Author: Shernide Delva
As a result of the high rates of heroin and painkiller abuse, some doctors are calling for mandatory drug tests for all pregnant women. The effects of drug and alcohol use on pregnancy is fully known to be harmful, however some argue that drug testing of pregnant women will actually cause more harm than good. Should pregnancy drug tests be mandatory?
When a pregnant woman uses drugs or alcohol throughout pregnancy, she puts her child at risk of developing neonatal abstinence syndrome (NAS) which produces a variety of withdrawal-like symptoms.
Common symptoms of Neonatal Abstinence Syndrome (NAS) include:
- Uncontrolled twitching
- Excessive and particularly high-pitched crying
- Problems feeding
- An inability to sleep
Babies exposed to opiate painkiller drugs in the womb can suffer withdrawals that are so painful, that they must be treated with morphine or other sedatives. The long term effects of babies born with NAS are still not fully known, however babies who are born with NAS are more likely to suffer from medical complications such as low birth weight, and sudden infant death syndrome (SIDS).
Due to the potentially severe consequences of drug use during pregnancy, many doctors have come out stating that they will require all expecting mothers to complete a drug tests. However, some argue that this will prevent those struggling from wanting to get adequate healthcare due to fear of being criminalized.
Because of this fear, doctors and health officials want to ensure that pregnant woman know they will not be punished for their drug use if the results come out negative. They want lawmakers to shield pregnant addicted mothers from punishment.
So far, legislature have taken the first step of quietly passed measures to prohibit doctors from giving results of a pregnant woman’s drug tests to police without a court order. Without laws like this becoming mainstream, many pregnant women struggling with drug addiction will be too afraid to come forward. However, the symptoms of NAS are too severe to ignore:
“Their care is very labor intensive because they’re nearly inconsolable,” said Dr. Mark Gentry, an obstetrician at Hendricks Regional Health in Brownsburg. “It’s heart-jerking and becoming much more prevalent.”
Gentry’s hospital is one in four in the state of Indiana that will start a pilot project testing pregnant women for drugs with the intention of promoting treatment, not criminalization. For now, women are allowed to opt out of the screenings since they are not legally required to do so.
Gentry states that many women will feel uncomfortable agreeing to the tests for fear of punishment. Under current law, doctors must call child welfare authorities if they feel a child is being abused. That could include cases where a child is exposed to drug in the womb, though no law specifically states this, and the state doesn’t track the number of drug-dependent newborns.
Sadly, hospitals have seen a spike in drug-dependent babies. The rate of babies born with drug dependency nearly quadrupled from 2004 to 2013. Now, every 27 of every 1,000 babies admitted to intensive-care are admitted due to drug related issues. Many states like Tennessee, Alabama, and South Carolina have tightened legislation to reduce the number of babies born with drug dependency. However, Gentry warn that laws like this actually scare woman away from the care they truly need.
Laws that focus on criminalizing pregnancy women struggling with drug addiction may be harmful to those who are suffering the most. Instead, laws that reaffirm women that they will not be criminalized are more likely to result in more women coming forward with their challenges.
Overall, the main goal is to prevent innocent babies from being born with NAS symptoms. Are mandatory drug tests for pregnant women the solution? If you are a pregnant women struggling with addiction, please come forward. It is not just your life, it is the life of your newborn at risk. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Justin Mckibben
Pregnancy and addiction are not as uncommon as many people may think, and quite often when an addict becomes pregnant they desperately want to quit or get help, but is afraid to do so. But the process of pregnancy and early motherhood is only more reason to step into a new life. Sadly not enough mothers get the treatment they deserve.
According to a recent nationwide survey, of pregnant women aged 15 – 44 years old:
- 6% used alcohol
- 3% used tobacco
- 6% used prescription medications
- 3% used illicit drugs
Using alcohol or drugs while pregnant in any capacity can have harmful effects on the unborn child of an addict. Risks and possible outcomes of using drugs or alcohol while pregnant include:
- premature delivery
- low birth weight
- neurological and congenital problems
- increased chance of SIDS (sudden infant death syndrome)
- developmental delays
- higher likelihood for neglect or abuse
- future mental health problems
- future substance abuse problems
Taking the risky results into account, there has been research indicating that comprehensive drug treatment, holistic healing, and prenatal care for mother and child significantly improves birth outcomes and the child’s future development. Contrary to what some believe, pregnant women who are dependent on substances of abuse to have the ability to deliver healthy babies, regardless of what stories like the 1990’s ‘crack-baby’ scare will tell you.
Trends of Substances
Some experts insist that smoking cigarettes during pregnancy—90% of her women do—carries much more risk than any illicit drug use, and an estimated two-thirds of babies exposed to opioids during pregnancy end up having withdrawal with half of them needing medication treatment.
Trailing the information back to 1999, the most popular drugs among admitted pregnant women were:
However, from the 2013 Treatment Episode Data Set (TEDS) information, it was estimated that among pregnant admissions:
- Alcohol abuse decreased from 46.6% in 2000 to 34.8% in 2010
- Drug abuse increased from 51.1% in 2000 to 63.8% in 2010
Executive Director at the University of North Carolina (UNC) Horizons substance abuse treatment program for pregnant women Dr. Hendree Jones stated that according to research 40% of the women who are treated there are dependent on opioids, mostly prescription Vicodin and Oxycontin, as well as a rise in use of IV heroin. They also still see cocaine, at about 30-33%, alcohol at about 30% and bit of activity regarding benzodiazepines, marijuana, and poly-substance abuse.
Many pregnant women need intensive treatment, but few treatment programs provide the necessary aftercare. Many traditional residential programs don’t want the liability of treating pregnant women. Pregnant women face increased societal stigma, fear they will lose custody of their children, lack access to gender-specific treatment, lack insurance coverage for aftercare, and lack childcare and/or transportation.
The National Survey of Substance Abuse Treatment Services (N-SSATS) reported that in 2011, of the 13,720 substance abuse treatment facilities in the US, only 12.7% of these were programs for pregnant or postpartum women, and only 3.9% had residential beds for their clients’ children. So many pregnant addicts who are seeking treatment feel they do not have as many options, or may be shut down enough that they almost give up because they aren’t aware of the other opportunities out there.
Detox and Medications
There are a lot of myths surrounding medically-assisted treatment, including detox, opioid replacement medication, and NAS. At the end of the day, a proper treatment facility will provide you with a clinical staff to help resolve any conflicts with medications.
Where we stand today there’s limited data for detoxing from opioids, but we do know that it is possible to safely detox from opiates during pregnancy during any trimester, if it’s done in a controlled, slow and gradual taper. Recent research strongly supports maintaining pregnant women on opioid-agonist pharmacotherapy throughout pregnancy and the postpartum period, so it is often suggested that a pregnant mother be given a monitored and medicated detox.
Some centers specialize in treating pregnant women dependent on opioids, and they will send mothers to an off-site hospital only when they need to detox from alcohol or benzodiazepines. These are the most dangerous drugs to withdraw from because of the risk of seizures.
Stigma is perhaps the biggest challenge facing women who are pregnant with a history of drug use, especially when it comes to punishing addicts instead of treating addiction as a medical disorder. That’s probably exemplified best in the new law passed in Tennessee that would charge a woman with aggravated assault if she tests positive for drugs during her pregnancy. Most doctors agree that this is a health issue—and one of primary concern for pregnant women, most of whom don’t have access to comprehensive drug and prenatal treatment; punishing women is not the answer.
Aftercare is a big problem, too. Making sure that the mothers comply with continued care after treatment can make or break their chances of lasting recovery. Along with this, the number one biggest challenge is not having a unified continuity of care for after they leave the program. And yes, that’s including gaps in the mothers insurance coverage, finding long-term housing for mothers and their babies, and continuing psychiatric care.
Trends of Treatment
As if there was not enough fear involved with drug or alcohol addict parents, Tennessee Pregnancy Criminalization Law would charge a pregnant mother with aggravated assault if they have a pregnancy complication due to the use of illegal narcotics or if the child is born addicted to or harmed by the narcotic drug.
Unfortunately, primarily due to things like fear-mongering and stigma the number of pregnant women who actually receive treatment for substance abuse is shockingly low. According to data from the 2013 Treatment Episode Data Set (TEDS) pregnant women between 15 to 44 years who were admitted to substance abuse treatment facilities typically ranged between 4.4% and 4.8% from 2000 to 2010.
Once accepted to a program, the process of treatment is not all that complicated. A caseworker will do a six-pronged evaluation upon enrollment of the new mother into a program that aims to review the whole picture:
- Physical factors
- Psychological factors
- Readiness for treatment
- Social factors
- Level of intoxication or withdrawal stage
- Access to recovery support
Following an initial assessment, a patient is directed to the appropriate level of care. With options like detoxification in a hospital and then residential treatment for the most intensive needs, or outpatient for less severe addiction, a pregnant mother can be placed in a position where she has every opportunity to make a change in her life that could change everything for her unborn child.
As it was said before, we as a people put too much stock into the stigma of addiction, and that alone can attribute to hundreds if not thousands of deaths or birth defects of children related to drugs and alcohol simply because the mother was too afraid to reach out and find help. We as a society need to recognize the disease for what it is, and start working together to change the way we address those who suffer. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
New Drug Law For Pregnant Women in Tennessee
New Tennessee pregnancy law has apparently claimed its first violator. This month the state of Tennessee has issued a new law allowing for a pregnant woman to be prosecuted for assault for the illegal use of a narcotic drug while pregnant if her infant is harmed or addicted to the narcotic upon delivery. A drug addiction mother can also be charged with homicide if the baby dies at any point.
Tennessee Gov. Bill Haslam signed the new piece of legislation back in April, and the governor said himself that the intent of the new law is to give local law enforcement and the district attorney’s office another powerful tool to address the growing concern of illicit drug use among pregnant women through giving them the necessary access to drug treatment programs. The new law is supposed to be designed to allow any woman charged to enter into a substance abuse treatment program before giving birth as a defense, and hopefully she will be able to successfully complete the program afterward.
Republican state Representative Terri Lynn Weaver sponsored the new law. When the bill was first being brought to fruition he was quoted as saying,
“It would just seem to me that any society that puts value on life would agree that these defenseless children deserve some protection and these babies need a voice.”
But perhaps what Weaver is unaware of in the vast amounts of fear and stigma surrounding mothers who struggle with substance abuse while pregnant, and how hard it can be to seek treatment.
The First Arrest
Just recently local deputies in Tennessee said they received a call from the Department of Child Services after a baby girl was born at UT Medical Center and after being tested she came up positive for meth. The 26-year-old mother was arrested, and informed of her charges as she was actually being discharged from the hospital.
The young mother is Mallory Loyola. Loyola has had a history of meth-related arrests in the past, and now she is the first woman to be charged with assault under the new Tennessee law that is directed at mothers who take drugs while pregnant. Mallory Loyola was released later on a $2,000 bail, and has been charged with a misdemeanor.
The Sheriff of Monroe County Bill Bivens stated recently that Mallory Loyola had later admitted to smoking meth just days before she had gave birth to her daughter. Sheriff Monroe insists that he hopes the arrest will set a tone for the future in the area. Officials and law enforcement expect it will deter other women from committing the crime and endangering the lives of their children who have not yet been born. The sheriff was quoted as saying,
“Hopefully it will send a signal to other women who are pregnant and have a drug problem to seek help. That’s what we want them to do.”
Opposing Opinions on the Effects
As good as the intentions may be, not everyone in Tennessee believes that this is the best course of action for the war on drugs to take. The law recently came under fire with local and national critics claiming it would have the opposite effect of what lawmakers are hoping to accomplish. Those opposing the new bill say it will greatly deter and intimidate drug-addicted pregnant women from getting the help they need.
The American Civil Liberties Union of Tennessee has stepped up to lead the efforts in combating the legislation. Tennessee ACLU challenges the law, which they said raises “serious constitutional concerns regarding equal treatment under the law.”
Thomas Castelli is the legal director of the ACLU of Tennessee, and in a statement to the presss he had expressed a strong opinion on the opposition of this new policy,
“This dangerous law unconstitutionally singles out new mothers struggling with addiction for criminal assault charges. By focusing on punishing women rather than promoting healthy pregnancies, the state is only deterring women struggling with alcohol or drug dependency from seeking the pre-natal care they need.”
So at this point, the law has already taken effect, and surely there are more arrests on the way, which brings the question as to how will this affect the mothers who currently struggle with substance abuse? Will they feel more prompted to seek help and medical treatment, or will they become more terrified of the implications of seeking treatment? Will this new law truly be making a positive change in the way substance abuse and addiction is being addressed in Tennessee, or will there only be greater complications as a result of these scare tactics?
Mothers and fathers battling substance abuse and addiction experience the suffering in different and intense ways, and so do the children of addicts or alcoholics. But that suffering can be avoided and recovery is possible with the right treatment. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
A landmark test case due to be heard by the Court of Appeal could criminalize heavy drinking during pregnancy. Sky News has reported that it will be disputed that a six-year-old girl is the victim of a crime because she suffered brain damage when she was exposed to alcohol in the womb – a danger that her mother was conscious of.
The case comes amongst a 50 per cent rise in FAS (Fetal Alcohol Syndrome) in the last three years, with 313 impaired from exposure to alcohol in the womb in 2012-2013. Figures from the Department of Health show in total around 1 in 100 babies are now born with alcohol-related conditions. Expert psychiatrist Dr. Raja Mukherjee cautioned that pregnant women do not have to binge-drink to be at jeopardy.
“If you avoid it that’s the safest route,” he told Sky News. “That doesn’t mean that people who’ve drunk a little bit have harmed their child, most people won’t have done, but if you want to guarantee safety and you want to guarantee no risk then no alcohol is the best way forward,” he added.
Sue Brett, the adoptive mother of 15-year-old Glenn who was born with FAS after his mother drank heavily, said women need to be better informed to the risks. She told the news channel: “It should be to abstain from alcohol throughout pregnancy. You can’t make it a criminal offence if you are still legally saying this is a safe amount to drink or you can drink. It needs to be clear from the start that you can’t drink.”
After Glenn was unprotected to alcohol in his mother’s womb, he has physical incapacities affecting his visualization and movement, and the intellectual age of a four-year-old. Susan Fleisher, the creator of the charity NOFAS-UK which supports awareness about the effect of alcohol during pregnancy, come to an agreement that more needs to be done to cut the number of children being affected, but does not think prosecution is the solution.
She stated to sky news that “women can’t be prosecuted for something they don’t know about, and, to be fair, women who are alcoholics, who have an issue with drinking, should be given support and should be given information so they know there’s a chance they could harm another life.”
In my opinion, this issue is very important but can be tricky to deal with. I do believe that if a mother is aware she is pregnant and excessively drinking, that it should be a problem. But if a woman isn’t aware of her pregnancy, how can we punish her for that? You can’t enforce a law and not apply it to everyone and this would be a law that would end up being very circumstantial. I know a few women who drank in the beginning of their pregnancy because they weren’t aware of the fact that they were pregnant. The question is – how would they actually enforce this law? If you or a loved one are struggling with substance abuse or addiction, please call toll free 1-800-951-6135.