UNC Horizons helps pregnant women and mothers curb substance abuse

Shana Harper struggled with addiction for years before finding UNC Horizons, a women-specific substance abuse program based out of the University’s Department of Obstetrics and Gynecology.

“Without Horizons, I wouldn’t be where I am today,” Harper said. “I wouldn’t have a job, and I’d probably be dead.”

The N.C. General Assembly founded the program in 1993 as a response to the country’s growing crack cocaine problem and the state’s high infant mortality rate, Director Hendrée Jones said.

Jones said UNC Horizons expanded from a four-employee program that only served a handful of pregnant women to an extensive outpatient program for both pregnant women and women with children.

“Horizons now operates outpatient programs in Chapel Hill and Raleigh, and we have 25 apartments where families can live for almost a year, a psychiatry training site for UNC (and) medication assisted treatment for opiate use disorders,” Jones said in an email.

Jones said women in the program range in age from 18 to 50 years, with an average age of 29. Horizons serves more than 200 women every year, and about half are pregnant at the time of admission.

Every patient is either covered by Medicaid or is uninsured, and more than half have had recent Child Protective Services involvement, Jones said.

Jones said 75 percent of patients at Horizons have been arrested, and patients average five arrests. Eighty percent come from families with drug addiction problems, and 70 percent have had past mental health treatment.

Residential Director Marc Strange said women living in the program’s apartments attend intensive groups Monday through Friday at Horizons’ outpatient program. Horizons offers services to help women rebuild their lives, including addiction education, relapse prevention skills, parenting classes and employment assessment and assistance.

“As they complete different aspects of group treatment, we assist the women to implement the education or employment plans they have developed with staff,” Strange said.

“Greater economic self-sufficiency and self-respect are key components to successful treatment.”

In 2015, 53 percent of Horizons’ graduates were employed when they finished treatment, and 13 percent were in school full time.

Harper said while completing the program, she discovered she wanted to provide support for other women in Horizons. She began working as a residential advisor and is now an employment peer mentor with the UNC Center for Excellence in Community Mental Health.

Harper said she recommends Horizons to mothers struggling with addiction, but it is important for women to realize the process won’t work if they don’t put the work in.

“Horizons taught me that things in life don’t come easy, that you have to work for what you want,” she said.

The program has served more than 5,000 women and their children. Jones said statewide, Horizons sees the most full-term births at normal birth weights than any other program like it.

“We believe that what makes Horizons unique is our focus on the mother and child as a dyad and not just the individual mother or child,” Jones said in an email.

Horizons offers services for children to combat the combination of poverty, early traumatic experiences, lack of stable housing and daily routines, in utero drug exposure and disrupted attachments that Jones said many face.

“It is the biggest reward to see how happy and excited the mothers and children are to be able to live in such a nice and supportive environment,” Jones said in an email.

“Our program is the most comprehensive one that I am aware of in the world.”

Horizons has also trained clinicians to administer similar programs around the world. Jones said they have hosted clinicians from Argentina, Australia, Brazil, Afghanistan and Pakistan in the past two years.

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