Turning the Tide

Turning the Tide promotes universal screening and stigma-free care for families impacted by substance use.

About Turning the Tide

Turning the Tide is Colorado’s statewide perinatal quality improvement initiative focused on improving outcomes for pregnant and postpartum people and their infants affected by perinatal substance use. Based upon an Alliance for Innovation on Maternal Health (AIM) Patient Safety Bundle, this 2-year, cohort-based initiative provides hospital-based teams with evidence-based tools, clinical best practices, and implementation support to enhance substance use screening, brief intervention, and referral to recovery treatment services. Turning the Tide promotes a compassionate, family-centered approach that reduces stigma by framing perinatal substance use disorder as a chronic and treatable medical condition.

Through active engagement in Turning the Tide, hospitals can meet the quality improvement requirement set by Colorado Senate Bill 24-175.

Enrollment for the 2-year cohort starting in January 2026 is open from October to December 2025. Visit qi.cpcqc.org to complete an interest form.

Why

Substance use during pregnancy is a growing public health concern linked to serious complications, including preterm birth, low birth weight, neonatal withdrawal, and increased risk of maternal illness or death. In Colorado, where 97% of births take place in hospitals, these care settings offer a critical window to identify and support individuals affected by perinatal substance use.

Perinatal substance use is more than a medical issue, it’s a matter of health equity. Too often, people who use substances during pregnancy face stigma, criminalization, and inconsistent care. These barriers worsen health outcomes and erode trust in the healthcare system. Turning the Tide seeks to change that narrative by supporting hospitals in delivering trauma-informed, non-punitive, and family-centered care. The initiative focuses on connecting patients with treatment and recovery supports, building coordinated systems of care, and ensuring that every person receives respectful, compassionate services that protect the health of both parent and baby.

Results

View the results of Turning the Tide here.

Hospitals participating in Turning the Tide are making meaningful improvements in care for birthing people affected by substance use. Key achievements to date include:

Expanded universal screening for substance use during pregnancy using validated, evidence-based tools
Stronger referral pathways and linkage to treatment and recovery supports for patients with substance use disorders
Increased staff training on trauma-informed, non-stigmatizing, person-centered care
Improved coordination between obstetric, pediatric, behavioral health, and social work teams to ensure seamless, wraparound support

As the initiative continues to grow, Turning the Tide is focused on advancing key measures of success:

Advanced Improvements for Perinatal Substance Use

Within the Turning the Tide initiative, hospitals that have met foundational program requirements, including universal screening, immediate intervention and referral to treatment, can take their work further through advanced education and hands-on technical assistance in addiction medicine and dyadic quality improvement.

This additional support enables hospitals to tailor their efforts to local needs and capacity while maintaining access to expert guidance and real-time data feedback from CPCQC’s quality improvement team.

Program Partners

Turning the Tide is made possible through collaboration with:

Colorado Department of Human Services, Office of Behavioral Health
Colorado Department of Public Health & Environment (CDPHE)
Hospitals and health systems statewide
Substance use treatment providers
Parent and family advocacy organizations
Community-based care coordinators and perinatal behavioral health specialists

Together, these partners are building a system of care that treats substance use in pregnancy not with punishment, but with support, compassion, and connection.