Pathway Healthcare is proud to highlight our Chief Medical Officer, Dr. Stephen Taylor, who recently hosted an episode of ASAM Practice Pearls focused on perinatal substance use care: “Perinatal Substance Use Care: Listening, Trust, and Treatment.” In conversation with Dr. Cara Poland (Vice President of ASAM), the episode explores what compassionate, evidence-based treatment looks like for pregnant and postpartum patients—especially amid today’s evolving drug supply and rising stimulant and fentanyl exposure.
Listening first: why trust changes outcomes
The episode opens with a vivid story of care that disarms shame and builds connection. Dr. Poland emphasizes that the healthcare system has too often trained patients—particularly pregnant patients with substance use disorder (SUD)—to expect judgment. Breaking stigma starts with how we show up: thanking patients for coming, using person-first language, lowering physical barriers in the room, and engaging them as partners in teaching future clinicians. When patients feel safe, honest dialogue (and therefore better care) becomes possible.
Evidence-based treatment during pregnancy
Dr. Poland underscoring the importance of medications for opioid use disorder (MOUD) in pregnancy—especially buprenorphine and methadone—reminds clinicians not to let myths or medicolegal fears block lifesaving care. Because of physiologic changes in pregnancy, many patients need dose adjustments (e.g., split dosing for methadone or higher doses of buprenorphine/methadone). The goal is the lowest effective dose that keeps withdrawal and cravings controlled. National guidelines from leading organizations reinforce that MOUD is associated with better maternal and infant outcomes compared with untreated OUD.
Reducing stigma—language and culture of care
Stigma remains one of the most damaging barriers for pregnant and postpartum patients. The conversation reinforces person-first, non-pejorative language and trauma-informed care. Many patients have significant adverse childhood experiences (ACEs) and enter clinical settings with heightened anxiety; thoughtful, authentic interactions help lower the “threat level” and open the door to treatment. Teams can further normalize care by offering practical, flexible pathways (home inductions when appropriate, warm introductions to new providers, and clear expectations).
Postpartum engagement and “hot-hand” handoffs
The postpartum period carries elevated overdose risk. Dr. Poland describes a structure that treats postpartum support as proactive and continuous—early check-ins (including virtual), a six-week follow-up, and ultra-warm handoffs to ongoing care. If a first referral isn’t the right fit, patients should feel welcome to “bounce back” and try another clinic without losing momentum. Simple planning for sleep, household support, cravings, and childcare can be as protective as medication adjustments.
Practical pearls for clinicians—and hope for families
Three takeaways ring throughout the episode:
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Don’t be an ahole**—lead with humanity, safety, and partnership.
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Don’t be afraid of MOUD in pregnancy—dose to effect and follow the evidence.
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Honor motivation and progress—pregnancy often catalyzes change; meet patients where they are and adapt care over time.
At Pathway Healthcare, we share these commitments. Our teams provide Medication-Assisted Treatment (MAT) alongside counseling and coordinated supports for pregnant and parenting patients. If you or someone you love is ready to take the next step, we’re here to help—without judgment and with dignity.
Listen to the full episode
Hear the conversation on ASAM Practice Pearls: “Perinatal Substance Use Care: Listening, Trust, and Treatment.”
Media Contact:
Brandon Sopher
281-734-1070
bsopher.dallas@pathwayhealthcare.com
