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The enactment of a Tennessee law that criminalizes substance abuse by pregnant women has made patients increasingly hesitant to pursue treatment for their drug addictions, according to Dr. Jessica Young, an obstetrician/gynecologist at Vanderbilt University Medical Center in Nashville, Tenn.
Tennessee’s law, which became effective in July, defines illegal narcotic use by pregnant women as assault, depending on whether the child is born addicted to or is harmed by the narcotic. A 26-year-old woman was among the first to be arrested in mid-July under the law.
"Since the new law was passed, women . . . often express a fatalistic attitude of, ‘Even if I do the right thing, I will be arrested or have my baby taken away,’ " said Dr. Young, who leads the Vanderbilt Drug Dependency Clinic for pregnant women.
The concern is that women will hide their addictions or self-detox at home, she said. "I think it will require some negative outcomes for this law to be struck down."
Physician associations, including the American Medical Association and ACOG, have long maintained that criminal punishment is not the answer to curbing drug abuse by pregnant women and that such laws create further harm to children. Fear of being reported to police was a primary reason women who abused drugs did not seek prenatal care, a recent study found (Am. J. Obstet. Gynecol. 2009;200:412.e1-10).
Laws that mandate criminal penalties against pregnant women who use drugs can significantly harm the physician-patient relationship, according to Dr. John M. Thorp, professor of obstetrics and gynecology at the University of North Carolina and director of women’s primary health care for UNC Healthcare, both in Chapel Hill.
These laws "put the physician or the clinic or hospital in the role of reporting the crime, which is completely the antithesis of wanting patients to be able to tell physicians what’s wrong with them and being able to offer treatment instead of punishment," Dr. Thorp said in an interview. "These laws are a real setback to the concept that substance abuse addiction is a disease, [and they are] another barrier for women seeking treatment."
Tennessee is the only state to consider drug abuse by pregnant women to be "assault." The law states that a woman may be prosecuted for assault if her child is born addicted or harmed by the drug and for homicide if the child dies from drug exposure. It is an affirmative defense to prosecution if the woman is actively enrolled in an addiction recovery program before the baby is born, remains in the program after delivery, and successfully completes the program.
The American Civil Liberties Union of Tennessee plans to challenge the law in court.
The Tennessee Medical Association opposed the law, but successfully pushed for amendments that would lessen the punitive damages against women, Dave Chaney, TMA director of communications, said in an interview. The medical association successfully lobbied to lower the charging level in the bill to a misdemeanor and helped secure a stipulation that women who enter a treatment program be punished only by a fine.
Various states pursue criminal charges against pregnant women who use narcotics. Eighteen states consider substance abuse during pregnancy to be "child abuse," and three other states consider substance abuse during pregnancy to be grounds for civil commitment, according to an August 2014 analysis by the Guttmacher Institute. Fifteen states require physicians to report suspected prenatal drug abuse to authorities, and four states require health providers to test for prenatal drug exposure if they suspect substance abuse.
Other states could soon follow in Tennessee’s footsteps, Elizabeth Nash, Guttmacher Institute state issues manager, said in an interview. "Legislatures see what’s happening in other states and decide whether it may be right for them."
Meanwhile, a newly proposed federal bill could assist states in addressing the issue of drug-addicted pregnant mothers and babies and drive more effective responses to the crisis. The Protecting Our Infants Act, introduced July 31 by Rep. Mitch McConnell (R-Ky.), aims to better identify and treat opioid use by pregnant women and neonatal abstinence syndrome (NAS) in newborns. The legislation is backed by ACOG.
"Currently, states vary widely in how they mandate and administer screening, diagnosis, and treatment of pregnant women using opioids," ACOG President John C. Jennings said in a statement. The federal "legislation will help identify, compile, and disseminate best practices developed by medical professional organizations, including ACOG, and identify any gaps in best practices that may require additional research or analysis."
The proposed legislation would facilitate the research and dissemination of evidence-informed recommendations for addressing maternal addiction and NAS and provide for NAS studies. The measure also would encourage the Centers for Disease Control and Prevention to work with states to improve the availability and quality of data to more effectively respond to drug-addicted pregnant women. At this article’s deadline, the proposed act was in the Committee on Health, Education, Labor and Pensions.
"My legislation is no silver bullet, but it will help ensure that our public health system is better equipped to prevent and treat opiate addiction in mothers and their newborn children," Mr. McConnell said in a statement. "Together, we can overcome this tragic problem."
Developing resources that promote better medical care for addicted women and their children is a more effective answer than punitive laws, added Hendree Jones, Ph.D., a professor of obstetrics and gynecology at the university and executive director of the UNC Horizons programs. Horizons provides substance abuse treatment and child care to women who are pregnant or parenting young children.
"Incarcerating women to reduce the prevalence of drug use during pregnancy is a misguided solution to the issue," Dr. Jones said in an interview. "Increasing access to high-quality treatment would be a much more fruitful approach."
On Twitter @legal_med
The enactment of a Tennessee law that criminalizes substance abuse by pregnant women has made patients increasingly hesitant to pursue treatment for their drug addictions, according to Dr. Jessica Young, an obstetrician/gynecologist at Vanderbilt University Medical Center in Nashville, Tenn.
Tennessee’s law, which became effective in July, defines illegal narcotic use by pregnant women as assault, depending on whether the child is born addicted to or is harmed by the narcotic. A 26-year-old woman was among the first to be arrested in mid-July under the law.
"Since the new law was passed, women . . . often express a fatalistic attitude of, ‘Even if I do the right thing, I will be arrested or have my baby taken away,’ " said Dr. Young, who leads the Vanderbilt Drug Dependency Clinic for pregnant women.
The concern is that women will hide their addictions or self-detox at home, she said. "I think it will require some negative outcomes for this law to be struck down."
Physician associations, including the American Medical Association and ACOG, have long maintained that criminal punishment is not the answer to curbing drug abuse by pregnant women and that such laws create further harm to children. Fear of being reported to police was a primary reason women who abused drugs did not seek prenatal care, a recent study found (Am. J. Obstet. Gynecol. 2009;200:412.e1-10).
Laws that mandate criminal penalties against pregnant women who use drugs can significantly harm the physician-patient relationship, according to Dr. John M. Thorp, professor of obstetrics and gynecology at the University of North Carolina and director of women’s primary health care for UNC Healthcare, both in Chapel Hill.
These laws "put the physician or the clinic or hospital in the role of reporting the crime, which is completely the antithesis of wanting patients to be able to tell physicians what’s wrong with them and being able to offer treatment instead of punishment," Dr. Thorp said in an interview. "These laws are a real setback to the concept that substance abuse addiction is a disease, [and they are] another barrier for women seeking treatment."
Tennessee is the only state to consider drug abuse by pregnant women to be "assault." The law states that a woman may be prosecuted for assault if her child is born addicted or harmed by the drug and for homicide if the child dies from drug exposure. It is an affirmative defense to prosecution if the woman is actively enrolled in an addiction recovery program before the baby is born, remains in the program after delivery, and successfully completes the program.
The American Civil Liberties Union of Tennessee plans to challenge the law in court.
The Tennessee Medical Association opposed the law, but successfully pushed for amendments that would lessen the punitive damages against women, Dave Chaney, TMA director of communications, said in an interview. The medical association successfully lobbied to lower the charging level in the bill to a misdemeanor and helped secure a stipulation that women who enter a treatment program be punished only by a fine.
Various states pursue criminal charges against pregnant women who use narcotics. Eighteen states consider substance abuse during pregnancy to be "child abuse," and three other states consider substance abuse during pregnancy to be grounds for civil commitment, according to an August 2014 analysis by the Guttmacher Institute. Fifteen states require physicians to report suspected prenatal drug abuse to authorities, and four states require health providers to test for prenatal drug exposure if they suspect substance abuse.
Other states could soon follow in Tennessee’s footsteps, Elizabeth Nash, Guttmacher Institute state issues manager, said in an interview. "Legislatures see what’s happening in other states and decide whether it may be right for them."
Meanwhile, a newly proposed federal bill could assist states in addressing the issue of drug-addicted pregnant mothers and babies and drive more effective responses to the crisis. The Protecting Our Infants Act, introduced July 31 by Rep. Mitch McConnell (R-Ky.), aims to better identify and treat opioid use by pregnant women and neonatal abstinence syndrome (NAS) in newborns. The legislation is backed by ACOG.
"Currently, states vary widely in how they mandate and administer screening, diagnosis, and treatment of pregnant women using opioids," ACOG President John C. Jennings said in a statement. The federal "legislation will help identify, compile, and disseminate best practices developed by medical professional organizations, including ACOG, and identify any gaps in best practices that may require additional research or analysis."
The proposed legislation would facilitate the research and dissemination of evidence-informed recommendations for addressing maternal addiction and NAS and provide for NAS studies. The measure also would encourage the Centers for Disease Control and Prevention to work with states to improve the availability and quality of data to more effectively respond to drug-addicted pregnant women. At this article’s deadline, the proposed act was in the Committee on Health, Education, Labor and Pensions.
"My legislation is no silver bullet, but it will help ensure that our public health system is better equipped to prevent and treat opiate addiction in mothers and their newborn children," Mr. McConnell said in a statement. "Together, we can overcome this tragic problem."
Developing resources that promote better medical care for addicted women and their children is a more effective answer than punitive laws, added Hendree Jones, Ph.D., a professor of obstetrics and gynecology at the university and executive director of the UNC Horizons programs. Horizons provides substance abuse treatment and child care to women who are pregnant or parenting young children.
"Incarcerating women to reduce the prevalence of drug use during pregnancy is a misguided solution to the issue," Dr. Jones said in an interview. "Increasing access to high-quality treatment would be a much more fruitful approach."
On Twitter @legal_med
The enactment of a Tennessee law that criminalizes substance abuse by pregnant women has made patients increasingly hesitant to pursue treatment for their drug addictions, according to Dr. Jessica Young, an obstetrician/gynecologist at Vanderbilt University Medical Center in Nashville, Tenn.
Tennessee’s law, which became effective in July, defines illegal narcotic use by pregnant women as assault, depending on whether the child is born addicted to or is harmed by the narcotic. A 26-year-old woman was among the first to be arrested in mid-July under the law.
"Since the new law was passed, women . . . often express a fatalistic attitude of, ‘Even if I do the right thing, I will be arrested or have my baby taken away,’ " said Dr. Young, who leads the Vanderbilt Drug Dependency Clinic for pregnant women.
The concern is that women will hide their addictions or self-detox at home, she said. "I think it will require some negative outcomes for this law to be struck down."
Physician associations, including the American Medical Association and ACOG, have long maintained that criminal punishment is not the answer to curbing drug abuse by pregnant women and that such laws create further harm to children. Fear of being reported to police was a primary reason women who abused drugs did not seek prenatal care, a recent study found (Am. J. Obstet. Gynecol. 2009;200:412.e1-10).
Laws that mandate criminal penalties against pregnant women who use drugs can significantly harm the physician-patient relationship, according to Dr. John M. Thorp, professor of obstetrics and gynecology at the University of North Carolina and director of women’s primary health care for UNC Healthcare, both in Chapel Hill.
These laws "put the physician or the clinic or hospital in the role of reporting the crime, which is completely the antithesis of wanting patients to be able to tell physicians what’s wrong with them and being able to offer treatment instead of punishment," Dr. Thorp said in an interview. "These laws are a real setback to the concept that substance abuse addiction is a disease, [and they are] another barrier for women seeking treatment."
Tennessee is the only state to consider drug abuse by pregnant women to be "assault." The law states that a woman may be prosecuted for assault if her child is born addicted or harmed by the drug and for homicide if the child dies from drug exposure. It is an affirmative defense to prosecution if the woman is actively enrolled in an addiction recovery program before the baby is born, remains in the program after delivery, and successfully completes the program.
The American Civil Liberties Union of Tennessee plans to challenge the law in court.
The Tennessee Medical Association opposed the law, but successfully pushed for amendments that would lessen the punitive damages against women, Dave Chaney, TMA director of communications, said in an interview. The medical association successfully lobbied to lower the charging level in the bill to a misdemeanor and helped secure a stipulation that women who enter a treatment program be punished only by a fine.
Various states pursue criminal charges against pregnant women who use narcotics. Eighteen states consider substance abuse during pregnancy to be "child abuse," and three other states consider substance abuse during pregnancy to be grounds for civil commitment, according to an August 2014 analysis by the Guttmacher Institute. Fifteen states require physicians to report suspected prenatal drug abuse to authorities, and four states require health providers to test for prenatal drug exposure if they suspect substance abuse.
Other states could soon follow in Tennessee’s footsteps, Elizabeth Nash, Guttmacher Institute state issues manager, said in an interview. "Legislatures see what’s happening in other states and decide whether it may be right for them."
Meanwhile, a newly proposed federal bill could assist states in addressing the issue of drug-addicted pregnant mothers and babies and drive more effective responses to the crisis. The Protecting Our Infants Act, introduced July 31 by Rep. Mitch McConnell (R-Ky.), aims to better identify and treat opioid use by pregnant women and neonatal abstinence syndrome (NAS) in newborns. The legislation is backed by ACOG.
"Currently, states vary widely in how they mandate and administer screening, diagnosis, and treatment of pregnant women using opioids," ACOG President John C. Jennings said in a statement. The federal "legislation will help identify, compile, and disseminate best practices developed by medical professional organizations, including ACOG, and identify any gaps in best practices that may require additional research or analysis."
The proposed legislation would facilitate the research and dissemination of evidence-informed recommendations for addressing maternal addiction and NAS and provide for NAS studies. The measure also would encourage the Centers for Disease Control and Prevention to work with states to improve the availability and quality of data to more effectively respond to drug-addicted pregnant women. At this article’s deadline, the proposed act was in the Committee on Health, Education, Labor and Pensions.
"My legislation is no silver bullet, but it will help ensure that our public health system is better equipped to prevent and treat opiate addiction in mothers and their newborn children," Mr. McConnell said in a statement. "Together, we can overcome this tragic problem."
Developing resources that promote better medical care for addicted women and their children is a more effective answer than punitive laws, added Hendree Jones, Ph.D., a professor of obstetrics and gynecology at the university and executive director of the UNC Horizons programs. Horizons provides substance abuse treatment and child care to women who are pregnant or parenting young children.
"Incarcerating women to reduce the prevalence of drug use during pregnancy is a misguided solution to the issue," Dr. Jones said in an interview. "Increasing access to high-quality treatment would be a much more fruitful approach."
On Twitter @legal_med
