Substance Use Disorder in Pregnancy: Navigating Confidentiality Law to Deliver Evidence- Based Collaborative Care

This presentation will be featured at Indonesia 2025, on the 18.09.2025.

Authors:

Gina Hofert, MA, The Suda Institute,

Mark Botts, JD, Associate Professor of Law at UNC School of Government,

Sonja Bohannon Thacker, LCSW, MSW Behavioral Health Director, Public Health Authority of Cabarrus County. 

Abstract:

Need

The Substance Abuse & Mental Health Services Administration and leading obstetrical and addiction medicine groups recommend prenatal care, medications to treat OUD, behavioral health therapy, and a cross-sector collaborative approach to address social determinant of health as best-practice treatment for pregnant individuals with OUD.

Fear, stigma, and systemic barriers to care cause pregnant people with OUD to experience health disparities that impact both mother and child. In addition, collaboration is often halted by agencies’ concerns about patient confidentiality.

Project Research

In response, the Substance Use Network (SUN) developed the legal infrastructure needed for a cross-sector, collaborative system of care to connect medical providers to nontraditional partners fostering social connectedness for patients. Studies demonstrate SUN participants have 94% treatment adherence, 100% full-term delivery rates, and improved child-welfare outcomes compared to non-intervention counties.

Implications

The complexity involved with information sharing across sectors requires the development of legal mechanisms that specifically addresses the protection of patients within a collaborative setting. Authors will present 1) an overview of best-practices for the treatment of OUD during the perinatal period, 2) implementation framework for collaborative system of care, including lifting the voices of people with lived/living experience, 3) confidentiality laws governing medical, substance use disorder, and child welfare information, and 4) legal tools to operationalize multidisciplinary team information sharing.

Participants will have an opportunity to discuss which elements of the collaborative approach could be used to address collaborative perinatal substance use disorder treatment in their communities.

Resources

Participants will have access to best-practice clinical guidelines for management of OUD in pregnancy; Multidisciplinary Team Information Sharing Guidance; & Cross-sector Collaborative and Legal Online Training Course.