Substance Use Navigator Training Toolkit

We’re thrilled to have you as a partner in the Improving Care for the Substance Exposed Dyad (ICSED) Plus initiative, supporting perinatal substance use care in Louisiana! 

This toolkit is more than a collection of resources- It’s a roadmap to help you confidently support pregnant and postpartum individuals navigating substance use challenges. Whether your background is clinical care, case management, peer support, or community advocacy, this guide is designed to meet you where you are and build your expertise step by step. 

In this toolkit, you’ll find: 

  • Foundational Knowledge: Core concepts in substance use and perinatal health, including stigma reduction, harm reduction principles, and trauma-informed care. 

  • Practical Tools: Strategies for screening, engagement, and linkage to treatment that prioritize dignity and patient-centered care. 

  • Systems Navigation: Guidance on coordinating across healthcare, behavioral health, and social services to ensure seamless support for families. 

  • Examples and Tips: help you apply these strategies in labor and delivery, postpartum, and neonatal care settings—focusing on collaboration with obstetric, pediatric, and nursing teams to ensure comprehensive, family-centered support. 

Our goal is to bridge gaps in care and empower you to make a meaningful impact. By using this toolkit, you’ll strengthen your ability to advocate for and deliver compassionate, evidence-based support to individuals and families during one of the most critical times in their lives. 

View the Full Training Presentation Here
SUN Perinatal SUD Training Video

UNDERSTANDING PERINATAL SUD AND THE ROLE OF A SUN

  • This section introduces SUNs to their critical role in birthing hospitals, where they serve as advocates, educators, and bridges between patients and clinical teams. Whether coming from a healthcare background or lived experience, SUNs are empowered to challenge stigma, support patient rights, and promote compassionate, evidence-informed care. Their presence helps humanize recovery, reduce bias, and ensure that every patient receives respectful and equitable treatment during one of life’s most vulnerable moments. 

    Resources and Education:

  • The following resources are meant to equip Substance Use Navigators (SUNs) with a clinical and practical understanding of addiction, tailored to perinatal populations. These resources should be used to supplement the knowledge you already have, provide information on substances you may be less familiar with, and provide a basic clinical background. By broadening your knowledge based, you’ll be even better equipped to support a diverse range of patients on their unique paths to recovery. 

    Resources and Education:

    Screening & SBIRT (Screening, Brief Intervention, Referral to Treatment) 

  • Withdrawal (“detox”) can be clinically challenging, and in some cases, a dangerous process. This is especially true in the setting of pregnancy. For substances like alcohol and benzodiazepines, withdrawal can be severe, potentially leading to life-threatening complications for both the mother and fetus. For other substances, such as opioids, stimulants, cannabis and nicotine, withdrawal is generally very uncomfortable but not life threatening for the mother. Untreated withdrawal can cause complications for the fetus, and all efforts should be made to treat these symptoms immediately. The good news is that medical treatment is available for withdrawal from most substances, helping to manage symptoms and ensure safety during this critical phase. The section will help educate you on the basics of withdrawal management. 

    Resources and Education:

  • For SUNs, understanding MAT/MOUD for addiction is key. While initial withdrawal can be challenging, MAT/MOUD focuses on long-term stability. This section covers the essential knowledge you’ll need to support individuals beginning this ongoing phase of their recovery journey, whether or not you have previous experience with these medications. 

    Resources and Education:

  • Training SUNs on naloxone (often referred to as “Narcan”) administration and overdose prevention is a critical component of ensuring the safety and well-being of individuals at risk of opioid overdose. This section will equip you with the knowledge and skills necessary to effectively recognize the signs of an overdose, administer naloxone, and take appropriate steps to prevent future incidents. Whether you are new to this area or have prior experience, the information provided here will be invaluable in your efforts to save lives and support recovery.  

    Resources and Education:

  • Warm handoffs are a best practice in care coordination where SUNs personally connect a patient to the next provider or service—rather than simply giving a referral. In birthing hospitals, this means helping patients transition from inpatient care to outpatient treatment, peer support, or community resources by actively scheduling appointments, introducing them to providers, and ensuring follow-through. This approach builds trust, reduces drop-off in care, and reinforces the patient’s sense of support during vulnerable moments. SUNs play a key role in making these transitions seamless and compassionate, especially for patients navigating substance use and recovery. 

    Resources and Education:

    Opioid Treatment Program Locators 

  • Hospital culture plays a critical role in shaping patient experiences, especially for perinatal women navigating substance use and recovery. A trauma-informed approach ensures that care environments feel safe, respectful, and free from judgment. This means recognizing the impact of stigma and bias, and actively working to dismantle these barriers. 

    In practice, creating safe spaces involves training staff to use non-stigmatizing language, honoring patient autonomy, and fostering environments where patients feel heard and valued. It also includes designing workflows that prioritize dignity, such as private intake areas, empathetic communication, and consistent reinforcement of trust. By embedding these principles into everyday interactions, hospitals can reduce re-traumatization, improve engagement in care, and strengthen the therapeutic alliance. 

    When patients sense compassion and psychological safety, they are more likely to disclose sensitive information, adhere to treatment plans, and remain connected to care. Trauma-informed practices are not just policies, they are cultural commitments that transform hospitals into healing spaces for all patients, particularly those affected by substance use disorders. 

    Resources and Education:

    Principles of Trauma Informed Care 

    Stigma & Bias 

SPECIAL CONSIDERATIONS IN DYADIC CARE

  • Neonatal withdrawal, often referred to as Neonatal Opioid Withdrawal Syndrome / Neonatal Abstinence Syndrome (NOWS/NAS), can be a challenging and distressing process for newborns and their caregivers. This condition occurs when infants are exposed to certain substances in utero and then experience withdrawal symptoms after birth. Substances such as opioids, stimulants, cannabis, and nicotine can lead to NOWS/NAS, causing symptoms like irritability, feeding difficulties, and sleep disturbances. 

    The Eat, Sleep, Console (ESC) concept is a non-pharmacologic approach to managing neonatal withdrawal symptoms. It focuses on assessing the infant's ability to eat, sleep, and be consoled as primary indicators of their well-being. This method emphasizes the importance of parental involvement and comfort measures to support the infant during withdrawal. By closely monitoring these three key behaviors, healthcare providers can tailor their care to meet the specific needs of each infant, ensuring a more individualized and compassionate approach to treatment. 

    The good news is that with proper management and support, many infants can successfully navigate the withdrawal process. This section will help educate you on the basics of neonatal withdrawal management, including the ESC concept, to ensure the best possible outcomes for affected infants. 

    Resources and Education:

  • Understanding toxicology testing (often referred to as a “drug test” or “drug screen”) and mandatory reporting is crucial for SUNs. While the initial identification of substance use can be complex, the focus here is on ensuring safety and compliance with legal requirements. This section provides the essential knowledge you’ll need to support individuals through the process of toxicology assessments and mandatory reporting, regardless of your previous experience in these areas. 

    It’s important to distinguish toxicology testing from universal screening, as the two are often confused but serve very different purposes: 

    • Toxicology testing is used to detect the presence of specific substances in a person’s body. It is important to understand that toxicology tests may have false positives and false negatives, and don’t provide any context to the results. Results from toxicology tests may trigger mandatory reporting requirements. Mothers should only be tested if there is a clinical indication, or desire of the patient, and with consent. Louisiana law requires newborn toxicology testing whenever there is cause to believe that the infant was exposed in utero to “unlawfully used” controlled substances.  

    • Universal screening, on the other hand, involves asking all patients standardized questions about substance use, regardless of whether there is a known concern. Universal screening is designed to identify patients who may benefit from further assessment or support, and it helps reduce stigma by applying the same process to everyone. 

    Resources and Education:

  • It’s important to understand the nuances of mandatory reporting as it pertains to substance use in pregnancy and while parenting, and be knowledgeable about the definition of child abuse and neglect in the context of active substance use. SUNs in Louisiana are generally considered mandated reporters when their roles intersect with licensed healthcare or mental health professions. If a SUN holds a professional license—such as a Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW)—they are unequivocally mandated reporters. Similarly, SUNs working in mental health or social work settings, including roles as counselors or case managers, typically fall under mandatory reporting requirements. While birthing hospitals themselves may not be classified as mental health or social work environments, SUNs operating within them may still be considered mandated reporters depending on their specific duties and professional background. Given the overlap between SUN responsibilities and social work functions, it is advisable to treat SUNs as mandated reporters in most cases. However, exceptions may exist based on the SUN’s exact role and whether they possess a healthcare license. SUNs should confirm their reporting obligations with their leadership to ensure compliance with Louisiana law. 

    DCFS and the Role of the SUN When the Department of Children and Family Services (DCFS) becomes involved, SUNs play a critical role in balancing compliance with advocacy. SUNs are not DCFS representatives—they are patient navigators whose primary responsibility is to support individuals through treatment and recovery while ensuring safety and legal obligations are met. Establishing clear boundaries is essential: SUNs should communicate their role upfront, emphasizing that their purpose is to help patients access care and resources, not to make custody decisions. 

    Building trust in these situations requires transparency and empathy. SUNs can explain mandatory reporting requirements early in the relationship, so patients understand what information may need to be shared. When DCFS is engaged, SUNs should position themselves as a bridge—facilitating communication between the patient, healthcare team, and DCFS while advocating for family-centered solutions. Maintaining confidentiality within legal limits, using nonjudgmental language, and focusing on harm reduction can help preserve trust even when child welfare agencies are involved. 

    • What is the difference between reporting prenatal neglect and submitting a Physician Notification Form?  The agency’s involvement through the Physician Notification Form (no neglect) does not initiate any type of investigation and applies when a neonate has been exposed to substances used in a prescribed or otherwise lawful manner.  

    Resources and Education:

PATIENT-FACING EDUCATIONAL HANDOUTS