To: Board of Supervisors
From: DHHS: Public Health
Agenda Section: Departmental
SUBJECT:
title
Resolution Regarding Cannabis Use During Pregnancy and Breastfeeding
end
RECOMMENDATION(S):
Recommendation
That the Board of Supervisors:
1. Adopt the attached resolution regarding cannabis use during pregnancy and breastfeeding;
2. Receive a presentation from Department of Health and Human Services (DHHS) - Public Health, First 5 Humboldt and other members of the Perinatal Substance Use Disorder Project related to the resolution; and
3. Direct the Clerk of the Board to return a certified copy of the attached resolution to DHHS - Public Health for further processing.
Body
SOURCE OF FUNDING:
N/A
DISCUSSION:
Humboldt County is known in large part for its long history in the cultivation of cannabis industry. Since the legalization of cannabis for adult use there has been an increased need for messaging about cannabis use, specifically for pregnant and breastfeeding women and providers that serve this population. Consuming cannabis can affect the health of a growing baby and is not recommended for women who are pregnant or breastfeeding, or who plan to become pregnant soon. Due to varying arguments for using cannabis during pregnancy and breastfeeding, there is significant need in Humboldt County to provide factual, research based information to the population to make informed choices on how cannabis affects the development and overall health of children when exposed to it.
According to the Office of Statewide Health Planning and Development (OSHPD), the rate of perinatal substance use disorder (SUD) in Humboldt County is 3.7 times the state average. Through strong partnerships across community organizations, it is possible to improve health outcomes for pregnant women with SUD and their infants in Humboldt County. In the spring of 2016, the Humboldt County Department of Health and Human Services (DHHS), the Humboldt Independent Practice Association (IPA), St Joseph Health - Humboldt County, the California Center for Rural Policy (CCRP) and many other stakeholders partnered on a Perinatal Substance Use Disorder (SUD) Project to explore and identify current practices in the screening and treatment of pregnant women with substance use disorder, including the identification of existing community resources, as well as identification of service gaps. The project team conducted a series of key informant interviews with 16 community stakeholders and providers and two focus groups with local groups and coalitions working with pregnant or new mothers that need alcohol and other drug (AOD) services. Phase II of the Perinatal SUD Project began in May 2017 to tackle three key areas that were identified as community priorities, one of which is developing community norms and clinical guidelines around cannabis use during pregnancy.
As a result, a subcommittee was formed with two main goals: to review the literature and research on cannabis use during pregnancy and breastfeeding to develop a resolution to be adopted by the Humboldt County Board of Supervisors in order for providers of this population to have consistent policies and messaging to pregnant and breastfeeding women, and to produce informational brochures for women, providers and families in the industry. It is comprised of members from First 5 Humboldt, the Child Welfare Services, United Indian Health Services, Humboldt State University Child Development Department, Moonstone Midwives Birth Center, With Open Arms Reproductive Health Care Services, K’ima:w Medical Center, St Joseph Health - Humboldt County, Open Door Community Health Centers, DHHS - Public Health, local pediatricians, obstetricians, gynecologists and lactation consultants.
The members have gathered and reviewed the literature and best practice findings from various sources and created the recommended resolution before your Board today that states there is no research evidence that shows cannabis use is safe during pregnancy and breastfeeding, therefore, women in Humboldt County who are contemplating pregnancy, are pregnant, who are breastfeeding or who plan to breastfeed should avoid using cannabis in any form (smoking, eating, vaporizing or as lotion/salve). Also, included with this agenda item are two educational brochures created by the subcommittee members: one for women regarding considerations for using cannabis when pregnant or breastfeeding and the other about the legalization of cannabis for adult use and tips for parents. The group is also currently developing written, informational material with clinical guidelines for medical providers. The Perinatal SUD Project subcommittee intends to promote the implementation of this resolution by the providers that serve pregnant and breastfeeding women by doing targeted outreach, in-services regarding the research, and providing copies of the brochures to be used in these agencies. The group also intends to message this position to women in Humboldt County who are pregnant, breastfeeding or contemplating pregnancy.
Recommendations from the California Department of Public Health (CDPH) are to know the population and their drivers for cannabis use when pregnant or breastfeeding in order to best target a marketing campaign. CDPH conducted research on this topic in order to do their own statewide messaging, however, the counties that were included do not adequately represent the Humboldt County community. Therefore, the need to conduct a survey and focus groups with Humboldt County’s pregnant and breastfeeding population on their beliefs of cannabis use has been discussed in the subcommittee in order to ensure the educational campaign is targeted appropriately. As a result, DHHS- Public Health and partners intend to work with CCRP to hold focus groups in the various regions of the county as well as conduct surveys to better understand this population’s drivers of cannabis use. The subcommittee members will then be well positioned to continue implementing a prevention campaign on cannabis use during pregnancy and breastfeeding.
FINANCIAL IMPACT:
Adoption of this resolution has no impact on Public Health funds. There is also no impact to the General Fund.
STRATEGIC FRAMEWORK:
This action supports your Board’s Strategic Framework by creating opportunities for improved safety and health and protecting vulnerable populations.
OTHER AGENCY INVOLVEMENT:
First 5 Humboldt, St. Joseph Health - Humboldt County, North Coast Health Improvement and Information Network (NCHIIN), DHHS Child Welfare Services, United Indian Health Services, Humboldt State University Child Development Department, Moonstone Midwives Birth Center, K’ima:w Medical Center, Open Door Community Health Centers, local pediatricians, obstetricians, family practice physicians and lactation consultants.
ALTERNATIVES TO STAFF RECOMMENDATIONS:
The Board may choose not to adopt the attached resolution regarding cannabis use during pregnancy and breastfeeding. However, this is not recommended as cannabis use during pregnancy and breastfeeding could pose a health risk to unborn children within Humboldt County.
ATTACHMENTS:
1. Resolution
2. Rack Card: Cannabis is Legal in California. Here are some things you need to know
3. Palm Card: Cannabis Use While Pregnant and Breastfeeding
PREVIOUS ACTION/REFERRAL:
Board Order No.: N/A
Meeting of: N/A
File No.: N/A