjunct to the treatment program. In addition, patients participate in group prenatal care (Centering in Pregnancy) which addresses topics related to both pregnancy, self-care and parenting. Patients have individual meetings with Maternal Fetal Medicine physicians at each clinic visit and consultation with Neonatology at least once through their prenatal care. In addition, co-morbid conditions such as smoking/polysubstance abuse, Hepatitis and poor dentition are addressed. Monthly multidisciplinary meetings among partnering clinicians in Nursing, Maternal Fetal Medicine, Psychiatry, Social Work and Neonatology are held to address patient care and complicated cases. Certainly the SIP clinic is quickly outgrowing our current resources and we are now looking to expand our clinical horizon. Over the course of the next months we will expand to a full day clinic to further address the needs of our opioid dependent pregnant population. As part of our expanding program, we are seeking funds for the following clinical and social issues: 1. We would like to retain the services of a part time case manager/MSW (approximately 25 hours/week). There is significant coordination of services needed with this patient group and currently this role is filled by our clinical social worker. This is obviously not efficient use of her time, particularly as our case load grows. 2. We would like to contract with Recovering(me) to continue the online teaching program as an adjunct to our psychosocial teaching. The licenses for this program cost $300/patient and we anticipate approximately 50 patients over the course of the next year. 3. All babies of mothers on any opioids (including OMT) are observed for symptoms of Neonatal Abstenance Syndrome (NAS) in the hospital for 5 days. Most Mothers are discharged from the hospital on postpartum day 2 or post-operative day 3. It is at that point that many babies begin to exhibit signs of NAS. We would like to introduce a pilot program for SIP program patients to be able to have extended stays in the hospital for these 5 days. It is our hypothesis that this will decrease rates of treatable NAS and NICU admissions. 4. We have found that transportation is a significant barrier to our patient group as many have limited resources and come from great distances. Certainly many patients have trouble reaching our clinic and a number of neonates require NICU admission and extended hospital stays for NAS. It is our understanding that Medicaid pays for hotel accommodation assistance for those patients who live more than 120 miles from the hospital. While some of our patients live this distance from Lexington, many are within this radius yet still distances that require major transportation (often a barrier for this patient group). We would like to supply patients with funds for transportation to/from clinic if this is an issue to individuals (ie cab fare, bus pass, gas card). In addition, for those patients with transportation barriers who live within 120 miles of the hospital and whose infants are in the NICU , we would like to provide hotel accommodation assistance. We believe that keeping mothers and babies close to each other during their treatment benefits both mother's stability and baby's health. The SIP clinic provides a unique and rapidly expanding comprehensive prenatal program for this region's opioid dependent pregnant population.
Effective start/end date8/12/156/30/16


  • KY Cabinet for Health and Family Services: $50,000.00


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