It’s Time to Support, Rather Than Punish, Pregnant Women With Substance Use Disorder

Daisy Goodman,Lucy C. Hodder,Bonny Whalen

doi:10.1001/jamanetworkopen.2019.14135

Abstract

Association of State Policies Related to Substance Use in Pregnancy With Rates of Neonatal Abstinence Syndrome

Highlights

Increasing prevalence of opioid use disorder (OUD) among pregnant women in recent years has led state policy makers and health care professionals alike to focus on reducing rates of neonatal abstinence syndrome (NAS) and associated complications experienced by families
Faherty et al[1] reported no apparent association between rates of NAS and the enactment of policies that require reporting of prenatal substance use to child protection services (CPS), suggesting that “reporting policies are more likely to result in conversations between clinicians and pregnant women that result in decreased opioid use or greater engagement in treatment for opioidrelated complications, actions that may decrease rates of NAS.”
Qualitative studies on this topic have suggested that women who fear losing custody of their children may not see much distinction between policies defining maternal substance use as child abuse and those which require reporting substance use to CPS based on prenatal substance exposure alone

Summary

Introduction

Increasing prevalence of opioid use disorder (OUD) among pregnant women in recent years has led state policy makers and health care professionals alike to focus on reducing rates of neonatal abstinence syndrome (NAS) and associated complications experienced by families. Faherty et al[1] reported no apparent association between rates of NAS and the enactment of policies that require reporting of prenatal substance use to child protection services (CPS), suggesting that “reporting policies are more likely to result in conversations between clinicians and pregnant women that result in decreased opioid use or greater engagement in treatment for opioidrelated complications, actions that may decrease rates of NAS.” We are not convinced.

Results

Conclusion