Establishes requirements for health care providers to encourage and facilitate drug counseling. Fentanylis a prescription opioid that can be used to treat severe pain. 19 stateshave either created or funded drug treatment programs specifically targeted to those who are pregnant, and 17 states and the District of Columbia provide pregnant people with priority access to state-funded drug treatment programs. Are Doctors Legally Required to Report Drug Use During Pregnancy Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. Drug Use by State: Problem Areas - WalletHub Pregnancy and Substance Use | Drug Policy Facts Her infant tested positive for cocaine shortly after birth. 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. Arizona's legislation, which became law in April, permits termination of a mother's parental rights, either immediately when her newborn is born or within one year of her newborn's birth, depending on how chronic the illicit drug use appears to the court. Three of the key areas in which they can have an effect are 1) adhering to safe prescribing practices, 2) encouraging healthy behaviors by providing appropriate information and education, and 3) identifying and referring patients already abusing drugs to addiction treatment professionals 13. When she visited him, she was distressed to find he often had seemingly untreated rashes. The Guttmacher Institute is registered as a 501(c)(3) nonprofit organization under the tax identification number 13-2890727. Indeed, Kentucky has one of the highest rates of child removal in the country. Study finds increased cannabis use during pregnancy Drug Use During Pregnancy Policies in the United States From 1970 to The report pays particular attention to the impact of the 'chemical endangerment' law in Alabama, the state that has carried out the most prosecutions against pregnant women; and Tennessee's 'fetal assault' law, which between 2014 and 2016 made it a crime to give birth to a child showing symptoms of drug exposure. Question by Miss Crickett: Az law on drug use during pregnancy? Babies exposed to cocaine in the womb have a 25 percent increased chance of being born premature. The South Carolina Supreme Court held that a viable fetus is a "person" under the state's criminal child-endangerment statute and that "maternal acts endangering or likely to endanger the life, comfort, or health of a viable fetus" constitute criminal child abuse. Keywords: laws, policies, substance use, care, treatment, infants, neglect Created Date: 8/17/2022 9:48:14 PM 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. We examined only published cases, almost all of which were appellate level decisions. M. thought she was doing the right thing. Illegal or recreational drugs and pregnancy | Tommy's She had given birth approximately one year earlier to a child who had also tested positive for cocaine. Civil child abuse proceedings are explicitly permitted in 18 states.9 These may lead to termination of parental rights, but not to prison sentences. Two States Just Made It Easier to Take Babies Away From Mothers Who Use Using Illegal Drugs During Pregnancy Prescription opioids may be prescribed by doctors to manage moderate to severe pain. Many states recognize this as an act of child abuse on the unborn fetus . Using illegal drugs during pregnancy is dangerous for an unborn baby and the mother. Cocaine use during pregnancy poses severe issues for affected babies both short and long-term. 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. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS). In the 22 judicial opinions wherein charges were dismissed or convictions overturned, all held that the legislature did not intend to include fetuses in the definition of a child or victim in the relevant statute. Several leading medical organizations opposed the legislation and cautioned that it would have a negative public health effect of scaring women away from seeking medical help. Substance Use While Pregnant and Breastfeeding CDC twenty four seven. Arizona now has one of the highest foster care placement rates in the nation. The decisions do not go so far as to say that it would be unlawful for the legislature explicitly to prohibit substance use during pregnancy, although questions about the constitutionality of such an approach have been raised in the legal literature.2,3,20 Rather, most of the decisions simply found that the legislature did not intend for the existing criminal laws to apply to prenatal conduct. The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. Illegal Drug Use and Pregnancy - Children's Hospital of Philadelphia 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. These unintended consequences include keeping women from getting the treatment they need and failing to reduce the number of babies addicted to drugs. 1996), State v. Aiwohi, 123 P.3d 1210 (Haw. Severalstudiesdocument that hospital staff disproportionately drug test and report to child protective services low-income women andwomen of color. App. Visitour state legislation trackerfor policy activity on all sexual and reproductive health topics. The National Survey on Drug Use and Health (NSDUH), conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides nationally representative data on the use of tobacco, alcohol, and illicit drugs; substance use disorders; receipt of substance use treatment; mental health issues; and the use of mental health Exact terminology for relevant crimes varies across states and broad inclusion criteria were used for initial case review. Most states do not have a law that requires hospitals to test infants and new moms for controlled substances. 96 A 2017 opinion posted by . 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. To date, the United States Supreme Court has declined to hear cases that raise questions about the constitutionality of such laws. 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. Reyes was charged with two counts of felony child endangerment for her heroin use 1992), Johnson v. State, 602 So.2d 1288 (Fla. 1992), State v. Gray, 584 N.E.2d 710 (Ohio 1992), Commonwealth v. Welch, 864 S.W.2d 280, 283 (Ky. 1993), Sheriff, Washoe County, Nevada v. Encoe, 885 P.2d 596 (Nev. 1994), Collins v. State, 890 S.W.2d 893 (Tex. In three of the cases in which medical expert testimony was referenced, the expert testimony was contradictory. And the scientific literature that suggests that substance use produces social cognitive deficits in parenting is in its infancy and rather underwhelming. 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. No adverse neonatal outcomes were reported in 41 percent of the pregnancies in this study. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . CDC also works to better understand the association between marijuana use while pregnant with birth outcomes and postpartum experiences, such as depression and breastfeeding. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. The state argued that the drug delivery occurred via the umbilical cord in the period after birth but before the cord was clamped. Among pregnant women aged 15 to 44, the average . 1991), State v. Luster, 419 S.E.2d 32 (Ga. Ct. App. Criminal Charges for Child Harm from Substance Use in Pregnancy Arrests of and Forced Interventions on Pregnant Women in the United In the family court systems, there is no respect for medicine or science, she wrote. Pregnant Mothers and Drugs - Should they be charged? The report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Criminal Charges for Child Harm from Substance Use in Pregnancy, Journal of the American Academy of Psychiatry and the Law Online, Substance and shadow: women and addiction in the United States, Pregnancy and drug use: the dangerous and unequal use of punitive measures, Fetal protection laws: moral panic and the new constitutional battlefront, Clinical, ethical, and legal considerations in pregnant women with opioid abuse, American Academy of Pediatrics Committee on Substance Abuse, Council on Addiction Psychiatry, American Psychiatric Association, Position statement on the care of pregnant and newly delivered women addicts, ACOG Committee Opinion No 473. CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. We identified 24 judicial opinions published between 1977 and 2015 in cases involving 29 women prosecuted in 19 states. 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. Along with counseling and behavioral therapy, opioid medications (buprenorphine, methadone, and naltrexone) may be used in medication assisted therapy (MAT) to treat opioid use disorder. First, they say the developing fetus and newborn will be harmed by prenatal exposure to illicit substances. 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. Many States Prosecute Pregnant Women for Drug Use. New Research - VUMC 24 states and the District of Columbia consider substance use during pregnancy to be child abuse under civil child-welfare statutes, and 3 consider it grounds for civil commitment. Your doctor can play an important role in helping you quit, including giving advice and support with quitting and connecting you with other resources. Between 2002-2003 and 2016-2017, past-month cannabis use increased from 3.4% to 7.0% among pregnant women overall and from 5.7% to 12.1% during the first trimester. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. Drug Use and Pregnancy | LegalMatch - LegalMatch Law Library State legislators, law enforcement officials, and physicians have struggled to reach consensus on how to identify, treat, and possibly punish women who abuse illegal substances during pregnancy. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. The child was placed with CPS and now is in the custody of the great grandmother. State Laws Punish Pregnant People Just For Seeking Drug Treatment Some research shows that marijuana use during pregnancy is linked to health concerns, including high use of other substances that may impact pregnancy and infant health such as tobacco, and developmental problems in adolescents. Substance misuse during pregnancy - Cambridge Core Substance use - Australian Government Department of Health and Aged Care 2023 Guttmacher Institute. They help us to know which pages are the most and least popular and see how visitors move around the site. Sign In to Email Alerts with your Email Address. While some papers estimate that 1-3% of birth defects are thought to be caused by medications taken during pregnancy, the authors could not find a source for this statement that was based on study d. More about medicines in pregnancy. Research projects funded by both state and federal agencies continue to examine effects of prenatal exposure on development, evaluate intervention programs, and describe the clinic population using comprehensive databases. Such inhumane responses to drug use can only exist because they are almost exclusively reserved for poor people and people of color. State law prohibits a medical provider from releasing information about a pregnant individuals drug or alcohol test without the patients consent. In totality, medical expertise seemed to play relatively little role in determining the outcome of most judicial decisions. State Responses to Substance Abuse Among Pregnant Women, Concerns Mount over Punitive Approaches to Substance Abuse Among Pregnant Women. Priority applies to pregnant people referred for treatment. Charges included child endangerment, child abuse, drug delivery, attempted aggravated child abuse, chemical endangerment of a child, child neglect, child mistreatment, homicide, manslaughter, and reckless injury to a child. Substance use providers that accept Medicaid must give pregnant people priority in accessing services. Anonymous screening of consecutive urine samples testing positive for pregnancy from a UK inner-city clinic demonstrated that approximately 16% of the women had taken one or more illicit substances (Sherwood et al, 1999). For more information, see What You Need to Know About Marijuana Use and Pregnancyand The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017). Saving Lives, Protecting People, https://www.samhsa.gov/medication-assisted-treatment, prevent overdoses and substance use-related harms, Learn about the Division of Reproductive Healths efforts to address opioid use disorder to improve maternal and infant health, CDC Guideline for Prescribing Opioids for Chronic Pain, A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders, Opioid Use and Opioid Use Disorder in Pregnancy, Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and their infants, Final Report: Opioid Use, Misuse, and Overdose in Women, What We Can Do About Opioid Use Disorder in Pregnancy, SAMHSAs Behavioral Health Treatment Services Locator, guidance from the American College of Obstetricians and Gynecologists, What You Need to Know About Marijuana Use and Pregnancy, The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research (2017), Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Thank you for taking the time to confirm your preferences. Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. Although this may be the case, the medical care mandated by many drug treatment courts falls well below the standard of care required for some pregnant women.53,54, Of note, the cases loosely reflect epidemiological trends in patterns of drugs of choice. Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await . Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. The federal Department of Health and Human Services recently released areportreviewing Kentuckys child welfare system. 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. It is, however, not known how many women, if any, have been convicted at the trial court level and not had their case heard at the appellate level. Significantly higher numbers come from the Centers for Disease Control, which in 2019 reported that some 16% of pregnant women . Oklahoma Law: Life Imprisonment for Using Drugs While Pregnant? Disclosures of financial or other potential conflicts of interest: None. 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. Criminalization of substance use during pregnancy because of harm to the fetus or child is fiercely debated. Further, some states, under the rubric of protecting the fetus, authorize civil commitment (such as forced admission to an inpatient treatment program) of pregnant people who use drugs; these policies sometimes also apply to alcohol use or other behaviors. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. The Legality of Drug-Testing Procedures for Pregnant Women Such laws may discourage people from seeking prenatal care. Moreover, there is a great deal of overlap between drug use during pregnancy policies and alcohol/pregnancy policies. Several methods of drug testing are efficacious in identifying and monitoring drug use during pregnancy. Despite progress in the criminal legal system, the drug war remains almost unchallenged in the child protection system, and it is wreaking havoc on families. For each case, we recorded the charges, the substance abused, neonatal outcome, legal resolution of the case, and judicial reasoning. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. NAS is a group of withdrawal symptoms that most commonly occurs in newborns after exposure to opioids during pregnancy.If you are pregnant and using opioid pain medications, CDC recommends you talk to your provider before starting or stopping any medications to help you understand all of the risks and make the safest choice for you and your pregnancy. First Woman Charged on Controversial Law that Criminalizes Drug Use Trainings on maternal substance abuse, child development, alcohol and other drug related effects are conducted for prevention providers. Marijuana During Pregnancy - SAMHSA - Substance Abuse and Mental Health Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice App. 1. It's best not to stop abruptly without first seeking medical advice as there may be . This is all exacerbated by a series of measures Arizona has undertaken to constrict its social safety net, leaving families struggling with inadequate access to cash, food, housing, child care, and transportation. Drug Use During Pregnancy: Will CPS Be Involved? - Williams Law Group, LLC Opioids can be prescription or illicit. Arizona also has the strictest TANF timeline in the nation, kicking families off welfare after one year. Another major concern is addressing the harm that a child of any age can \ suffer when a parent's use of alcohol or other substances leads to neglect of the child, or the child is exposed to illegal drug activity. With the U.S. Supreme Court considering a high-profile case involving the prosecution of pregnant substance abusers, policymakers and advocates once again are confronted with the decade-old question of how best to deal with pregnant women who use drugs. Although pregnancy is an exciting time, there are stresses and risks that come with pregnancy and the postpartum period. If you valued this article, please help us produce more journalism like this by making a contribution today. Additionally, in three states, Minnesota, South Dakota, and Wisconsin, women who use drugs during pregnancy can be involuntarily committed to a treatment program. 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. There were over 100,000 drug overdose . To learn more about medication-assisted treatment for opioid use disorder and considerations in pregnancy, visit https://www.samhsa.gov/medication-assisted-treatment. DRH presents state and national estimates of marijuana use among pregnant women. Although the legal bases for appellate court decisions varied (see Table 1), the functional outcome was that the charges were dismissed (n = 14) or convictions overturned (n = 11) for 86.2 percent of the women (25/ 29). 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. " Among pregnant women aged 15 to 44, 5.4 percent were current illicit drug users based on data averaged across 2012 and 2013.