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The IMPACT WV project has partnered with the WV Home Visitation Program to provide early identification and intervention for high-risk families who have experienced substance use.

This page is intended to provide access to resources and tools related to serving children diagnosed with NAS, women who were, or are, using substances, and their families who receive services from home visiting programs. The information is intended for service providers from a variety of backgrounds including medical, mental health, substance treatment specialists, home visiting, social workers, education and employment specialists.

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Volunteers help soothe West Virginia’s drug-exposed babies

Questions from Providers

According to the March of Dimes, "Neonatal abstinence syndrome (also called NAS) is a group of conditions caused when a baby withdraws from certain drugs he's exposed to in the womb before birth. NAS is most often caused when a woman takes drugs called opioids during pregnancy. But it also can be caused by antidepressants (used to treat depression), barbiturates or benzodiazepines (sleeping pills). When you take these drugs during pregnancy, they can pass through the placenta and cause serious problems for your baby. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord."

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The main difference between a Peer Recovery Coach and a Recovery Coach is that Peer Recovery Coaches have lived experiences. Peer Recovery Coaches are individuals who have lived addiction and have enough ‘clean and sober time’ in recovery to qualify to take a test through the West Virginia Addiction Professional Board licensing them to become a Peer Recovery Coach. A Recovery Coach has no lived experiences and is not eligible to take testing to become a Peer Recovery Coach, but they provide information on education and research.

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According to SAMSHSA, "Methadone, buprenorphine, and naltrexone are used to treat opioid dependence and addiction to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone… FDA approved naloxone, an injectable drug used to prevent an opioid overdose.” Learn more about the specific differences between the medications here.

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According to the American Psychiatric Association, "Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives." Learn more about addiction

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Many babies exposed to certain substances in the womb (especially opioids) will show some signs of withdrawal after birth since they are no longer exposed to those substances once their umbilical cord is cut and their bodies process those substances out of their system. Withdrawal signs may include:

Tremors (jitteriness or shaking of the extremities) Trouble sleeping (falling asleep and staying asleep)
Overactive reflexes (twitching movements) Breathing problems (fast breathing)
Tight muscle tone (stiffness) Elevated body temperature (fever, sweating, blotchy skin)
Fussiness (excessive crying or having a high-pitched cry) Excessively rooting with trouble sucking
Poor feeding (unable to eat enough, vomiting) Lots of yawning
Slow weight gain (burning too many calories, poor feeding, diarrhea, vomiting) Stuffy nose and/or lots of sneezing

Learn more, by reading the Signs of NAS blog post here.

"You can reduce stigma and help save lives, just by changing your language. Person first language is proven to reduce stigma and improve treatment. Person-first language doesn’t define a person based on any medical disorder she may have. It’s nonjudgmental, it’s neutral, and the diagnosis is purely clinical." - Shatterproof

Terminology Recommendation

Stigmatic Terminology Recommended Terminology
Aberrant Behaviors Using Medication Not as Prescribed or Intended
Abuse Non-Medical Use
Addict Person with Substance-Use Disorder
Addiction Substance Use Disorder
Addictive Substance Compound Which Might Promote Substance-Use
Clean Urine Negative versus Positive, or Unexpected
Clean Addict Person in Recovery
Criminal Law Health Law
Dependent A Person with a Substance-Use Disorder
Detoxification In Therapy for Cessation
Noncompliant Not in Agreement with the Treatment Plan
Opioid Substitution Medication-assisted Treatment
Physical Dependence Withdrawal and/or Tolerance
Problem User Person with Substance-Use Disorder
Resistant Has Not Begun, or Experiencing Ambivalence About
Opioid Substitution Opioid Agonist Therapy
Unmotivated Opted Not To

Finding Quality Treatment for Substance Use Disorder with three steps to access care and five signs of quality treatment from SAMHSA (PDF).

Substance use treatment is provided at different levels of care and is often available in multiple treatment settings. The level of care is determined by severity of problem and use. Inpatient treatment is reserved for those with more serious use or those requiring detox. *Information from an IMPACT WV SBIRT Training by Keigan Aabel-Brown, MSW.

Treatment may include:

  1. Counseling, therapy, and other psychological rehabilitation services
  2. Medications: psychiatric for co-occurring disorders (in conjunction with talk-therapy) or Drug agonist (Buprenorphine) antagonist (naltrexone) therapy
  3. Self-Help or Support Groups (AA, NA, Al-Anon)
  4. Health and Wellness coaching (diet, exercise, meditation)
  5. Combination of the above

Find treatment.

Substance Abuse Prevention and Treatment Block Grant (SABG) [PDF]

  • The Time is Now
    Video discusses the process under Chapter 49 of WV Code. It explains how the court system and professionals involved make reasonable efforts to work with parents and reunite families. It emphasizes that time is of the essence, and parents’ rights may be terminated if in their children’s best interests.
  • Child Protective Services in WV
    Website provides information on: Intake Assessment, Family Functioning Assessment, Protective Capacities Family Assessment, Case Plan and Evaluation, When Cases go to Court, State and Federal Statues, Child Protective Services and other Related Policies, WV Code, Benchmark for Child Abuse and Neglect Proceedings, Partners, and Newsletters
  • WV Bureau for Children and Families Child Welfare Services
    Website provides information on: Who can receive services, Responsibilities of Child Welfare Services, and How to make a report to Child Welfare Services at 1-800-352-6513
  • Advocating for the Best Interest of the Child
    Guide describing the various hearings that will occur from intake and potential outcome situations. Also explains common terms used in a CPS process, as well as what a guardian at litem is. Geared towards foster parents, but is a resource for parents too showing the hearing portion immediately after removal.
  • Screening and Assessment for Family Engagement, Retention, and Recovery (SAFERR)
    Guide on the SAFERR model from the National Center on Substance Use and Child Welfare and the US Department of Health and Human Services to help caseworkers screen parents for substance use and make decisions about children's safety.

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