In three of the cases in which medical expert testimony was referenced, the expert testimony was contradictory. An official website of the State of Georgia. An official website of the State of Georgia. Key takeaways: In some states in the U.S., healthcare providers are required by law to report substance use during pregnancy. Support a worker-led Appeal. Such policies are rooted in stigma and gross indifference to what the best available science tells us about how to compassionately and effectively serve pregnant women struggling with drug use disorders and their families. Only two courts found for the defendant, in part on the grounds that there was no medical evidence to support the charge. The research that does claim to link substance use to maltreatment of children is not authoritative. Before sharing sensitive or personal information, make sure youre on an official state website. Heroin is an illicit opioid. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. An example of this reasoning was articulated by the majority in State v. Welch: 19 states have either created or funded drug treatment programs specifically targeted to those who are pregnant, and 17 states and the District of Columbia provide pregnant people with priority access to state-funded drug treatment programs. This is a sad situation. Both stand to undermine the medical treatment of pregnant women with substance use disorders and potentially increase harm to mothers and children. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. The discourse about criminalization of substance use in pregnancy suggests that women are at serious risk of successful prosecution for illicit drug use during pregnancy.8,15 Based on our review of published judicial decisions, this does not appear to be the case in most jurisdictions. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. MSACD collaborates with Georgias Alcohol Prevention Providers and their communities in all six of Georgias regions to raise awareness about alcohol and substance abuse among pregnant women. If a woman is drinking alcohol during pregnancy, it is never too late to stop. In 2014, Tennessee became the first (and only) state to pass a law that criminalized drug use during pregnancy, after a district court judge added an additional six years to the prison sentence of a woman who had been involved in a methamphetamine manufacturing operation while pregnant. 96 A 2017 opinion posted by . Mar 02, 2022. More about medicines in pregnancy. 2015), The prevalence of illicit-drug or alcohol use during pregnancy and discrepancies in mandatory reporting in Pinellas County, Florida, Substance use during pregnancy and postnatal outcomes, Punishing pregnant drug users: enhancing the flight from care, Women's perspectives on screening for alcohol and drug use in prenatal care, Drug use and limited prenatal care: an examination of responsible barriers, Universal screening for alcohol and drug use and racial disparities in child protective services reporting, The American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women and American Society of Addiction Medicine, Committee Opinion No 524. Cocaine lingers in a fetus much longer than an adult and often 5-7 days after birth. Under states child abuse law, a parent is considered unfit if they test positive for substances within eight hours after delivery and have previously been convicted of child abuse or neglect or if they failed to complete a drug treatment program recommended by Child Protective Services. Drug addiction is a serious problem, especially when the drug addict is pregnant. Intellectual & Developmental Disabilities, Applications for New & Existing Providers, Improving Health Outcomes Initiative Collaborative Learning Center, How to Report a Concern or Complaint about the Quality of Care or Safety, Facebook page for Georgia Department of Behavioral Health and Developmental Disabilities, Twitter page for Georgia Department of Behavioral Health and Developmental Disabilities, Linkedin page for Georgia Department of Behavioral Health and Developmental Disabilities, The Maternal Substance Abuse and ChildDevelopment, Maternal Substance Abuse and Child Development Project. For example, the court held in State v. Gethers that, fear of prosecution could deter pregnant drug abusers from seeking treatment for drug problems.26 Thus, all of the courts whose decisions functionally overturned convictions or dismissed charges did so on the basis of legislative intent, but varied with respect to additional supporting legal arguments. "Among newborns exposed to opioids in utero, between 55 percent and 94 percent develop withdrawal signsand 30 to 80 . Hence, health care providers should select relatively safe drugs. We also were unable to determine the race or economic status of the defendants and do not know if poor or minority women are overrepresented among the defendants. Daily/near daily cannabis use in the past month increased from 0.9% to 3.4% among pregnant women overall, and from 1.8% to 5.3% during the first trimester; from 0.6% to 2.5% during . by Leticia Miranda, Vince Dixon and Cecilia Reyes A representative example of this due process reasoning was expressed by the court in State v. Martinez: To expand the ordinary meaning of this statute would deny Defendant reasonable notice that her actions were criminal, thereby violating her due process rights.39 Six courts held that allowing the contested statute to apply to prenatal drug use would in effect permit it to be applied to a range of prenatal conduct not previously considered illegal, in effect opening the floodgates to prosecution of pregnant women. Hair has been recognized as a possible alternate test specimen, but wider acceptance of hair testing must await . Georgia regulates the possession of both illegal and prescription drugs. This was lower than the rate among women in this age group who were not pregnant (11.4 percent). Despite progress in the criminal legal system, the drug war remains almost unchallenged in the child protection system, and it is wreaking havoc on families. If you valued this article, please help us produce more journalism like this by making a contribution today. State Policies on Substance Use During Pregnancy. Wisconsin provides priority access to pregnant people in both general and private programs. 2007), State v. Geiser, 763 N.W.2d 469 (N.D. 2009), Cochran v. Commonwealth, 315 S.W.3d 325 (Ky. 2010), State v. Stegall, 828 N.W.2d 526 (N.D. 2013), Arms v. State, 471 S.W.3d 637 (Ark. A substantial body of legal literature traces the development of case law related to substance use during pregnancy and problems with criminalization of pregnant women.15,19,,23 In this article, we systematically review published legal cases of women charged with offenses causing harm to their fetus or child as a result of substance use during pregnancy, wherein the trial court decision was appealed. Supporters of these laws blame the mothers for the dissolution of their families, arguing that the mothers need only enroll in a drug treatment program to retain custody of their children. While a robust body of literature supports a causal connection between prenatal exposure to alcohol or tobacco (or lead or poverty for that matter) and negative postnatal health outcomes, thescientific literaturehas not conclusively demonstrated any long-term negative effect of prenatal exposure to opioids. A new study co-authored by a University of Central Florida researcher shows that laws that punish substance use during pregnancy actually do more harm than good. Drug Use by State: Problem Areas. Women charged with or convicted of crimes against their child or fetus related to substance use during pregnancy have won on appeal much more often than they have lost. 10 states prohibit publicly funded drug treatment programs from discriminating against pregnant people. Opioids are a class of drugs used to manage pain, but also have serious risks, such as addiction. Terminating a mothers rights to her newborn is an especially brutal drug war tactic that research and experience show will inflict far more harm than good on the children and families it allegedly aims to protect. 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. Unless otherwise noted, you can republish our stories for free if you follow these rules. At least in theory, legislatures could amend criminal laws to make clear that they intend them to apply to prenatal conduct that affects fetuses. Based on results of this analysis, the authors jointly finalized the coding scheme, which was then applied to all of the identified cases. Substance use in pregnancy is an important issue in antenatal care. Most states do not have a law that requires hospitals to test infants and new moms for controlled substances. Drug abuse has a long and storied history in the United States, and we've been "at war" with it since 1971 under the Nixon administration. Many substance use treatment services dont accept pregnant women, or are otherwiseinaccessibleto them, despitefederalandstateregulations that require prioritizing them for treatment. Arizona's legislation, which became law in April, permits termination of a mother's parental rights, either immediately when her newborn is born or within one year of her newborn's birth, depending on how chronic the illicit drug use appears to the court. It is part of the non-profit Organization of Teratology Information Specialists (OTIS), a national information network. Exposing how the U.S. criminal legal system fails to keep people safe and perpetuates harm. Unfortunately, many women of childbearing age in the U.S. use some form of illegal drug. Collaborations have included media messages on maternal substance abuse during pregnancy and supplying resources addressing the use of any substance. 31]. Twelve opinions noted that other jurisdictions ruled similarly when faced with such cases. CDCs Division of Reproductive Health (DRH) provides scientific leadership in the surveillance of marijuana use during pregnancy. To learn about CDC activities to educate the public about the harms of tobacco use, visit Tips From Former Smokers (Tips) from the Office on Smoking and Health. The report also found that Kentuckys child protection agency was not making enough efforts to prevent removal or re-entry to foster care. But, for that matter, she could have been a pregnant alcoholic, causing fetal alcohol syndrome; or she could have been addicted to self abuse by smoking, or by abusing prescription painkillers, or over-the-counter medicine; or for that matter she could have been addicted to downhill skiing or some other sport creating serious risk of prenatal injury, risk which the mother wantonly disregarded as a matter of self-indulgence. Among pregnant women aged 15 to 44, the average . Contributions are tax deductible to the fullest extent allowable. The state argued that the drug delivery occurred via the umbilical cord in the period after birth but before the cord was clamped. This is all exacerbated by a series of measures Arizona has undertaken to constrict its social safety net, leaving families struggling with inadequate access to cash, food, housing, child care, and transportation. Local, state, and federal government websites often end in .gov. *The Alabama Supreme Court held that drug use while pregnant is considered chemical endangerment of a child. The survey also notes that if prenatal drug use is suspected, Illinois, Michigan, Ohio and Wisconsin require health professionals to report it while Indiana requires pregnant women to be tested; Iowa, Minnesota, North Dakota and South Dakota require both. CPS immediately removed her newborn from her care, largely based on evidence of her opioid use. Some research shows that marijuana use during pregnancy is linked to health concerns, including high use of other substances that may impact pregnancy and infant health such as tobacco, and developmental problems in adolescents. Maternal deaths in the United States are increasing. This conclusion should not be a surprise, given that appellate decisions are based on interpretation of law, not facts. Some research shows that marijuana use during pregnancy is linked to health concerns, including high use of other substances that may impact pregnancy and infant health such as tobacco, and developmental problems in adolescents. 25states and the District of Columbia require health care professionals to report suspected prenatal drug use, and 8states require them to test for prenatal drug exposure if they suspect drug use. Criminalization has taken many forms including, but not limited to, the passage of fetal assault laws, policies that punish or penalize pregnant people for substance use during pregnancy, and the practice of judicial intervention or legal attempts at coercion for refusal of care during pregnancy. Opioid use disorder among pregnant women is a significant public health concern in the United States. 1996), State v. Aiwohi, 123 P.3d 1210 (Haw. The Guttmacher Institute is registered as a 501(c)(3) nonprofit organization under the tax identification number 13-2890727. Between 2002-2003 and 2016-2017, past-month cannabis use increased from 3.4% to 7.0% among pregnant women overall and from 5.7% to 12.1% during the first trimester. The groups listed below help people with drug abuse. On June 13, 1997, the governor of Tennessee signed House Bill 1413, making it a Class A misdemeanor for child abuse where: (1) a woman consumes alcohol or illegal drugs during pregnancy with knowledge or the reason to know that such consumption may result in harm to her child; and (2) the child is born addicted to alcohol or drugs. In the three judicial opinions that upheld convictions, the court determined that the legislature intended to include fetuses in the definition of child for the purposes of the relevant statute. The following information can help you understand [] " Among pregnant women aged 15 to 44, 5.4 percent were current illicit drug users based on data averaged across 2012 and 2013. We conducted a LexisNexis search of published U.S. state and federal cases in these categories using the following search terms: pregnant OR pregnancy AND cocaine OR methadone OR heroin OR controlled substance OR methamphetamine OR narcotic AND child abuse OR child neglect OR child endangerment OR assault OR homicide OR murder OR manslaughter. As part of CDCs efforts to prevent overdoses and substance use-related harms, CDC is taking specific actions to prevent opioid use disorder among pregnant women and women who could become pregnant and to make sure women with opioid use disorder get proper treatment. Opioid use disorder during pregnancy has been linked with serious negative health outcomes for pregnant women and developing babies, including preterm birth, stillbirth, maternal mortality, and neonatal abstinence syndrome (NAS). In all of the cases, the judicial decision depended on the disposition of the question of whether, for the purpose of adjudicating the criminal charges, a fetus is a child. Ct. App. 2005), Kilmon v. State, 905 A.2d 306, 314 (Md. You will be subject to the destination website's privacy policy when you follow the link. Ct. App. Smoking during pregnancy increases the risk of health problems for developing babies, including preterm birth, low birth weight, and birth defects of the mouth and lip. Proceedings resulted in dismissal of the charges or convictions overturned for 86.2 percent of the women. Maternal Substance Abuse and Child Development Project The laws can vary widely from state to state in terms of reporting requirements and consequences of reporting. Learn about the Division of Reproductive Healths efforts to address opioid use disorder to improve maternal and infant health. We do not know the role that medical expertise and testimony played in influencing the judicial outcome at the trial court level. For tips and advice to quit smoking, you can also visit How to Quit and Pregnancy, Motherhood, and Smoking. In the subsequent months, M. saw her son once a week at best. "Opioids are what we worry about most," he explained. State laws vary, but at least 23 states and the District of Columbia articulate that substance use during pregnancy is child abuse, and virtually every state in the U.S. will open an investigation (at the very least) into a person who tests positive for substances during or shortly after pregnancy. Charges included child endangerment, child abuse, drug delivery, attempted aggravated child abuse, chemical endangerment of a child, child neglect, child mistreatment, homicide, manslaughter, and reckless injury to a child. Narcotics Anonymous World Service Office in Los Angeles PO Box 9999 Van Nuys, California 91409 Telephone: (818) 773-9999 Fax: (818) 700-0700 Web site: www.na.org Substance Abuse and Mental Health Services Administration Here is a survey of state laws. Medical and public health authoritieswarn that women who fear losing their babies upon seeking medical care will bedeterredfrom seeking the care they need. With the U.S. Supreme Court considering a high-profile case involving the prosecution of pregnant substance abusers, policymakers and advocates once again are confronted with the decade-old question of how best to deal with pregnant women who use drugs. Because drug use during pregnancy can potentially harm a fetus, federal law requires state CPS agencies maintain a protocol for when babies are born with drugs in their system or showing drug withdrawals. You can review and change the way we collect information below. Reyes was charged with two counts of felony child endangerment for her heroin use These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. While some papers estimate that 1-3% of birth defects are thought to be caused by medications taken during pregnancy, the authors could not find a source for this statement that was based on study d. A November study published in the Journal of the American Medical Association tracked the rise of laws that criminalized taking drugs while pregnant, as well as classifying drug use during pregnancy as child abuse that could result in loss of custody rights or as grounds for a civil commitment. Georgia Marijuana Statutes This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. The child was placed with CPS and now is in the custody of the great grandmother. Fetal or infant toxicology was reported in 24 of the pregnancies, and included positive findings for cocaine (n = 13), heroin (n = 1), and methamphetamine (n = 8) and one case wherein testing was negative for the relevant drug oxycodone, but the infant nonetheless displayed signs of withdrawal.31. Prosecuting Women for Drug Use During Pregnancy: The Criminal Justice System Should Step Out and the Affordable Care Act Should Step Up. If you regularly use drugs, it's important to tackle this now you're pregnant. The balance in the courts in favor of treating substance use during pregnancy as a medical problem depends on the definition of a child for the purposes of criminal statutes. Georgia drug possession laws treat the crime very seriously and a conviction for possession of even a small amount of an illegal drug can subject you to serious penalties. In the 22 judicial opinions wherein charges were dismissed or convictions overturned, all held that the legislature did not intend to include fetuses in the definition of a child or victim in the relevant statute. Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. 1 Unhealthy drug use is more commonly reported by young adults aged 18 to 25 . To view abstracts of recent publications in PubMed, see Prevalence and patterns of marijuana use among pregnant and nonpregnant women of reproductive age and Marijuana use during and after pregnancy and association of prenatal use on birth outcomes: A population-based study. These cookies may also be used for advertising purposes by these third parties. State laws now vary considerably in their approach to the problem, reflecting a deep division in public opinion. 1994), Reinesto v. Superior Court, 894 P.2d 733 (Ariz. Ct. App. New Jersey, however, does not view drug use during pregnancy as constituting child abuse or neglect on its own, unlike other states. These 24 cases included 29 women in 19 states who were prosecuted for criminal charges related to harm to a fetus or child as a result of substance use during pregnancy. In totality, medical expertise seemed to play relatively little role in determining the outcome of most judicial decisions. The South Carolina Supreme Court held that a viable fetus is a "person" under the state's criminal child-endangerment statute and that "maternal acts endangering or likely to endanger the life, comfort, or health of a viable fetus" constitute criminal child abuse. Fetal Assault Laws. A neonatologist who was an expert witness for the defense testified that the cocaine derivatives present in the children's urine were from exchange between the womb and placenta during pregnancy and that only a tiny amount of cocaine derivative could have passed through the umbilical cord during the 30- to 60-second period after the child was born and before the umbilical cord was cut. Subscribe to our newsletters for regular updates, analysis and context straight to your email. You can also call 1-800-QUIT-NOW (1-800-784-8669) for free support. Drugs with evidence of fetal harm were widely used. Community after community has seen this in the aftermath oflocal crackdownson drug-using pregnant womenfewer women seek prenatal care and substance use treatment, even after the local authorities decide to change course. We reviewed legal decisions regarding women charged with a crime against a fetus or child as a result of substance use during pregnancy. Neonatal abstinence syndrome (NAS) is itself a treatable and transient condition, anda growing body of literatureconfirms 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. To learn about CDC activities to prevent fetal alcohol spectrum disorders, visit About Us from the National Center on Birth Defects and Developmental Disabilities. She had become dependent on opioids, but when she learned she was pregnant, she immediately tried to enroll in a medication assisted treatment (MAT) program. In jurisdictions where criminal charges are permitted, dispositions for convicted women should be treatment oriented. A drug possession conviction in Georgia also results in the suspension of your driver's license. DRH presents state and national estimates of marijuana use among pregnant women. The Maternal Substance Abuse and ChildDevelopment (MSACD) Project focuses on theprevention of negative consequences of a maternalsubstance use through a variety of services. All of these cases were appellate decisions except for one published trial court decision,24 which we discuss separately, given that trial court decisions are not typically published and do not resolve matters of law. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Drug use during pregnancy is a severe problem worldwide because it exposes not only the woman but also her developing baby to harmful substances. It's best not to stop abruptly without first seeking medical advice as there may be . Using illegal drugs while pregnant can cause many complications to the baby including brain damage, premature birth, low birth weight and even fetal death. Several methods of drug testing are efficacious in identifying and monitoring drug use during pregnancy. In contrast, state legislatures could choose to preclude attempted efforts at prosecution with amendments that make explicit that existing laws are not meant to apply to prenatal conduct that may affect fetuses. Although briefs from medical or public health organizations supporting the defendants' position were submitted to the court in 29 percent of the cases (n = 7), only one majority ruling directly referenced a medical or public health organization amicus brief. An obvious example is the recent Tennessee law that explicitly made illicit drug use during pregnancy a form of criminal assault. Women might use opioids as prescribed, misuse prescription opioids, use illicit opioids such as heroin, or use opioids (opioid agonists and/or antagonists) as treatment for opioid use disorder. The use of tobacco and alcohol are common (these are discussed in Sections 12 and 13) but the use of illicit substances and the misuse of prescription medications is also important. In that way, this legislations attempt to punish mothers and fathers acts as a civil death penalty for families, for which children will pay the ultimate price.. Reproductive rights are under attack. If youre using marijuana and are pregnant or are planning to become pregnant, talk to your healthcare provider. Clear evidence suggests that recognizing the substance exposed infant and . Opioids can be prescription or illicit. There are several limitations to this study. However, pregnant women with a disease called phenylketonuria shouldn't eat or drink aspartame. A newborn infant's death nearly 15 years ago is still causing a fierce legislative battle in Arizona and other states around the country. M. thought she was doing the right thing. The Center for MSACD also provides training, workshops, and other informational services concerning prenatal exposure to alcohol, nicotine, illicit drugs, and prescription drugs. These may include the medical model of substance use disorders,4 racial disparities in substance use screening and reporting in pregnancy,47 and the difficulty of attributing a particular birth outcome to a single cause.48, Criminalization of pregnant women for substance abuse is fraught with problems related to conceptual and practical implementation, even if in theory one believes that substance use in pregnancy is both a moral dilemma and a medical problem. 1991), State v. Luster, 419 S.E.2d 32 (Ga. Ct. App. MSACD is committed to raising the awareness of thedevastating effects of alcohol and other substances whenused during pregnancy. This claim also disregards the seriousgapsin access to treatment for substance use disorders, especially for poor people, and the absence of a social safety net to even support struggling families in the first place. Good reproductive health policy starts with credible research. The report pays particular attention to the impact of the 'chemical endangerment' law in Alabama, the state that has carried out the most prosecutions against pregnant women; and Tennessee's 'fetal assault' law, which between 2014 and 2016 made it a crime to give birth to a child showing symptoms of drug exposure. Heavy use of marijuana - that is, marijuana with high amounts of THC - has been linked to decreased fertility in both men and women. They have 1 child together that was born prematurely due to her drug use. 1992), Johnson v. State, 602 So.2d 1288 (Fla. 1992), State v. Gray, 584 N.E.2d 710 (Ohio 1992), Commonwealth v. Welch, 864 S.W.2d 280, 283 (Ky. 1993), Sheriff, Washoe County, Nevada v. Encoe, 885 P.2d 596 (Nev. 1994), Collins v. State, 890 S.W.2d 893 (Tex. While medication assisted treatment (MAT) is covered under Arizonas newly expanded Medicaid programs, Arizonans still struggle withaccessto MAT treatment. Three of the key areas in which they can have an effect are 1) adhering to safe prescribing practices, 2) encouraging healthy behaviors by providing appropriate information and education, and 3) identifying and referring patients already abusing drugs to addiction treatment professionals 13. For example, onestudyfound that parents who use opiates find babies less cutewhile conceivably notable, this finding does not meet the legal standard for terminating a parents rights. "Complex Calculations: How Drug Use during Pregnancy Becomes a Barrier to Prenatal Care." . The state legislature passed the law in 2014 explicitly to permit criminal assault charges for illicit substance use in pregnancy and, on conviction, imprisonment.10 The impetus for the law was rapidly rising rates of neonatal abstinence syndrome, an opioid withdrawal syndrome in infants that may require prolonged monitoring in intensive care units.12 The law expired on July 1, 2016, based on a sunset provision in the original bill.10 No other states have similar criminal statutes, but two other state legislatures recently debated criminalization to combat the opioid epidemic.13,14. Arizona also has the strictest TANF timeline in the nation, kicking families off welfare after one year. The overwhelming majority of parents prosecuted by the child welfare system are poor, and parents ofcolorare overrepresented. Y.N., 104 A.3d 244 (N.J. 2014), Late-Onset Sex Offending and the Assessment of Behavioral Variant Frontotemporal Dementia (bvFTD), Factors Associated with Successful Completion of Juvenile Mental Health Court, by The American Academy of Psychiatry and the Law, https://www.guttmacher.org/statecenter/spibs/spib_SADP.pdf/, http://www.tennessean.com/story/opinion/contributors/2014/05/10/tennessee-voices-drug-use-pregnancy-epidemic/8914401/, http://wpde.com/news/videos/regina-mcknight-released-from-prison/, 2017 American Academy of Psychiatry and the Law.