The Global Commission on Drug Policy. IDPH is expanding funding and increasing awareness of the state perinatal depression MOMS hotline. Mandated Substance Abuse Programs. Whether these studies will lead to stricter regulations and punishments on pregnant women is highly debatable. These laws have not controlled illicit drug use, nor has it stopped the opioid pandemic from growing. Monitor, Analyze, and Communicate Trends. Avoid close contact with those who are sick, Avoid touching your eyes, nose or mouthafter you have touched objects that could possibly be contaminated, Clean/disinfect frequently touched surfacesat home, school or work, especially when someone is ill, Eat nutritious foods and drink plenty of fluids. Buprenorphine and Naloxone Versus Buprenorphine for Opioid Use Disorder in Pregnancy: A Cohort Study. This article highlights some misconceptions and underscores the challenges they face as they navigate the justice and healthcare systems while also providing possible solutions to address their underlying addiction. There are advantages and disadvantages to both universal and risk-based testing. Meconium the traditional specimen to detect and document drug use during pregnancy, while umbilical cord tissue is relatively new for testing. Risk-based testing may also miss infants exposed to drugs if the policies do not adequately identify and test for probable exposures. Safe Harbor and Medication-Assisted Treatment. American College of Obstetricians and Gynecologists https://drugabusestatistics.org/, [32] Institute G. Interactive Map: US Abortion Policies and Access After Roe. Some states consider substance misuse (and even prescribed use) during pregnancy child abuse. Policy makers must place emphasis on the safety of the patient and baby rather than the cessation of substance use. 2022;99(2):316-327. doi:10.1007/s11524-022-00610-0, [23] Mayes LC, Granger RH, Bornstein MH, Zuckerman B. However, if an employee tests positive on a random drug test, no action can be taken if it can't be proven the substance was used in the workplace. On April 29, 2021, IDPH released Illinois' second Maternal Morbidity and Mortality Report. Officials have prosecuted countless women across 45 states for exposing their unborn children to drugs. Further, the law states that it is not illegal for employers to require drug tests from employees who have been or are in a drug rehabilitation program. DHHS Revised September 11, 2018 https://aspe.hhs.gov/reports/economic-opportunity-opioid-crisis-geographic-economic-trends, [14] Midon, M. Z., Gerzon, L. R., & de Almeida, C. S. (2021). Centers for Disease Control and Prevention. National Institute on Drug Abuse. 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. For example, Virginia considers substance use during pregnancy child abuse and mandates that healthcare providers report it. People often leave prisons and jail without a sense of purpose, which can lead to relapse and reincarceration. In 2011, the Global Commission on Drug Policy released a report that concluded that the initiative had been futile, as arresting and incarcerating tens of millions of these people in recent decades has filled prisons and destroyed lives and families without reducing the availability of illicit drugs or the power of criminal organizations.[6] One study published in the International Journal of Drug Policy in the same year found that funding drug law enforcement paradoxically contributed to increasing gun violence and homicide rates. No one ever informed her of, nor asked her permission for, a drug test. Additionally, in three states, Minnesota, South Dakota, and Wisconsin, women who use drugs during pregnancy can be involuntarily committed to a treatment program. In most states, there is no law that requires hospitals to test infants and new moms for illicit substances. Providers should ensure women are connected to mental health services. Dentists who are knowledgeable about periodontal disease are more likely to counsel their patients who are pregnant about periodontal health. [21] Currently, the impact of the COVID-19 pandemic on the prevalence of newborns with neonatal abstinence syndrome is unknown. Neonatal abstinence syndrome (NAS) is itself a treatable and transient condition, and a growing body of literature confirms 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. Text4Baby Training Center: https://partners.text4baby.org/index.php/get-involved-pg/partners/training-center, Behavioral Risk Factor Surveillance System, Pregnancy Risk Assessment Monitoring System, Current Maternal Health Projects and Committees, https://www.cdc.gov/flu/protect/keyfacts.htm, https://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm, https://www.vaccines.gov/who_and_when/pregnant/index.html, https://www.cdc.gov/vaccines/pregnancy/hcp/guidelines.html, https://www.cdc.gov/vaccinesafety/ensuringsafety/monitoring/index.html, http://immunizationforwomen.org/providers/resources/acog-resources/default.php, http://www.midwife.org/Immunization-Resources-for-Providers, https://www.cdc.gov/flu/professionals/antivirals/avrec_ob.htm, https://www.cdc.gov/flu/professionals/vaccination/, https://www.cdc.gov/flu/professionals/infectioncontrol/index.htm, https://www.cdc.gov/flu/professionals/diagnosis/index.htm, https://www.cdc.gov/flu/resource-center/freeresources/index.htm, https://www.cdc.gov/flu/professionals/training/index.htm, https://www.cdc.gov/flu/weekly/fluactivitysurv.htm, https://www.cdc.gov/vaccines/hcp/admin/storage/index.html, https://www.cdc.gov/flu/about/qa/flushot.htm, https://www.cdc.gov/vaccines/ed/patient-ed.html, https://partners.text4baby.org/index.php/get-involved-pg/partners/training-center, Tips for Good Oral Health During Pregnancy, Two Healthy Smiles: Tips to Keep You and Your Baby Healthy, National Maternal & Child Oral Health Resource Center, Resource Highlights: Oral Health During Pregnancy, 2018 Illinois Maternal Morbidity and Mortality Report, Infographic - Overcoming Breastfeeding Challenges, Grant Accountability and Transparency (GATA), receive health care before, during, and after pregnancy and childbirth, receive care for her and her infant that is consistent with generally accepted medical standards, choose a certified nurse midwife or physician as her maternity care professional, choose her birth setting from the full range of birthing options available in her community, leave her maternity care professional and select another if she becomes dissatisfied with her care, receive information about the names of those health care professionals involved in her care, receive information concerning her condition and proposed treatment, be informed if her caregivers wish to enroll her or her infant in a research study, receive information in a language in which she can communicate, receive emotional and physical support during labor and birth, freedom of movement during labor and to give birth in the position of her choice, decide collaboratively with caregivers when she and her baby will leave the birth site for home, be treated with respect at all times before, during, and after pregnancy by her health care professionals, examine and receive a reasonable explanation of her total bill for services. NPR. Emily Hirsch, Ameri Klafeta (ACLU-IL) Emma Roth (NAPW), Ultimately, DCFS subjected Ms. F. and her husband to a, How The Local Elected Offices On Your 2023 Ballot Impact Civil Liberties, With The Patient and Provider Protection Act, Illinois Shows Once Again That It Trusts Patients, Black and Brown Chicagoans Testify in Court About Police Harassment, Violent Home Raids, and Harm to People with Disabilities. Resource lists for health care providers are available inAppendix Bof the report. The Reproductive Health Act (RHA) says that the government cannot punish or prosecute for something a pregnant woman may or may not have done due to the government's claim that it is harmful. 2013;102(11):1060-1066. doi:10.1111/apa.12378, [36] Ilett KF, Hackett LP, Gower S, Doherty DA, Hamilton D, Bartu AE. Bulk pricing was not found for item. Pregnancy Justice. Just a few feet away from his room, behind the nurses station, were the two newborns feeling the same withdrawal symptoms that this teenager likely experienced in the first few hours of his life. No, Illinois does not require testing over suspicions. With renewed focus on academic strength, we aim to contribute to the array of bioethics literature by continuing to publish op-eds and research essays that challenge the reader to explore novel viewpoints. Emphasizing public health measures and adequate medical care can prevent complications and developmental issues in newborns and pregnant women with substance use disorders. Support ProPublica's award-winning investigative journalism. 102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 HB4116 . JAMA Pediatr. This testing approach, however, may be perceived as unfairly profiling mothers, exposing the institution to legal issues. [27], While I have witnessed this behavior in the teenage patient during my pediatrics rotation, not all newborns with intrauterine drug exposure are inevitably bound to have psychiatric and behavioral issues later in life. Pregnant women are considered to be at higher risk of influenza complications by the Advisory Committee on Immunization Practices, and thus, empiric treatment is recommended. Black women are aboutthree timesas likely to die from a pregnancy-related condition as White women. Unless otherwise noted, you can republish our stories for free if you follow these rules. The charge alleges that Saint Alexiuss practice of drug testing pregnant women without their knowledge or consent and in the absence of a medical justification discriminated against Ms. F. on the basis of sex and pregnancy. Health care providers of pregnant women play a vital role in advising patients on how to protect themselves and their developing babies against flu. In 2014, Tennessees legislature passed a Fetal Assault Law, which made it possible to prosecute pregnant women for drug use during pregnancy. 2011;22(2):87-94. doi:10.1016/j.drugpo.2011.02.002, [8] Global Commission on Drug Policy, 2011, [9] Women NA for P. Tennessees Fetal Assault Law: Understanding its impact on marginalized women - New York. Drug Testing in Illinois Testing locations are available in all areas. Ultimately, DCFS subjected Ms. F. and her husband to a safety plan, requiring them to have someone else in the home with Ms. F. and the baby at all times. Illinois state law does not prohibit drug testing. [34] Additionally, newborns with neonatal abstinence syndrome who are breastfed by mothers receiving methadone or buprenorphine require less pharmacological treatment, have lower withdrawal scores, and experience shorter hospital stays. [41] It is erroneous to assume that their substance use disorder would disappear after a period without substance use while behind bars. [9] The fear that this law instilled in pregnant women with substance use disorder can still be seen across the US today. Published May 3, 2010. https://www.npr.org/templates/story/story.php?storyId=126478643, [29] Miranda L, Dixon V, September CRP on, 30, 2015. [4] A History of the Drug War. The Pregnancy Risk Assessment Monitoring System (PRAMS) collects state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy. Many different definitions of maternal mortality are used to track and analyze deaths in different contexts, but Illinois uses the following standard definitions from the Centers for Disease Control and Prevention (CDC): Pregnancy-Associated Death- the death of a woman during pregnancy or within one year of the end of a pregnancy from any cause. Millions of dollars are being poured into managing neonatal abstinence syndrome, including prosecuting women and taking their children away. Black women were more likely to die from pregnancy-related medical conditions. At the federal and state levels, ACOG supports policy prescriptions that prioritize a healthy outcome for both mother and baby including: Routine urine drug screening is controversial. Text4baby is a free mobile health information service for pregnant women and new parents with infants under the age of 1 year. https://drugabusestatistics.org/drug-related-crime-statistics/. Severe complications are rare, with a relatively small number of women experiencing the most severe complication: death. or the [child neglect statute]. Women need accurate information about the importance of practicing good oral health habits throughout their lives as well as about the importance and safety of receiving oral health care during pregnancy. Smoking During Pregnancy. This practice arose out of the failed War on Drugs, which advanced a narrative that cast suspicion on people of color and resulted in federal laws to ostensibly provide drug treatment to pregnant women. The Maternal Lifestyle Study. In line with the recommendations by Global Commission on Drug Policy and the lessons learned from the failed War on Drugs, one proposed change in our criminal justice system would be to require enrollment and participation in assisted alcohol cessation programs before legal punishment. Newborn Drug Screening - Meconium and Umbilical Cord Tissue 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. Please go to www.prep4illinois.com or call the hotline at (800) 825-3518. Routine urine drug screening is controversial. doi:10.1542/peds.2018-3801, [20] Winkelman TNA, Villapiano N, Kozhimannil KB, Davis MM, Patrick SW. How States Handle Drug Use During Pregnancy http://projects.propublica.org/graphics/maternity-drug-policies-by-state, [30] NCDAS: Substance Abuse and Addiction Statistics [2023]. On October 18, 2018, IDPH released Illinois firstMaternal Morbidity and Mortality Report. Misconception Two: Mothers with SUD are Not Fit to Care for Children. https://nida.nih.gov/about-nida/noras-blog/2023/02/pregnant-people-substance-use-disorders-need-treatment-not-criminalization, [2] Substance Use Disorder Hurts Moms and Babies. To learn more about Education on a variety of health topics including immunization that are delivered through text messaging and an app based on the due date or baby's birthday, visit the Text4Baby site: https://partners.text4baby.org/index.php. 2011;33(1):78-87. doi:10.1016/j.ntt.2010.06.005, [28] N, P, R. Crack Babies: Twenty Years Later. The employer may conduct drug tests without affecting individual rights. Abortion laws vary by state, and in Tennessee, for instance, abortions are banned after six weeks of gestation, typically when fetal heart rhythms are detected. The results of the investigation determine whether the baby is taken permanently. 2020;174(2):200-202. doi:10.1001/jamapediatrics.2019.4791, [22] Ghose R, Forati AM, Mantsch JR. Impact of the COVID-19 Pandemic on Opioid Overdose Deaths: a Spatiotemporal Analysis. [4] However, it is worth noting that one can trace the roots of this initiative back further. This routine practice, sometimes termed "test and report," disrupts bodily autonomy of the pregnant person and their newborn and is inconsistent with treating substance use disorder as a health condition with social and behavioral dimensions (See "Test and Report: Bad for Children and Families" at I predict that the increase in opioid and polysubstance use during the pandemic will increase the number of newborns with neonatal abstinence syndrome, thereby significantly increasing the public burden and cost. Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance. During his hospitalization, he was so violent towards healthcare providers that security had to intervene. Appointment reminders and an immunization tracker can be used to support a woman in getting the vaccines she needs for herself during pregnancy and for her new baby. June 2021. Laws Pertaining to Pregnant Women Who Use Drugs View Marijuana Laws 2010;20(3):193-200. doi:10.1016/j.whi.2010.02.003, [11] Klaman SL, Isaacs K, Leopold A, et al. Future interventions should focus on improving the oral health knowledge of dentists and other health professionals about the importance of comprehensive oral health care, including periodontal treatment when needed, for all pregnant women. Decriminalizing drug use and encouraging good health habits during pregnancy is essential, as is access to prenatal care, especially for lower socioeconomic patients. Office of Assistant Secretary for Planning and Evaluation. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Breastfeeding, for example, helps the baby develop a strong immune system while reducing the mothers risk of cancer and high blood pressure. Drug Policy Alliance. Infants exposed to drugs prenatally have an increased risk of complications, stillbirth, and life-altering developmental disabilities. Retrieved from https://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm. [3] All stories have been fictionalized and anonymized. NAS can lead to long-term health and developmental problems such as hearing and vision problems and issues with learning and behavior. 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.. Instead of deterring drug use, the law discouraged pregnant women with substance use disorder . Voices in Bioethicsbrings together diverse views through an academically rigorous online format and seeks to identify issues and present workable long-term solutions. It must be asked, by what judicially defined standard would a mother have her every act or omission while pregnant subjected to State scrutiny? [40] Only 11 percent of the 65 percent of our nations inmates with substance use disorder receive treatment, implying that the other 89 percent were left without much-needed support to overcome their addiction. ACLU of Illinois Responds to Decision by Texas Court on With The Patient and Provider Protection Act, Illinois Shows Once HB 4664: Patient and Provider Protection Act. [36] Moreover, oxytocin, the hormone responsible for mother-baby bonding, is increased in breastfeeding mothers, reducing withdrawal symptoms and stress-induced reactivity and cravings while also increasing protective maternal instincts. In 1914, Congress enacted the Harrison Narcotics Tax Act to target the recreational use of drugs such as morphine and opium. Published December 14, 2020. https://www.pregnancyjusticeus.org/tennessees-fetal-assault-law-understanding-its-impact-on-marginalized-women/, [10] Roberts SCM, Nuru-Jeter A. Womens perspectives on screening for alcohol and drug use in prenatal care. Elizabeth Nolan Brown | 4.23.2021 8:30 AM. Womens Health Issues Off Publ Jacobs Inst Womens Health. [14], Nonetheless, many studies have demonstrated that drug use during pregnancy can adversely impact fetal development. J Addict. States were questioned about their policies with respect to genetic counseling, CVS, and amniocentesis testing for pregnant women. Although the number of people sentenced to state prisons for drug related crimes has been declining, it is still alarming that there were 171,300 sentencings in 2019. [33] Fortunately, studies suggest keeping mother and baby together has many benefits. Community-based organizations should educate women on the importance of getting prenatal care. [3], The War on Drugs was a government-led initiative launched in 1970 by President Richard M. Nixon with the aim of curtailing illegal drug use, distribution, and trade by imposing harsher prison sentences and punishments. There should be advocation for legislative change, not by providing an opinion but by highlighting the facts and conclusions of scientific studies grounded in scientific evidence, health, security, and human rights. In fifteen states, health care workers are required to report to authorities if they suspect a woman is abusing drugs during pregnancy. Despite this, routine oral health care is often avoided or postponed for the duration of pregnancy. In some cases, police can even take a woman into custody if they suspect her substance abuse will harm her unborn child, even involuntarily commit until the child is born. drug testing policy, random drug testing policy, or a : 24: drug-free workplace policy or from disciplining an employee : 25: For more information on antivirals for pregnant and postpartum patients, please visit the CDC: https://www.cdc.gov/flu/professionals/antivirals/avrec_ob.htm. In 2014, Tennessee's legislature passed a "Fetal Assault Law," which made it possible to prosecute pregnant women for drug use during pregnancy. Nations Health. Centers for Disease Control and Prevention. https://drugpolicy.org/issues/brief-history-drug-war, [5] The Harrison Narcotic Act (1914) https://www.druglibrary.org/Schaffer/library/studies/cu/cu8.html, [6] The War on Drugs. 2012;7:269-274. doi:10.1089/bfm.2011.0096, [37] Pedersen CA, Smedley KL, Leserman J, et al. Illinois newborn drug testing laws mandate cases to be reported to the Department of Children and Family Services (DCFS) and the Department of Public Health (DPH), where an investigation will begin. No new mother should ever face such traumatic and discriminatory treatment." 1 comment .