Stakeholders should ensure safe prescribing practice for pregnant women through developin Georgia regulates the possession of both illegal and prescription drugs. Drugs with evidence of fetal harm were widely used. Subscribe to our newsletters for regular updates, analysis and context straight to your email. 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. 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. What if a pregnant woman drives over the speed limit, or as a matter of vanity doesn't wear the prescription lenses she knows she needs to see the dangers of the road? 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. Sign In to Email Alerts with your Email Address. 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. 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. 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. 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. The effects of illegal drugs, such as cocaine, can be devastating on a fetus. Aspartame. At the present time, the Center for MSACD fulfills several roles in Georgia by sponsoring clinical, prevention, and research programs. For access to services and immediate crisis help, call theGeorgia Crisis & Access Line(GCAL) at1-800-715-4225, available 24/7. 1994), Reinesto v. Superior Court, 894 P.2d 733 (Ariz. Ct. App. For example, a woman in New Jersey faced civil child abuse and neglect proceedings for complying with her doctor's recommendation to stay on methadone treatment while pregnant,57 the gold standard treatment for opioid dependency during pregnancy.53 The proceedings against her were ultimately thrown out by an appellate court. 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). 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. 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. Published on September, 30, 2015. 1. State laws now vary considerably in their approach to the problem, reflecting a deep division in public opinion. You can review and change the way we collect information below. 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. Illegal Drug Use and Pregnancy. 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. 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. Otherwise, the law on drug testing newborns varies from state to state. Contributions are tax deductible to the fullest extent allowable. State Policies on Substance Use During Pregnancy. Good reproductive health policy starts with credible research. 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. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. 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 groups listed below help people with drug abuse. Not coincidentally, in the aftermath of the 2008 financial crisis, as Arizonas social safety net shrank, its foster care numbers soared. 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. The child was placed with CPS and now is in the custody of the great grandmother. 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. 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. Prescription Opioid Pain Reliever Use During Pregnancy, The US Opioid Crisis & Maternal Infant Health, Centers for Disease Control and Prevention. 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. 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. 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 . Contact your healthcare provider, local Alcoholics Anonymous, or local alcohol treatment center. Heroin is an illicit opioid. (3) 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. Establishes requirements for health care providers to encourage and facilitate drug counseling. Convictions were upheld only in Alabama and South Carolina, involving a total of four women. 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. 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. We examined only published cases, almost all of which were appellate level decisions. In 2014, Tennessee made national news when it became the first state in the country to pass a law specifically making it a crime to use drugs while pregnant. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. Such inhumane responses to drug use can only exist because they are almost exclusively reserved for poor people and people of color. 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 In Johnson v. State, the defendant was charged and convicted of two counts of delivery of a controlled substance to a minor via the umbilical cord after she reported to the treating obstetrician that she had smoked marijuana and crack cocaine the day she went into labor. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a 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. To view abstracts of recent publications in PubMed, see Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age and Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. Using illegal drugs while pregnant can cause many complications to the baby including brain damage, premature birth, low birth weight and even fetal death. Laws on drug testing of infants and new mothers vary, but the stakes are always high. Apr 20, 2022, M. Forrest Behne, Craig Waleed, Meghan Peterson, and Lauren Brinkley-Rubinstein Abstract. After the passage of the 2014 law, this reasoning no longer applied, although it became relevant again with the fetal assault law's expiration in July 2016. We identified 24 judicial opinions published between 1977 and 2015 in cases involving 29 women prosecuted in 19 states. Many substance use treatment services dont accept pregnant women, or are otherwiseinaccessibleto them, despitefederalandstateregulations that require prioritizing them for treatment. 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. Theresearchis also clear that the results of a drug test alone are not an appropriate proxy for determining parental fitness. 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. 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. Civil child abuse proceedings are explicitly permitted in 18 states.9 These may lead to termination of parental rights, but not to prison sentences. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. 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. More mothers may soon know M.s pain. 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. In males, marijuana is thought to decrease sperm quality and testosterone levels. 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. Additionally, in three states, Minnesota, South Dakota, and Wisconsin, women who use drugs during pregnancy can be involuntarily committed to a treatment program. To learn more about medication-assisted treatment for opioid use disorder and considerations in pregnancy, visit https://www.samhsa.gov/medication-assisted-treatment. 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. Arizona also has the strictest TANF timeline in the nation, kicking families off welfare after one year. In many places, women lose their children or end up in behind bars, sometimes even if the drug was prescribed. 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. Priority applies to pregnant people referred for treatment. donate today. Urine screening remains the most commonly used method despite the limited period during which drugs can be detected. Reyes was charged with two counts of felony child endangerment for her heroin use 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. We reviewed legal decisions regarding women charged with a crime against a fetus or child as a result of substance use during pregnancy. 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.