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Contact the SENI Program at or 907-269-3426.

The AKPQC is partnering with the State of Alaska Substance-Exposed Newborns Initiative (SENI) to promote universal verbal prenatal screening utilizing a validated screening tool. The SENI tool relies on the 4P’s Plus©, which is the only screening instrument for tobacco, drugs, and alcohol that is specifically validated for pregnant people.

SENI also provides staff trainings in Screening, Brief Intervention and Referral to Treatment (SBIRT), including CEUs. SBIRT gives staff the tools and confidence to universally screen as well as offer timely intervention to improve patient outcomes.

SENI offers the screening tool, training, and support to additional hospitals, outpatient facilities, birth centers, and midwifery practices. If your facility or practice is interested in screening childbearing people for substances utilizing the validated SENI tool, please email

SENI screening tool .jpg

The 4Ps Plus© is a copyrighted instrument with a licensing fee paid for by the State of Alaska. The SENI Screening Tool many not be used, reproduced, or distributed without the written consent of the SENI Program. Please note that most patients will only require completion of the top half of the tool. The bottom of the tool is completed when a person indicates that they had “any” tobacco, alcohol, or marijuana in the month before they were pregnant.


In 2016, the Alaska Department of Health and Social Services (DHSS) Divisions of Behavioral (DBH) and Public Health (DPH), Office of Substance Misuse and Addiction Prevention (OSMAP), and hospitals in Anchorage, Fairbanks, Juneau, and Palmer launched a project to screen childbearing people being admitted for childbirth for harmful substances, domestic violence, depression, and desire for subsequent pregnancy. The goal of the project was to support clinicians to provide evidence-based care for pregnant women and their infants.  By early 2017, the project evolved into the Alaska Prenatal Screening Program (APSP). 


In February 2017, Alaska’s Governor issued a disaster declaration for Alaska’s opioid epidemic. The magnitude of the epidemic’s impact among Medicaid-covered childbearing people and infants born during 2007-2016, was astounding, with their rate of Neonatal Abstinence Syndrome increasing from 4.4 to 16.9 cases per 1,000 live births.

By July 2019, the APSP had screened 2,298 childbearing people.  Later that year the program re-branded and became the Substance Exposed Newborns Initiative (SENI) as the focus of the program expanded into inclusion of promoting screening in outpatient prenatal care settings.

In January 2020, the AKPQC began supporting SENI with a goal to include recommendations and resources for infant toxicology testing, optimizing non-pharmacologic management, standards for pharmacologic management, as well as Plans of Safe Care and full spectrum community support services for infants and families with substance exposure.

SENI Publications and Reports


Substance Use Treatment in Alaska


Background and Foundational Resources


SENI has a limited supply of Nourishing Connections: A Guide for Healthy Breastfeeding by Ira Chasnoff, MD. This is a helpful guide for health care workers to use to educate and counsel patients who are breastfeeding and using substances. If you would like to order a copy of this guide at no cost for your hospital, birth center, or midwifery practice, please email  


Stay tuned to this webpage for more information and initiative resources.


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