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. Heavy use of marijuana - that is, marijuana with high amounts of THC - has been linked to decreased fertility in both men and women. 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. State Laws Punish Pregnant People Just For Seeking Drug Treatment For example, pregnant women should drink less than 1 liter (about 3 cans) of diet soda per day. 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. 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. It found that parents face long wait lists when accessing substance use treatment services and often dont have the means to pay. The underlying legal question considered in the judicial decisions in these cases is whether, for the purpose of adjudicating the criminal charges, a fetus is a child. The survey also notes that if prenatal drug use is suspected, Illinois, Michigan, Ohio and Wisconsin require health professionals to report it while Indiana requires pregnant women to be tested; Iowa, Minnesota, North Dakota and South Dakota require both. Detection of drug use during pregnancy - PubMed 1. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. The other opinion33 that directly referenced medical literature did so to demonstrate the range of behaviors that are not legally proscribed (e.g., smoking, failing to obtain prenatal care) that are associated with poor neonatal outcomes. She told her treating physician about her opioid use during pregnancy, not realizing this could precipitate call to Child Protective Services (CPS). How you know. First, they say the developing fetus and newborn will be harmed by prenatal exposure to illicit substances. Unless otherwise noted, you can republish our stories for free if you follow these rules. 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. Maternal deaths in the United States are increasing. 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. Quitline coaches can answer questions, help you develop a quit plan, and provide support. 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. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. 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. Many states recognize this as an act of child abuse on the unborn fetus . The apparent lack of a link between the proscribed conduct and a distinct harm in a large number of the cases is one example of this significant limit to the rationale for criminalization. DRH presents state and national estimates of marijuana use among pregnant women. Federal Drug Laws. Three courts stated that permitting prosecutions under the contested statute was counterproductive to state policy goals and public health. The number of pregnant women with opioid use disorder at labor and delivery more than quadrupled from 1999 to 2014, according to a recent CDC analysis. 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. Approximately 700 women in the United States die every year . 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. You will be subject to the destination website's privacy policy when you follow the link. Opioid use during pregnancy can affect women and their babies. 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. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. There may be many more unpublished trial decisions, the dimensions of which we have no way of assessing. It's best not to stop abruptly without first seeking medical advice as there may be . As Substance Abuse Rises, Hospitals Drug Test Mothers, Newborns 1995), State v. Dunn, 916 P.2d 952 (Wash. Ct. App. The child was placed with CPS and now is in the custody of the great grandmother. 2006), State v. Wade, 232 S.W.3d 663, 665 (Mo. 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. Using Illegal Drugs During Pregnancy Cases were decided by state supreme courts (n = 15) and state courts of appeals (n = 14). This is a sad situation. Later in the pregnancy, these illicit drugs may cause. No adverse neonatal outcomes were reported in 41 percent of the pregnancies in this study. Question by Miss Crickett: Az law on drug use during pregnancy? Dr. Angelotta is Instructor of Psychiatry and Behavioral Sciences, Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL. Smoking during and after pregnancy also increases the risk of sudden infant death syndrome (SIDS). Drug Use by State: Problem Areas. Subscribe to our newsletters for regular updates, analysis and context straight to your email. 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. Consistent with guidance from the American College of Obstetricians and Gynecologists, CDC advises against using marijuana during pregnancy. Moreover, there is a great deal of overlap between drug use during pregnancy policies and alcohol/pregnancy policies. Teratology and Drug Use During Pregnancy - Medscape -- 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 . For the purpose of this review, we identified published legal decisions regarding women criminally charged with a crime against a fetus or child for substance use during pregnancy from appellate level courts. 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). 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. This claim disregards the fact that drug addiction is ahealth issuewith biological, behavioral, and genetic dimensions, and similar to other health conditions, itdoes not respond wellto artificially imposed treatment timelines or mandated treatment. 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. Support a worker-led Appeal. Here is a survey of state laws. But, for that matter, she could have been a pregnant alcoholic, causing fetal alcohol syndrome; or she could have been addicted to self abuse by smoking, or by abusing prescription painkillers, or over-the-counter medicine; or for that matter she could have been addicted to downhill skiing or some other sport creating serious risk of prenatal injury, risk which the mother wantonly disregarded as a matter of self-indulgence. As of 2018, 38 states had . Opioids can be prescription or illicit. Significantly higher numbers come from the Centers for Disease Control, which in 2019 reported that some 16% of pregnant women . Defense attorneys who represent women charged for prenatal conduct may benefit from resources that clarify the relevant medical concerns. The laws can vary widely from state to state in terms of reporting requirements and consequences of reporting. Professional advocacy may best be directed at state legislatures. These cookies may also be used for advertising purposes by these third parties. Local, state, and federal government websites often end in .gov. Additional factors were relevant to the stated judicial rationale in at least some of the cases. These cases typically involve significant civil matters, such as termination of parental rights or civil commitment to inpatient treatment facilities.55,56 There are instances where women have faced civil complaints for behavior that is consistent with current standards of care for medical treatment of addictions. If you or someone you know has a drug problem, seek help. In three of the cases in which medical expert testimony was referenced, the expert testimony was contradictory. In the subsequent months, M. saw her son once a week at best. 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. App. "Opioids are what we worry about most," he explained. 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. Twelve opinions noted that other jurisdictions ruled similarly when faced with such cases. To date, the United States Supreme Court has declined to hear cases that raise questions about the constitutionality of such laws. Prevalence of Current Substance Use Among Pregnant People in the US. 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. In that way, this legislations attempt to punish mothers and fathers acts as a civil death penalty for families, for which children will pay the ultimate price.. The Legality of Drug-Testing Procedures for Pregnant Women Babies exposed to cocaine in the womb have a 25 percent increased chance of being born premature. The Tips campaign features information about how smoking and secondhand smoking affect specific groups, including pregnant women or women planning to have a baby. Many States Prosecute Pregnant Women for Drug Use. New Research - VUMC 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. Meanwhile, several states have expanded their civil child-welfare requirements to include prenatal substance use, so that prenatal drug exposure can provide grounds for terminating parental rights because of child abuse or neglect. Will you help us fight back with facts? Screening for Unhealthy Drug Use: Recommendation Statement Illegal or recreational drugs and pregnancy | Tommy's 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. Convictions were upheld only in Alabama and South Carolina, involving a total of four women. 1 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. We reviewed legal decisions regarding women charged with a crime against a fetus or child as a result of substance use during pregnancy. Copyright 2023 by The American Academy of Psychiatry and the Law. In 2014, Tennessee became the first (and only) state to pass a law that criminalized drug use during pregnancy, after a district court judge added an additional six years to the prison sentence of a woman who had been involved in a methamphetamine manufacturing operation while pregnant. Priority applies to pregnant people referred for treatment. 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. 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. 2023 Guttmacher Institute. Aspartame is an artificial sweetener in some food and drinks and small amounts may be safe during pregnancy. A total of 24 published judicial opinions met the inclusion criteria (Table 1). More about medicines in pregnancy. 2015), The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida, Substance use during pregnancy and postnatal outcomes, Punishing pregnant drug users: enhancing the flight from care, Women's perspectives on screening for alcohol and drug use in prenatal care, Drug use and limited prenatal care: an examination of responsible barriers, Universal screening for alcohol and drug use and racial disparities in child protective services reporting, The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women and American Society of Addiction Medicine, Committee Opinion No 524. Drug Use During Pregnancy Policies in the United States From 1970 to 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. It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. Otherwise, the law on drug testing newborns varies from state to state. MSACD collaborates with Georgias Alcohol Prevention Providers and their communities in all six of Georgias regions to raise awareness about alcohol and substance abuse among pregnant women. 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. 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. These unintended consequences include keeping women from getting the treatment they need and failing to reduce the number of babies addicted to drugs. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. Visitour state legislation trackerfor policy activity on all sexual and reproductive health topics. 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. Keywords: laws, policies, substance use, care, treatment, infants, neglect Created Date: 8/17/2022 9:48:14 PM 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. Drug Use During Pregnancy: Will CPS Be Involved? - Williams Law Group, LLC Using illegal or street drugs during pregnancy, including cannabis, ecstasy, cocaine and heroin, can have a potentially serious effect on your unborn baby. Yet despite the country's best efforts to fight it, the problem is getting worse, and is exacerbated by the COVID-19 pandemic. How some hospitals are drug testing new mothers without consent, How Alabamas meth lab law is unfairly punishing pregnant women, Mothers: tell us about drug testing at your hospital. It often relies on caseworker-confirmed reports of child maltreatment, despite thewell-documentedpropensity of caseworkers and family courts to base findings of child neglect on evidence of drug use alone. These same legislators would be hard-pressed to take babies away from mothers who were struggling with medical treatment for hypertension or diabetes. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. Theresearchis also clear that the results of a drug test alone are not an appropriate proxy for determining parental fitness. However, pregnant women with a disease called phenylketonuria shouldn't eat or drink aspartame. Using illegal drugs during pregnancy is dangerous for an unborn baby and the mother. Kentucky ranks amongst the last in the nation in rates ofchildhood poverty. They have 1 child together that was born prematurely due to her drug use. MSACD is committed to raising the awareness of thedevastating effects of alcohol and other substances whenused during pregnancy. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. 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. 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. 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 . Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. All types of alcohol are equally harmful, including all wines and beer. "Among newborns exposed to opioids in utero, between 55 percent and 94 percent develop withdrawal signsand 30 to 80 . Community after community has seen this in the aftermath oflocal crackdownson drug-using pregnant womenfewer women seek prenatal care and substance use treatment, even after the local authorities decide to change course. Should Pregnant Women be Subject to Criminal Prosecution for 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. We do not capture any email address. Additionally, e-cigarettes and other tobacco products containing nicotine (the addictive drug found in tobacco) are not safe to use during pregnancy. Eighteen states have laws that say drug use during pregnancy is child abuse. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. Opioid use disorder among pregnant women is a significant public health concern in the United States. Prosecutors have attempted to rely on a host of criminal laws already on the books to attack prenatal substance use. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice Establishes requirements for health care providers to encourage and facilitate drug counseling. You should also speak to your GP, midwife or a drug support service if you're regularly taking prescribed medicines. Getty Creative. 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. The mother was a drug addict. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. National Survey on Drug Use and Health - Substance Abuse and Mental Kentucky similarly struggles with poverty, poor access to substance use treatment services, and a child protective system that spends more resources on placing children in foster care than keeping them with their families. 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. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. 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.. 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. The pregnancies had the following outcome: no adverse effects of the substance reported (n = 12), withdrawal symptoms (n = 7), prematurity and/or small size at birth (n = 5), death in the neonatal period (n = 3), and stillbirth (n = 2). Substance misuse during pregnancy - Cambridge Core If youre using marijuana and are pregnant or are planning to become pregnant, talk to your healthcare provider. This means that a woman who uses opiates during pregnancy may be prosecuted if her child shows any signs of harm (including neonatal withdrawal) related to the use of opiates. Learn more at Alcohol Use in Pregnancy from the Division of Birth Defects and Infant Disorders. In other instances, where medical expertise was referenced, it did not necessarily support the defendants' position. Indeed, Kentucky has one of the highest rates of child removal in the country. CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. remove barriers to pregnant women with substance use disorders from getting evidence-based treatment that's tailored to their unique needs. 96 A 2017 opinion posted by . 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . 2006), State v. Martinez, 137 P.3d 1195, 1198 (N.M. Ct. App. The Wisconsin law is especially draconian: A woman can be detained against her will for the duration of her pregnancy, her fetus has its own court-appointed lawyer, she can lose custody of her baby after birth and the proceedings are mostly secret. The groups listed below help people with drug abuse. Georgia Marijuana Statutes 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. The Supreme Courts in Alabama and South Carolina have upheld convictions ruling that an individuals substance use in pregnancy constitutes criminal child abuse. Terminating a mothers rights to her newborn is an especially brutal drug war tactic that research and experience show will inflict far more harm than good on the children and families it allegedly aims to protect. The infant was born prematurely. There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant. That said, there are a few things you should know about "drugs-while-pregnant" law across the U.S.: Most states have tried, at one point or another, to prosecute women for drug use during pregnancy. In Kilmon v. State, the court said, 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 Clear evidence suggests that recognizing the substance exposed infant and . The following information can help you understand [] 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. Since 1973, authorities in at least 45 states have sought to prosecute women for exposing their unborn children to drugs. 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). The substances related to the charges included cocaine, heroin, methamphetamine, marijuana, and prescription pills. Abstract. Marijuana remains illegal at the federal level, even as some states have legalized it for recreational and medicinal use. The substances being abused during pregnancy can include alcohol, cocaine, heroin, and opioid addiction. 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.