Just Us: Before, Birth, and Beyond

The finale of season 5 of Just Us: Before, Birth, and Beyond features two PSUDs extraordinaries, Kimá Joy Taylor, MD, MPH, FAAP; and Melinda Ramage, FNP. Mel and Kimá discuss perinatal substance use disorders at the systems level, identifying aspects of the current structure of care are misaligned with what patients and families need. They describe key opportunities to effectively support parent-infant dyads, and the importance of shifting away from punitive systems of care. Listen in to hear two experts’ takes on how a brighter future of PSUDs care can be achieved. 

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Key Resources:

• North Carolina's Perinatal Substance Use Disorder Network - NC PSUD Network | Perinatal Substance Use Disorder Network [PSUD Network]
• Kleon, A. (2012). Steal like an artist: 10 things nobody told you about being creative. Workman Publishing.

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Season 5, episode 8 of Just Us: Before, Birth, and Beyond highlights two amazing programs at the University of North Carolina at Chapel Hill: UNC Horizons, a substance use disorder treatment program for women including those who are pregnant and postpartum; and the Opioid Data Lab, a drug checking program that analyzes samples sent in from across the United States.  Elisabeth Johnson, director of UNC Horizons, and Illyana Massey, a licensed therapist and community liaison for the Opioid Data Lab, discuss the ins and outs of their respective programs and strategies that they use to stay ahead of an ever-changing drug supply. 

Key Resources: 

• UNC Opioid Data Lab - UNC Street Drug Analysis Lab and OpioidData.org news
• UNC Horizons Perinatal SUD Clinic - UNC Horizons Program
• North Carolina's Perinatal Substance Use Disorder Network - NC PSUD Network | Perinatal Substance Use Disorder Network [PSUD Network]
• SAMHSA Guidance - clinical guidance for treating pregnant and parenting women with opioid use disorder and their infants
• Perinatal Harm Reduction Toolkit - Toolkit: Pregnancy + Substance Use | Academy of Perinatal Harm Reduction

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Music credit: "Carefree" Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 4.0 License
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The finale of season 5 of Just Us: Before, Birth, and Beyond features two PSUDs extraordinaries, Kimá Joy Taylor, MD, MPH, FAAP; and Melinda Ramage, FNP. Mel and Kimá discuss perinatal substance use disorders at the systems level, identifying aspects of the current structure of care are misaligned with what patients and families need. They describe key opportunities to effectively support parent-infant dyads, and the importance of shifting away from punitive systems of care. Listen in to hear two experts’ takes on how a brighter future of PSUDs care can be achieved. 

Key Resources:

• North Carolina's Perinatal Substance Use Disorder Network - NC PSUD Network | Perinatal Substance Use Disorder Network [PSUD Network]
•  Kleon, A. (2012). Steal like an artist: 10 things nobody told you about being creative. Workman Publishing. 

We would love your feedback on our podcast!  Please take our listener survey to provide your comments.

Music credit: "Carefree" Kevin MacLeod (incompetech.com) 

Licensed under Creative Commons: By Attribution 4.0 License
http://creativecommons.org/licenses/by/4.0 

Please provide feedback here:
https://redcap.mahec.net/redcap/surveys/?s=XTM8T3RPNK 

Season 5, episode 7 of Just Us: Before, Birth, and Beyond emphasizes the necessity of perinatal substance use disorder education in training the next generation of healthcare providers. Mel Ramage, director of the NC PSUD Network, leads this discussion with Erin Lorencz, MD, Maria Onuzko, PharmD, and Sophie Buchheit, MS1, all former learners in a PSUD space. Tune in to hear about each of their respective introductions to PSUD care, as well as a roundtable on what PSUD education should look like in the future of medical training. 

Key Resources:

• The Curbsiders Addiction Medicine Podcast: Addiction Medicine Podcast - The Curbsiders.
• Stash Free Documentaries. Original Body of Pain | Health Documentary | Full Movie | Drug Addiction. YouTube. Published 30 June 2024. https://youtu.be/eoqiWFFNN0E?si=wWknJ4f6mQuennU7.
• Project ECHO: Home - Project ECHO
• NM Bridge – Hospital-Based OUD Treatment: NM Bridge | Need an Addiction Medicine Expert? Call 800.222.1222

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Music credit: "Carefree" Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 4.0 License
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Season 5, episode 6 of Just Us: Before, Birth, and Beyond features two members of the Project CARA team who implement and operationalize the contingency management (CM) program at MAHEC in a perinatal setting. This is an effective, evidence-based treatment for substance use disorder that is based on positive reinforcement throughout recovery. Despite its proven efficacy, implementing CM can come with logistical challenges and barriers. Listen in to learn how Project CARA navigated these in designing their own CM program to provide optimal, patient-centered care. 

Key Resources

• Jones, H. E., et al. (2012). Voucher-based contingency management improves outcomes in substance use treatment. Journal of Substance Abuse Treatment, 43(3), 267–274.
• Festinger, D. S., Dugosh, K. L., Kirby, K. C., & Seymour, B. L. (2014). Contingency management for cocaine treatment: Cash vs. vouchers. Journal of Substance Abuse Treatment, 47(2), 168–174. 
• SAMHSA. (2025). Contingency management for the treatment of substance use disorders: Advisory. U.S. Department of Health and Human Services.
• Rash, C. J. (2023). Implementing an evidence-based prize contingency management protocol for stimulant use disorders. Journal of Substance Abuse Treatment.
• U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. (2024, November 7). Contingency management for the treatment of substance use disorders: Enhancing access, quality, and program integrity for an evidence-based intervention (Report to Congress). U.S. Department of Health and Human Services.
• National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (3rd ed.). National Institutes of Health.
• Major, E., Blake, E., Bass, R., Galvin, A., Crowder, T., & Ramage, M. (2023). Contingency management in a perinatal substance exposure clinic. The American Journal of Accountable Care, 11(2), 16-21. https://doi.org/10.37765/ajac.2023.89380

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Music credit: "Carefree" Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 4.0 License
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Season 5, episode 5 of Just Us: Before, Birth and Beyond features three addiction specialists in Western North Carolina. Erin Bowman, LCAS, LCSW, CCS; Zach White, LCAS, LCSW; and Blake Fagan, MD, discuss the current state of recovery housing in Western NC. They review best practices for recovery institutions, with an emphasis on non-punitive approaches. Erin Bowman highlights common barriers to recovery housing access and areas for improvement within this valuable resource for people in recovery from substance use disorder. Tune in to learn how providers can maximize their patients’ access to residences in their area. 

Key Resources:

• SAMHSA (2023) -  Best Practices for Recovery Housing
• NARR - Home | National Alliance for Recovery Residences
• MAHEC - FindMyCareWNC - Interactive map for Transitions, Access, and Continuity of Care (ITACC) 
• Recovery friendly workplaces - Recovery Friendly NC
• National Alliance for Recovery Residences - Recovery Housing Policy Brief
• National Council for Mental Wellbeing - Demonstrating the Value of Recovery Housing: Technical Expert Panel Findings
• National Council for Behavioral Health & NARR - Building Recovery: State Policy Guide for Supporting Recovery Housing
• Mericle AA, Howell J, Borkman T, Subbaraman MS, Sanders BF, Polcin DL. Social Model Recovery and Recovery Housing. Addict Res Theory. 2023;31(5):370-377. doi:10.1080/16066359.2023.2179996 
• Polcin DL, Korcha RA, Bond J, Galloway G. Sober living houses for alcohol and drug dependence: 18-month outcomes. J Subst Abuse Treat. 2010;38(4):356-365. doi:10.1016/j.jsat.2010.02.003
• Jason LA, Olson BD, Ferrari JR, Lo Sasso AT. Communal housing settings enhance substance abuse recovery. Am J Public Health. 2006;96(10):1727-1729. doi:10.2105/AJPH.2005.070839

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Music credit: "Carefree" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 4.0 License
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Season 5, episode 4 of Just Us: Before, Birth, and Beyond features Dr. Nate Mullins, an Ob/Gyn physician, and Dr. Olivia Caron, PharmD, both providers at project CARA. Drs. Mullins and Caron dive deeply into the nuances of methadone in the era of highly potent synthetic opioids, identifying challenges to induction, modern regulations, and methadone during pregnancy. Tune in for a deep discussion regarding this valuable medication for opioid use disorder.

Resources: 

• SAMHSA Methadone Fact Page: https://www.samhsa.gov/substance-use/treatment/options/methadone 
• SAMHSA and DHHS – Federal Ruling Updates Regarding Opioid Treatment Programs: https://www.federalregister.gov/documents/2024/02/02/2024-01693/medications-for-the-treatment-of-opioid-use-disorder 
• Jones HE, Fischer G, Heil SH, et al. Maternal Opioid Treatment: Human Experimental Research (MOTHER)--approach, issues and lessons learned. Addiction. 2012;107 Suppl 1(0 1):28-35. doi:10.1111/j.1360-0443.2012.04036.x 
• Information on split dosing during pregnancy: https://pubmed.ncbi.nlm.nih.gov/25599433/ 
• Find the location of opioid treatment programs in your state: https://www.thecentralregistry.com/map/

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Music credit: "Carefree" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 4.0 License http://creativecommons.org/licenses/by/4.0/ 

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Season 5, episode 3 of Just Us: Before, Birth, and Beyond features behavioral health therapists Caitlin Hettich and Jen Palin, as well as research associate and social worker Megan Williams. They discuss the importance of providing quality, non-punitive healthcare to women who are incarcerated, especially those who are pregnant or experiencing a substance use disorder.  Learn how they navigate the flaws of the criminal justice system, insurance difficulties, and other complicating factors to support patients on their path to recovery throughout incarceration. 

Resources: 

• CASAWorks program: https://ncpoep.org/guidance-document/treatment-matters/nc-perinatal-and-maternal-substance-abuse-and-the-casaworks-for-families-residential-initiatives/  
• Never Use Alone - US National Overdose Prevention Line: https://neverusealone.com/ 
• Sylvia Rivera Law Project: https://srlp.org/
• Fisher, Janina (2021). Transforming The Living Legacy of Trauma: A Workbook for Survivors and Therapists. PESI Publishing & Media. 
• Sunrise Community for Recovery and Wellness: https://sunriseinasheville.org/
• Incarcerated Women’s Health, part of the UNC Collaborative for Maternal and Infant Health: https://incarceratedwomenshealth.org/
• NC Department of Health and Human Services - Medicaid eligibility clarification letter: https://medicaid.ncdhhs.gov/flyer-medicaid-recertification-englishspanish/open
• North Carolina Prisoner Legal Services: https://www.ncpls.org/
• Operation Gateway - Recovery and Reentry: https://www.operationgateway.org/
• UNC Horizons Justice Involved Specific Services: https://www.med.unc.edu/obgyn/horizons/our-services/justice-involved-specific-services/
• Asheville Community Bail Fund: https://avlcommunitybail.carrd.co/
• NC Community Bail Fund of Durham: https://www.nccbailfund.org/donate

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Music credit: "Carefree" Kevin MacLeod (incompetech.com)
  Licensed under Creative Commons: By Attribution 4.0

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Season 5, episode 2 of the Just Us podcast places an emphasis on the treatment of substance use disorder in adolescents and young adults. Psychiatrist Leeallie Carter and family medicine physician Blake Fagan discuss the interactions between human biology, adverse childhood experiences, and substance use during this developmental period. The nuances of and barriers to adolescent SUD treatment are discussed in detail. Listen in to learn more!

Resources: 

• Substance Use Disorder Treatment Resources for Youth, Young Adults, and Families: https://opa.hhs.gov/adolescent-health/substance-use-adolescence 
• Resources to Address the Opioid Epidemic: https://www.aap.org/en/patient-care/substance-use-and-prevention/resources-to-address-the-opioid-epidemic/ 
• Substance Use Disorder Treatment Resources for Youth, Young Adults, and Families: https://www.samhsa.gov/substance-use/treatment/youth-and-families 

 We would love your feedback on our podcast!  Please take our listener survey to provide your comments.

Music credit: "Carefree" Kevin MacLeod (incompetech.com)
  Licensed under Creative Commons: By Attribution 4.0 License
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We are excited to kick off season 5 of the Just Us: Before, Birth, and Beyond podcast with two peer support extraordinaries, Cassie York and Cassie Burleson. This episode dives deeply into what it means to be a peer support specialist, discussing the unique role they fill in supporting people through recovery. Listen in to learn about how the Cassies’ lived experience has allowed them to be such incredible advocates for their patients, processes for becoming a peer support specialist, and more! 

Resources: 

• North Carolina Certified Peer Support Specialist Program https://www.ncdhhs.gov/cpssapplicationprocess20240425/open 
• North Carolina Certified Peer Support Specialist Program: https://pss.unc.edu/ 
• Scannell C. (2021). Voices of Hope: Substance Use Peer Support in a System of Care. Substance abuse : research and treatment, 15, 11782218211050360. https://doi.org/10.1177/11782218211050360 
• Center for Health Care Strategies (Jan 2026). Peer Recovery Support Services in Substance Use Treatment. Retrieved from https://www.chcs.org/resource/peer-recovery-support-services-in-substance-use-treatment/ 
• Eddie, D., O’Connor, J.B., George, S.S. et al. Peer Recovery Support Services and Recovery Coaching for Substance Use Disorder: A Systematic Review. Curr Addict Rep 12, 40 (2025). https://doi.org/10.1007/s40429-025-00645-8

We would love your feedback on our podcast!  Please take our listener survey to provide your comments. Music credit: "Carefree" Kevin MacLeod (incompetech.com)

  Licensed under Creative Commons: By Attribution 4.0 License
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