The University of Alabama at Birmingham has established the Comprehensive Addiction in Pregnancy Program (CAPP) within the Division of Maternal Fetal Medicine. In the state of Alabama, the Chemical Endangerment Law makes it is a felony offense to use drugs during pregnancy. CAPP provides vulnerable mothers who voluntarily enter the program with prenatal and postnatal care, navigating government systems and resources, social work support, opioid replacement therapy, and ultimately, recovery. As of April 2019, CAPP has enrolled 48 women into the program. Since July 2018, 22 women have successfully completed a treatment program.
“The women we treat face tremendous barriers to care during pregnancy, including social stigma, legal consequences, transportation, poor communications between providers and limited facilities for addiction treatment programs,” said Dr. Lorie Harper, maternal-fetal medicine specialist and director of CAPP. “In this first year, we have exceeded our own expectations and have created a sustainable model of care for vulnerable patients who not only need our direction and resources, but truly are buying into our program of sobriety and success.”
CAPP is one-of-a-kind in the state of Alabama and provides women with a full complement of obstetric addiction therapy. Many of the women who participate in the program would not normally seek recovery-based services during pregnancy out of fear of criminal consequences. However, the safe environment provided by CAPP has allowed these mothers to complete their detox regimen.
“CAPP provided such a safe space where I could grow and learn. I wasn’t just learning how to be a mother, but I was also learning how to be the best version of myself,” said one of the program’s participants. “Knowing the CAPP team was investing in all aspects of my sobriety and journey made all the difference. Dr. Harper even stayed by my side during all 30 hours of my labor — that’s just one testament to what this program provides.”
Going forward, CAPP’s directors have many goals for expanding upon the program’s success including reaching more patients outside of Birmingham, supporting fathers, continuing postpartum care, connecting early intervention services to patients, and identifying further community support. One of the program’s most recent developments in the “CAPP Cash Program,” which will create a store within the clinic where mothers can shop for items such as car seats and other necessities.
“We’re working hard to remove barriers to care, and while we need to continue to focus on what we can do locally, I look forward to being able to take this a few circles out and see if we can have an impact on a bigger footprint and population,” said Suzanne Muir, UAB Substance Abuse Programs associate director. “There’s such a shortage of treatment in Alabama, and as much as we scramble here in Jefferson County, we are still considered resource-rich. To be able to bring the model to other Alabama women in need of care would be amazing.”