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. 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. Despite several phone calls to treatment providers in her county and surrounding counties, M. could not find a provider who was willing to accept her. The use of illicit substances such as cocaine and heroin during pregnancy is common. The infant was born prematurely. Sign In to Email Alerts with your Email Address. Those efforts continue under a wide variety of laws even in states where high courts have previously rejected the prosecution approach. The new requirements become effective on July 1, 2007 Your doctor can play an important role in helping you quit, including giving advice and support with quitting and connecting you with other resources. 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. More mothers may soon know M.s pain. 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. Narcotics Anonymous World Service Office in Los Angeles PO Box 9999 Van Nuys, California 91409 Telephone: (818) 773-9999 Fax: (818) 700-0700 Web site: www.na.org Substance Abuse and Mental Health Services Administration An official website of the State of Georgia. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. 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. 2007), State v. Geiser, 763 N.W.2d 469 (N.D. 2009), Cochran v. Commonwealth, 315 S.W.3d 325 (Ky. 2010), State v. Stegall, 828 N.W.2d 526 (N.D. 2013), Arms v. State, 471 S.W.3d 637 (Ark. Drugs with evidence of fetal harm were widely used. 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). From 2009 to 2017, the adjusted prevalence of cannabis use in the year before pregnancy increased from 6.8% to 12.5%, and the adjusted prevalence of cannabis use during pregnancy increased from 1.95% to 3.38 percent. Many substance use treatment centers do not offer MAT due to the stigma associated with it, and those centers that do provide MAT have not necessarily fulfilled their responsibility toprioritizepregnant women. Babies exposed to cocaine in the womb have a 25 percent increased chance of being born premature. 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. To learn more about medication-assisted treatment for opioid use disorder and considerations in pregnancy, visit https://www.samhsa.gov/medication-assisted-treatment. Contributions are tax deductible to the fullest extent allowable. Wisconsin provides priority access to pregnant people in both general and private programs. In jurisdictions where criminal charges are permitted, dispositions for convicted women should be treatment oriented. Trainings on maternal substance abuse, child development, alcohol and other drug related effects are conducted for prevention providers. These same legislators would be hard-pressed to take babies away from mothers who were struggling with medical treatment for hypertension or diabetes. The federal Department of Health and Human Services recently released areportreviewing Kentuckys child welfare system. App. In the medical model, treatment, not punishment, is the remedy to reduce consumption of substances during pregnancy.4 Medical and public health experts are widely opposed to efforts to criminalize substance use by pregnant women.5,,8, Reflecting societal uncertainty about the best approach, legal penalties for substance use during pregnancy because of harm to the fetus or child vary significantly among the states. Further research is needed to better understand how marijuana may affect pregnant women and developing babies. This evolution over time may reflect contemporaneous moral panic linked to the potential deleterious effects of particular substances on fetal outcomes.1. No adverse neonatal outcomes were reported in 41 percent of the pregnancies in this study. If you are pregnant or trying to get pregnant and cannot stop drinking, get help. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . Every pregnant woman facing substance use disorder deserves to get the help she needs so that she and her infant have the best possible chance to thrive. 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. Prescription opioids may be prescribed by doctors to manage moderate to severe pain. Quitting tobacco can be hard, but it is possible. Cocaine (including crack cocaine) and methamphetamine (speed, or ice) are powerful stimulants that effect the central nervous system. State laws vary, but at least 23 states and the District of Columbia articulate that substance use during pregnancy is child abuse, and virtually every state in the U.S. will open an investigation (at the very least) into a person who tests positive for substances during or shortly after pregnancy. State laws now vary considerably in their approach to the problem, reflecting a deep division in public opinion. Such information can assist in making diagnosis of neonatal abstinence syndrome (NAS), as well as help clinicians focus the plan for treatment and follow-up for the neonates. Dr. Appelbaum is Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law, Department of Psychiatry, Columbia University, and Director, Division of Law, Ethics, and Psychiatry, Columbia College of Physicians and Surgeons, and NY State Psychiatric Institute, New York, NY. Additionally, e-cigarettes and other tobacco products containing nicotine (the addictive drug found in tobacco) are not safe to use during pregnancy. Future professional advocacy efforts may be most beneficial when directed at state legislatures that are dealing with proposed statutes that address these questions. "Complex Calculations: How Drug Use during Pregnancy Becomes a Barrier to Prenatal Care." . Briefs from medical or public health organizations were submitted to the court in seven of the cases, all supporting the defendant's position. Federal Drug Laws. 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. However, pregnant women with a disease called phenylketonuria shouldn't eat or drink aspartame. One of the authors read six cases in random order, abstracting data into the identified categories of variables to determine the applicability of the a priori coding scheme. Her infant tested positive for cocaine shortly after birth. Opioid use during pregnancy can affect women and their babies. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby. Support a worker-led Appeal. While the findings varied dependent upon county, across the board, only 18 received any kind of rehab/treatment for drug abuse as . Drug addiction is a serious problem, especially when the drug addict is pregnant. The groups listed below help people with drug abuse. 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. This helps clinicians better understand the prevalence of marijuana use as they care for their pregnant patients and provide screening and treatment. Video Transcribed: Life imprisonment for using drugs while pregnant.I'm Tulsa criminal defense attorney James Wirth, and we're talking about a new law in Oklahoma.And that became effective in September of 2020, and it essentially provides that mothers to be who use drugs or CDS, while pregnant, can be prosecuted for child neglect, receiving up to life imprisonment. Quitting early or before pregnancy is best, but its never too late to quit smoking. 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. The Center for MSACD also provides training, workshops, and other informational services concerning prenatal exposure to alcohol, nicotine, illicit drugs, and prescription drugs. 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. These cookies may also be used for advertising purposes by these third parties. The city of Savannah decriminalized the possession of marijuana, effective July 1, 2018. This is all done under the cloak of what is in the best interest of the childbut that is ironic, because they are hurting my son.. Ct. App. Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. 1. 1. Thus, it is not clear whether racial or economic bias is a factor in these cases. 1991), People v. Hardy, 469 N.W.2d50 (Mich. Ct. App. In totality, medical expertise seemed to play relatively little role in determining the outcome of most judicial decisions. -- A Tennessee woman is the first to be charged under a new state law that specifically makes it a crime to take drugs while pregnant . Meanwhile, private insurance companies have found ways to circumvent Obamacare requirements on MAT coverage. This is a sad situation. 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. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. 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. 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. More about medicines in pregnancy. Getty Creative. The Tips campaign features information about how smoking and secondhand smoking affect specific groups, including pregnant women or women planning to have a baby. 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. 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. All information these cookies collect is aggregated and therefore anonymous. If you or someone close to you needs help for a substance use disorder, talk to your healthcare provider or call SAMHSAs National Helpline at1-800-662-HELP. 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. 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. For example, onestudyfound that parents who use opiates find babies less cutewhile conceivably notable, this finding does not meet the legal standard for terminating a parents rights. When she visited him, she was distressed to find he often had seemingly untreated rashes. 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). " Among pregnant women aged 15 to 44, 5.4 percent were current illicit drug users based on data averaged across 2012 and 2013. Thank you for taking the time to confirm your preferences. Mar 02, 2022. In Minnesota and North Dakota, a test is required if there are drug-related complications at birth. Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. As of last year, they were still apart, and M. has since lost touch with her lawyer. by Leticia Miranda, Vince Dixon and Cecilia Reyes 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. 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. We examined only published cases, almost all of which were appellate level decisions. Termination of parental rights is a mechanism by which families are turned into strangers, all contact and personal identity is erased, and families are destroyed forever. Finally, a number of states have placed a priority on making drug treatment more readily available to pregnant individuals, which is bolstered by federal funds that require prioritized access to treatment programs for anyone who is pregnant. 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. As part of CDCs efforts to prevent overdoses and substance use-related harms, CDC is taking specific actions to prevent opioid use disorder among pregnant women and women who could become pregnant and to make sure women with opioid use disorder get proper treatment. Twelve opinions noted that other jurisdictions ruled similarly when faced with such cases. Ct. App. 1 Similarly, in Ankrom v. State, the state supreme court found that the plain meaning of the word child is broad enough to encompass all childrenborn and unborn.18 When fetuses are included in the definition of child, the child abuse statutes are then found to be applicable to the alleged prenatal conduct. Nicotine is a health danger for pregnant women and developing babies and can damage a developing babys brain and lungs. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. Fifteen states have laws requiring health care workers to report to authorities if they suspect a woman is abusing drugs during pregnancy. We also identified judicial references to expert or fact witness medical testimony and to medical literature or medical or public health-related amicus briefs. 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. MSACD has currently established relationships with at least one community in every region across the state. Heroin is an illicit opioid. The court also referred to rulings by appellate courts in other jurisdictions that had held similarly in comparable cases. Laws on drug testing of infants and new mothers vary, but the stakes are always high. Enter multiple addresses on separate lines or separate them with commas. Cookies used to make website functionality more relevant to you. App.3d 214 (Cal. (3) 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. Quitline coaches can answer questions, help you develop a quit plan, and provide support. Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. Despite the opposition of medical and public health professionals, several state legislatures are considering laws that permit child abuse charges for substance use during pregnancy. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. Before losing contact with her lawyer, M. told me her story via email. 1994), Reinesto v. Superior Court, 894 P.2d 733 (Ariz. Ct. App. CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. An official website of the State of Georgia. Cocaine use during pregnancy poses severe issues for affected babies both short and long-term. This isaccomplished through a statewide OBHP contract withEmory University. Prevalence of Current Substance Use Among Pregnant People in the US. Smoking during pregnancy increases the risk of health problems for developing babies, including preterm birth, low birth weight, and birth defects of the mouth and lip. App. Professional advocacy may best be directed at state legislatures. Three of the nine mothers arrested that year tested positive for marijuana, and all were held on $100,000 bonds. 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 controlled substances. More and more states are adopting drug testing for newborns because of the recent increase in opioid use . The South Carolina Supreme Court in McKnight v. State17 referenced its earlier decision in Whitner v. South State16 when it opined that, in several cases this Court has specifically held that the Legislature's use of the term child includes a viable fetus. The court also pointed out that, after the Whitner decision, the legislature did not modify the statute to exclude viable fetuses from its definition of child. She struggled every day with the unimaginable pain and grief of separation from her newborn. Not coincidentally, in the aftermath of the 2008 financial crisis, as Arizonas social safety net shrank, its foster care numbers soared. remove barriers to pregnant women with substance use disorders from getting evidence-based treatment that's tailored to their unique needs. Many states recognize this as an act of child abuse on the unborn fetus . Between 1992 and 1995, the number of states that prosecuted drug-addicted pregnant women increased nearly threefold. First, they say the developing fetus and newborn will be harmed by prenatal exposure to illicit substances. Support ProPublica's award-winning investigative journalism. On June 13, 1997, the governor of Tennessee signed House Bill 1413, making it a Class A misdemeanor for child abuse where: (1) a woman consumes alcohol or illegal drugs during pregnancy with knowledge or the reason to know that such consumption may result in harm to her child; and (2) the child is born addicted to alcohol or drugs. Through these efforts, the Center for MSACD continues to be a valuable resource to individuals, parents, and professionals in Georgia and the Southeast. In Kilmon v. State, the court said, Priority applies to pregnant people referred for treatment. 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. My distant cousin is a meth addict. Substance use in pregnancy is an important issue in antenatal care. These unintended consequences include keeping women from getting the treatment they need and failing to reduce the number of babies addicted to drugs. Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. Since 1973, authorities in at least 45 states have tried to prosecute women for exposing unborn children to drugs. Such laws may discourage people from seeking prenatal care. 2006), State v. Martinez, 137 P.3d 1195, 1198 (N.M. Ct. App. For example, the Maryland state law that permits manslaughter or murder charges if a person kills a viable fetus has an exception that does not permit a woman to be charged with manslaughter for actions that led to the death of her own viable fetus. She was charged with chemical endangerment of a child. 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 Using drugs while pregnant and addiction is a grave concern because it puts two lives at risk. 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. 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. 488. first criminal charges brought against a woman for using drugs during pregnancy came in 1977 against Margaret Reyes. In the subsequent months, M. saw her son once a week at best. Maternal Substance Abuse and Child Development Project | Georgia Department of Behavioral Health and Developmental Disabilities For access to services and immediate crisis help, call the Georgia Crisis & Access Line (GCAL) at 1-800-715-4225, available 24/7. Hence, health care providers should select relatively safe drugs. It found that parents face long wait lists when accessing substance use treatment services and often dont have the means to pay. Of the 24 judicial opinions, only nine directly referenced medical evidence in the form of medical expert testimony (n = 7), published medical literature (n = 3), or amicus briefs (n = 1). 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. At least two states, Arizona and Kentucky, have just made it easier to terminate the rights of mothers who use controlled substances while pregnant. If youre using marijuana and are pregnant or are planning to become pregnant, talk to your healthcare provider.