December 8, 2015 — State laws that penalize pregnant women who use drugs are correlated with a decreased likelihood that women will receive the appropriate health care, according to research presented last week at the annual meeting of the American Academy of Addiction Psychiatry, MedPage Today reports (Brown, MedPage Today, 12/4).
Background on Laws Criminalizing Pregnant Women's Drug Use
Some states are working to penalize pregnant women who use drugs, countering advice from medical groups that recommend treatment instead. In some cases, the states are responding to reported increases in drug use.
According to a report from the Guttmacher Institute, 18 states currently classify drug use by a pregnant woman to be a form of child abuse, and few of those states overlap with the 19 states that have established or funded programs designed to treat pregnant women who use drugs. Specifically, 10 of the 18 states that classify drug use as a form of child abuse have not established drug treatment programs for pregnant women. Similarly, only six of the 15 states that impose mandatory reporting requirements for suspected substance use have funded or established such programs. Further, some states, such as Tennessee, have imposed additional penalties on pregnant women who use drugs.
Meanwhile, the American Congress of Obstetricians and Gynecologists and the American Civil Liberties Union, among other groups, have criticized the penalization of pregnant women for substance use. CDC and ACOG, for example, have urged states to reduce substance use among pregnant women through treatment programs instead. ACOG and ACLU also have noted that laws such as Tennessee's discourage women from seeking prenatal care rather than encouraging them to seek treatment (Women's Health Policy Report, 8/13).
For the study, researchers examined more than 8,000 cases in 2012 of pregnant women who sought treatment for opioid dependency.
Overall, the researchers found that medication-assisted treatment, which is the standard of care, was used in 46% of all cases. More specifically, the study found that medication-assisted treatment was used in 33.15% of admissions in states with prenatal drug use laws, compared with 51.33% of admissions in states that do not have such laws.
Further, the study found that when criminal justice systems in states that have prenatal child abuse laws directed women to treatment, medication-assisted treatment was used in only 11% of cases. Meanwhile, when criminal justice systems in states that do not have such laws directed women to treatment, medication-assisted treatment was used in 21% of cases.
According to MedPage Today, half of states with prenatal substance use laws are in the South, where medication-assisted treatment is not as common. Cornell University's Carol Weiss, one of the study authors, said the criminal justice system in southern states directed women to medication-assisted treatment significantly less often than other sources such as drug counselors, other medical professionals or community referrals.
Weiss said, "There's a correlation between states that have laws saying that pregnant [women who use drugs] are committing child abuse and can lose their child, and states that refer these [women] less frequently to treatment." She added, "So they both punish them and don't have the appropriate treatment and don't refer them to the appropriate treatment."
According to Weiss, medication-assisted treatment is the safest form of treatment for pregnant women who use drugs, and numerous professional groups consider it the standard of care. She said research has shown that such treatment was "uncontroversially safer" than other options. "Laws that charge pregnant [women who use drugs] with child abuse actually harm the [woman] and the fetus," she said (MedPage Today, 12/4).