While providing obstetrical care to pregnant women in his practice, William Johnstone, MD, UNC Professor of Obstetrics and Gynecology in Wilmington, NC began to notice that both the number of patients with opioid use disorder and associated deaths from overdose were increasing at an alarming rate. In the summer of 2016, he set out to learn about opioid use disorder and community programs designed to provide treatment and therapy. Throughout the process, he educated himself about opioid use through coursework and evidence-based literature. Pregnancy is a unique opportunity for engagement in recovery because of the enhanced dopamine networks that occur when hormones flood the brain, resulting in “maternal motivation”. Dr. Johnstone completed the American Society of Addiction Medicine’s “Treatment of Opioid Use Disorder” course. He met with community stakeholders to discuss the issue and identify ways that different entities could come together to provide a solution. He met with professionals both locally and throughout the state. It became clear that weaving together existing community programs to establish an intensive, residential treatment program tailored to meet the unique needs of child-bearing women with opioid use disorder would be a viable solution. In October 2017, Dr. Johnstone established Tides, Inc.