However, in 2015, law enforcement cracked down on drug use during pregnancy. Convictions were upheld only in Alabama and South Carolina, involving a total of four women. Learn more at Alcohol Use in Pregnancy from the Division of Birth Defects and Infant Disorders. Effects of Drugs & Alcohol During Pregnancy - WebMD The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. State Responses to Substance Abuse Among Pregnant Women, Concerns Mount over Punitive Approaches to Substance Abuse Among Pregnant Women. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Under states child abuse law, a parent is considered unfit if they test positive for substances within eight hours after delivery and have previously been convicted of child abuse or neglect or if they failed to complete a drug treatment program recommended by Child Protective Services. Applying CDCs Guideline for Prescribing Opioids: Substance Abuse and Mental Health Services Administration: American College of Obstetricians and Gynecologists (ACOG) Committee Opinion: The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. The court also referred to rulings by appellate courts in other jurisdictions that had held similarly in comparable cases. The use of prescription drugs during pregnancy, excluding supplements, in Ethiopia was high. 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. Medical and public health experts who are desirous of seeing a greater focus on treatment of substance-abusing pregnant women must stay particularly alert to legislative efforts to expand the legal definition of a child to include fetuses or to define prenatal substance use explicitly as a form of child abuse. Cookies used to make website functionality more relevant to you. These 24 cases included 29 women in 19 states who were prosecuted for criminal charges related to harm to a fetus or child as a result of substance use during pregnancy. Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. App. Guide to U.S. Drug Laws | Recovery.org The treating pediatrician opined that the cause of death was respiratory arrest secondary to prematurity, whereas the medical examiner said that the cause of death was acute methamphetamine intoxication.18 Two of the opinions16,30 that directly referenced published medical literature referred to data that supported the conclusion that cocaine use during pregnancy creates a substantial and well-established risk to the unborn child and that this effect is within the scope of public knowledge. Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await . MAT is the standard of care for treating people with opioid use disorder especially pregnant women, as quitting opioids too suddenly during pregnancy can result in complications. The legal consequences of using drugs while pregnantSubstance Use During Pregnancy | CDC App. To learn about CDC activities to educate the public about the harms of tobacco use, visit Tips From Former Smokers (Tips) from the Office on Smoking and Health. 2023 Guttmacher Institute. We developed categories of relevant variables to code a priori. 38]. In order to to avoid the risk of withdrawal and possibly harming her fetus, M. did what many pregnant women in her situation do she continued to use illicit opioids. Second, they claim that drug use during pregnancy is a reliable indicator of parental unfitness. Neonatal abstinence syndrome (NAS) is itself a treatable and transient condition, anda growing body of literatureconfirms that one of the most effective treatments for NAS is keeping the newborn and mother together in a soothing environment while encouraging skin-to-skin contact and breastfeeding. Thus, it is not clear whether racial or economic bias is a factor in these cases. State laws now vary considerably in their approach to the problem, reflecting a deep division in public opinion. 2006), State v. Wade, 232 S.W.3d 663, 665 (Mo. In all of the cases, the judicial decision depended on the disposition of the question of whether, for the purpose of adjudicating the criminal charges, a fetus is a child. One published trial court decision was identified.24 In this case, a New York trial court in 1992 dismissed the charge of child endangerment for cocaine ingestion during pregnancy. donate today. Before losing contact with her lawyer, M. told me her story via email. This was lower than the rate among women in this age group who were not pregnant (11.4 percent). Although briefs from medical or public health organizations supporting the defendants' position were submitted to the court in 29 percent of the cases (n = 7), only one majority ruling directly referenced a medical or public health organization amicus brief. In other words, the key concern in the judicial decisions to date has turned on the courts' interpretation of legislative intent. This evolution over time may reflect contemporaneous moral panic linked to the potential deleterious effects of particular substances on fetal outcomes.1. They also found that cocaine users were more likely to use alcohol or other drugs during pregnancy: 88 percent of pregnant cocaine users smoked, 80 percent consumed alcohol, 72 percent smoked marijuana, 14 percent used opiates and 9 percent used other illicit drugs. Illegal Drug Use and Pregnancy - Children's Hospital of Philadelphia We also identified judicial references to expert or fact witness medical testimony and to medical literature or medical or public health-related amicus briefs. Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. Illegal Drug Use and Pregnancy. While a robust body of literature supports a causal connection between prenatal exposure to alcohol or tobacco (or lead or poverty for that matter) and negative postnatal health outcomes, thescientific literaturehas not conclusively demonstrated any long-term negative effect of prenatal exposure to opioids. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. Visitour state legislation trackerfor policy activity on all sexual and reproductive health topics. More about smoking in pregnancy and drinking alcohol in pregnancy. Such policies are rooted in stigma and gross indifference to what the best available science tells us about how to compassionately and effectively serve pregnant women struggling with drug use disorders and their families. Marijuana is the most widely used illegal drug during pregnancy in the U.S., and marijuana use is on the rise among all adult age groups, both sexes, and pregnant women. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . Screening for Unhealthy Drug Use: Recommendation Statement July 14, 2014 -- Though the first mother has been charged under a new Tennessee law that makes it a crime to use drugs while pregnant, many of the most respected medical groups have opposed . Drugs with evidence of fetal harm were widely used. You will be subject to the destination website's privacy policy when you follow the link. As is true across the nation, rural areas have limited, if any, access to MAT. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. At least in theory, legislatures could amend criminal laws to make clear that they intend them to apply to prenatal conduct that affects fetuses. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Tennessee is the only state that has enacted a law that targets substance use by pregnant women on the basis of presumed harm to the fetus or child. A study Wexelblatt led between 2012 and 2013 found 5.4% of all mothers had a positive drug test on admission and 3.2% of the mothers tested positive for opioids. Women might use opioids as prescribed, misuse prescription opioids, use illicit opioids such as heroin, or use opioids (opioid agonists and/or antagonists) as treatment for opioid use disorder. Illegal drugs in pregnancy. Tennessee To Decide If It Will Keep Criminalizing Pregnant Women For Drug Use by State: Problem Areas. Published on September, 30, 2015 Across the country, hundreds of pregnant women and new mothers have been accused of child abuse or other crimes when they or their newborns tested positive for. MSACD is committed to raising the awareness of thedevastating effects of alcohol and other substances whenused during pregnancy. A mother taking illegal drugs during pregnancy increases her risk for anemia, blood and heart infections, skin infections, hepatitis, and other infectious diseases. In Tennessee, this law carries a maximum penalty of 15 years in prison. Pregnancy - Department of HealthDrug Use During Pregnancy - MSD Manual Consumer Version The balance in the courts in favor of treating substance use during pregnancy as a medical problem depends on the definition of a child for the purposes of criminal statutes. Criminalizing Pregnancy: Policing Pregnant Women Who Use Drugs in the New Jersey, however, does not view drug use during pregnancy as constituting child abuse or neglect on its own, unlike other states. She had become dependent on opioids, but when she learned she was pregnant, she immediately tried to enroll in a medication assisted treatment (MAT) program. Arizonaslegislation, which became law in April, permits termination of a mothers parental rights, either immediately when her newborn is born or within one year of her newborns birth, depending on how chronic the illicit drug use appears to the court. Drug use is an uncommon cause of birth defects, yet approximately 200,000 children (3-5% of live births) are born with birth defects each year. Lets Be Clear GA - MARIJUANA AND PREGNANCY Moreover, there is a great deal of overlap between drug use during pregnancy policies and alcohol/pregnancy policies. Opioids can be prescription or illicit. Federal agencies collaborate with both state and local law enforcement to ensure effective controls over substances that are deemed to be a danger to individuals and to society. Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. Apr 20, 2022, M. Forrest Behne, Craig Waleed, Meghan Peterson, and Lauren Brinkley-Rubinstein Drug Use During Pregnancy Policies in the United States From 1970 to If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Published on September, 30, 2015. In Kilmon v. State, the court said, Through these efforts, the Center for MSACD continues to be a valuable resource to individuals, parents, and professionals in Georgia and the Southeast. Study finds increased cannabis use during pregnancy 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Born addicted: Drug-screening pushed for pregnant women - USA TODAY The research that does claim to link substance use to maltreatment of children is not authoritative. A recent addition to the Center is Mother To Baby Georgia, a service providing evidence-based information to women about exposures to medications and other substances during pregnancy. Trainings on maternal substance abuse, child development, alcohol and other drug related effects are conducted for prevention providers. We reviewed legal decisions regarding women charged with a crime against a fetus or child as a result of substance use during pregnancy. Reyes was charged with two counts of felony child endangerment for her heroin use The following information can help you understand [] The federal Department of Health and Human Services recently released areportreviewing Kentuckys child welfare system. In other instances, where medical expertise was referenced, it did not necessarily support the defendants' position. And the scientific literature that suggests that substance use produces social cognitive deficits in parenting is in its infancy and rather underwhelming. Using illegal drugs during pregnancy is dangerous for an unborn baby and the mother. Quitting tobacco can be hard, but it is possible. Kentuckyslegislation, which also became law last month, permits termination of a mothers parental rights if her newborn exhibits signs of withdrawal, known as neonatal abstinence syndrome, as the result of illicit opioid use, unless the mother is in substantial compliance with both a drug treatment program and a regimen of postnatal care within 90 days of giving birth. Instead of punishing women for the chronic condition of addiction, something that is unethical, ineffective and inhumane, we should invest instead in the expansion of women- and family-friendly treatment resources, said Dr. Mishka Terplan, a professor in obstetrics and gynecology and psychiatry and associate director in addiction medicine at Virginia Commonwealth University. Drug abuse has a long and storied history in the United States, and we've been "at war" with it since 1971 under the Nixon administration. Subscribe to our newsletters for regular updates, analysis and context straight to your email. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. In Alabama and South Carolina, high courts have interpreted existing child endangerment and chemical endangerment statutes to allow prosecution of drug-using pregnant women and new mothers. Many advocates I interviewed in the course of my own research on this subject described the surveillance of pregnancies and non-consensual drug testing performed on pregnant women and their newborns as comparable to stop-and-frisks for young men of color. Such laws may discourage people from seeking prenatal care. Local, state, and federal government websites often end in .gov. Fifteen states have laws requiring health care workers to report to authorities if they suspect a woman is abusing drugs during pregnancy. Marijuana During Pregnancy - SAMHSA - Substance Abuse and Mental Health Opioid use disorder is a problematic pattern of opioid use that can result in health problems, disability, or failure to meet major responsibilities at work, school or home. In jurisdictions where criminal charges are permitted, dispositions for convicted women should be treatment oriented. remove barriers to pregnant women with substance use disorders from getting evidence-based treatment that's tailored to their unique needs. Section 2 of the Georgia Security and Immigration Compliance Act of 2006 (Act 457) requires public employers, their contractors and subcontractors to verify the work eligibility of all newly hired employees through an electronic federal work authorization program. Rapidly detecting fetal exposure to licit and illicit drugs is of considerable medical value. A neonatologist who was an expert witness for the defense testified that the cocaine derivatives present in the children's urine were from exchange between the womb and placenta during pregnancy and that only a tiny amount of cocaine derivative could have passed through the umbilical cord during the 30- to 60-second period after the child was born and before the umbilical cord was cut. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. Facts are largely determined at the trial level. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. Opioid use disorder during pregnancy has been linked with serious negative health outcomes for pregnant women and developing babies, including preterm birth, stillbirth, maternal mortality, and neonatal abstinence syndrome (NAS). If you or someone you know has a drug problem, seek help. Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. Arizona also has the strictest TANF timeline in the nation, kicking families off welfare after one year. The implication for medical experts is that advocacy efforts may be most useful when focused on state legislatures that are contemplating policies to reduce harms associated with prenatal substance abuse. Neonatal exposure to some drugs during pregnancy can have harmful effects on development and may lead to acute adverse events, including neonatal abstinence syndrome (NAS) and infant mortality. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. If you regularly use drugs, it's important to tackle this now you're pregnant. When she visited him, she was distressed to find he often had seemingly untreated rashes. LEXIS 496 (Tenn. Crim. Experts recognize that pregnancy and childbirth present an especially opportune moment to connect a woman with services, including substance use disorder treatmentyet threats of punishment onlyisolatepregnant women. There is also no safe time during pregnancy to drink. These cookies may also be used for advertising purposes by these third parties. In Alabama and South Carolina, the majority of state supreme court judges determined that the plain meaning of the word child includes a fetus, or in their term, an unborn child.16,,18 In the other 17 states that considered the question, the opposite conclusion was reached: that is, a fetus is not a child in the eyes of the law in those jurisdictions. Georgia Marijuana Laws - FindLaw Enter multiple addresses on separate lines or separate them with commas. Comparisons of drug laws to alcohol laws show that the policy trajectories started in opposite directions, but by 2016, the results were the same: Punitive policies were more prevalent than supportive policies across states. Prescription drugs use during pregnancy in Ethiopia: A - PubMed Later in the pregnancy, these illicit drugs may cause. (3) Ct. App. More mothers may soon know M.s pain. Pregnant Women Facing Incarceration For Drug Abuse All of these cases were appellate decisions except for one published trial court decision,24 which we discuss separately, given that trial court decisions are not typically published and do not resolve matters of law. 1991), State v. Luster, 419 S.E.2d 32 (Ga. Ct. App. Arizona now has one of the highest foster care placement rates in the nation. Substance Use While Pregnant and Breastfeeding 96 A 2017 opinion posted by . She told her treating physician about her opioid use during pregnancy, not realizing this could precipitate call to Child Protective Services (CPS). Opioid use disorder among pregnant women is a significant public health concern in the United States. SUBSTANCE USE DURING PREGNANCY CONSIDERED: WHEN DRUG USE DIAGNOSED OR SUSPECTED, STATE REQUIRES: Pregnant People Given Priority Access in General Programs, Pregnant People Protected from Discrimination in Publicly Funded Programs. The vast majority ofTemporary Assistance for Needy Families (TANF) funding, or federal welfare dollars meant to help the poor, is not spent on assistance to poor families, but rather on placing and keeping children in the foster care system. Opioid abuse, dependence, and addiction in pregnancy, Medication assisted treatment in US drug courts: results from a nationwide survey of availability, barriers and attitudes, Maternal-fetal rights and substance abuse: gestation without representation, Pregnant women and the use of corrections restraints and substance use commitment, New Jersey Division of Child Protection & Permanency v. Aspartame. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. Cases of Women Charged With Child AbuseRelated Crimes for Substance Use During Pregnancy, The substances related to the charges were cocaine (n = 15), methamphetamine (n = 10), heroin (n = 2), marijuana (n = 1), oxycodone (n = 1), and unspecified prescription pills (n = 1). Hence, health care providers should select relatively safe drugs. A representative example is State v. Wade, where the court stated, The plain language of the child endangerment statute does not proscribe conduct harmful to fetuses.40 The courts typically made explicit that any ambiguity in the statutes must be construed liberally in favor of the criminal defendant. Before sharing sensitive or personal information, make sure youre on an official state website. Dehumanizing Discourse, Anti-drug Law, and Policy in America: A "Crack Mother's" Nightmare . Taking drugs in pregnancy | Ready Steady Baby! The Florida Supreme Court found the medical testimony inadequate to support the trial court's finding that a delivery occurred during the birth process, even if the criminal statute had been applicable.29 In Arms v. State, Arms was also convicted of a drug delivery charge that was overturned by the state supreme court, in part on the grounds that the relevant statute, does not expressly criminalize the passive bodily processes that results in a mother's use of a drug entering her unborn, or newborn child's system.45. Fetal or infant toxicology was reported in 24 of the pregnancies, and included positive findings for cocaine (n = 13), heroin (n = 1), and methamphetamine (n = 8) and one case wherein testing was negative for the relevant drug oxycodone, but the infant nonetheless displayed signs of withdrawal.31. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. A number of states require health care professionals to report or test for prenatal drug exposure, which can be used as evidence in child-welfare proceedings. [Ref. As Substance Abuse Rises, Hospitals Drug Test Mothers, Newborns Substance use providers that accept Medicaid must give pregnant people priority in accessing services.
