ECU Health has launched the IMPACT Clinic to address the needs of pregnant patients with substance use disorders in eastern North Carolina. The clinic, which stands for Integrated Model of Perinatal Addiction Care and Treatment, is designed to provide stigma-free, evidence-based care by combining obstetric and addiction services in a single setting.
Dr. David Ryan, an obstetrician-gynecologist at ECU Health who also completed an addiction medicine fellowship at the University of North Carolina at Chapel Hill, helped establish the clinic after observing a rise in addiction among pregnant patients. He noted that these individuals often face stigma and lack access to specialized care.
“In North Carolina in 2018 and 2019, one out of every four pregnancy-related deaths was an overdose,” said Dr. Ryan. “Seventy-five percent of all the deaths occur in the postpartum period.”
The IMPACT Clinic seeks to eliminate barriers by embedding addiction services within ECU Health’s outpatient obstetrics clinic. According to Dr. Ryan, “Patients who are pregnant encounter stigma when they have substance use disorders. It can be extraordinarily challenging to get treatment anywhere, but particularly in certain addiction clinics. It can be really hard to walk in there when you’re pregnant.”
The integrated model allows patients to receive both obstetric and addiction care during the same visit.
“What we are seeking to do and what we are doing is offering both obstetric and addiction care in the same setting, in the same visit, at the same time,” said Dr. David Ryan.
The clinic also provides support beyond medical treatment through lactation consultants, social workers who assist with housing and transportation needs, and mental health providers for co-occurring conditions such as depression or anxiety.
“With addiction comes mental health, and with mental health needs oftentimes comes addiction,” says Dr. Ryan. “There’s a large amount of overlap, so not only are we able to address the addiction, but if there’s underlying mental health needs, we can address that too.”
A team-based approach ensures coordinated support from specialists including OB-GYNs and high-risk pregnancy experts.
“To the patient, it’s all happening at one place,” Dr. Ryan said. “They feel like everybody has been a part of their team.”
Given that patients with opioid use disorder are significantly more likely to die from overdose after delivery compared to other groups, ongoing support is provided through telehealth and follow-up visits.
“Just because they’re no longer pregnant does not mean that their time with the IMPACT Clinic has to end,” said Dr. Ryan.
ECU Health’s initiative marks it as the first perinatal addiction program of its kind in eastern North Carolina—one of only six statewide—aiming to fill a gap for mothers needing specialized care.
“There’s a huge need in our community,” Dr. Ryan said. “Our ultimate goal is just to improve the health and well-being of the patients of eastern North Carolina.”
He added: “We work with patients who are pregnant with substance use disorders to give them a place where they can be honest, where they don’t feel like they’re judged, where they can seek out whatever care, help, treatment that they think they want… And ultimately, we look forward to just being a part of people’s journey and improving people’s lives.”
