| Opiate addiction is a major health concern. When opiate addiction accompanies pregnancy, the women and her fetus can have adverse health outcomes. Advanced practice nurses (APNs) with doctorate of nursing practice (DNP) degrees are part of a larger treatment team that must care for these women and provide adequate treatment that not only keeps the woman healthy, but her fetus as well. This research examined potential barriers to treatment of pregnant opiate-addicted women on a methadone maintenance program in Broome County, New York that might contribute to relapse. The model selected to frame this project is the ecological model of health promotion developed by McLeroy and his colleagues. The levels of this model include intrapersonal, interpersonal, institutional/organizational, community, and public policy and describe the ways that each of these levels influences a person's life and the decisions that they make about their health. A survey about potential barriers to maintaining sobriety was distributed to 27 women at the Southern Tier Drug Abuse Treatment Center (STDATC) who were either pregnant or had been pregnant while on a methadone maintenance program, with 24 surveys returned. Local community agency representatives were also interviewed about their policies and practices regarding pregnant women on a methadone maintenance program. For the STDATC participants, scales identified as areas in need of improvement were mental health issues, stigma, family use, addiction groups, and supportive staffs. The agency interview answers resulted in themes of agencies collaborating well together, communication takes place through phone or face to face, a concern about the lack of support from family members, more services are needed in the community, and stigma. Research findings indicate that there is significant overlap between the STDATC participant results and the interview agency answers in regards to stigma within the community and the need for more area resources. Changes to how agencies interact may help reduce barriers to treatment. Advanced practice nurses (APNs) with the doctorate of nursing practice (DNP) degree can serve as a consultant to community groups to improve coordination of care and help promote sobriety. |
