Drug addiction and pregnancy: policy crossroads.

Chavkin, Wendy

doi:10.2105/ajph.80.4.483

Cited by 173 publications

(69 citation statements)

References 20 publications

(6 reference statements)

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“…In other cases, such as the value of mandated treatment for new mothers based on a positive neonatal toxicology, differences may reflect deep ideological conflicts about the best policy approach to reducing drug use during pregnancy. 24 In addition, the consequences of one policy may often depend on whether other policies are in place. For example, requiring drug-using women to complete drug treatment prior to regaining custody of their children is a rational but empty policy if drug treatment slots are not available.…”

Section: Discussionmentioning

confidence: 99%

Harlem Service Providers' Perceptions of the Impact of Municipal Policies on Their Clients With Substance Use Problems

Olphen

Freudenberg

2004

Journal of Urban Health: Bulletin of the New York Academy of Me

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Section: Discussionmentioning

confidence: 99%

Harlem Service Providers' Perceptions of the Impact of Municipal Policies on Their Clients With Substance Use Problems

Olphen

Freudenberg

2004

Journal of Urban Health: Bulletin of the New York Academy of Me

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“…44 -46 Indeed, positive newborn urine toxicology screening results have been used as evidence to prosecute mothers criminally as drug users or even as drug traffickers. 45 A more therapeutic model holds that a diagnosis of child neglect is intended to lead to the provision of rehabilitative services to further the best interests of the child. 45,[47][48][49] The American Academy of Pediatrics considers unethical the practice of performing drug screening for the primary purpose of detecting illegal use.…”

mentioning

confidence: 99%

“…45 A more therapeutic model holds that a diagnosis of child neglect is intended to lead to the provision of rehabilitative services to further the best interests of the child. 45,[47][48][49] The American Academy of Pediatrics considers unethical the practice of performing drug screening for the primary purpose of detecting illegal use. 50 The medical literature has not ignored the controversial legal ramifications of criminal prosecution of new mothers.…”

mentioning

confidence: 99%

Perinatal Substance Abuse: The Impact of Reporting Infants to Child Protective Services

MacMahon

1997

Pediatrics

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ABSTRACT. Objective. The purposes of this study were to follow the judicial placement of newborns with positive toxicology screening results and to determine how long such infants remained in foster care, separated from their mothers or other relatives, and the length of court dependency. We also determined the mothers' compliance with court orders, the availability and use of rehabilitative services, factors used by the court to determine the final disposition, and the eventual placement of the infants.Methods. The cohort sample consisted of all infants from San Mateo County (CA) born at Stanford University Hospital during a 2-year period whose urine tests in the well-baby nursery were positive for illicit substances. Fifty-three newborns were identified, and their medical records and court documents were matched and reviewed from birth until termination of judicial review (or 5 years). Data were summarized and analyzed by logistic regressions to identify predictors of specific outcomes.Results. All 53 infants had normal physical examinations and uneventful hospital courses. Their ethnic distribution, with 68% being African-American and 7% being Hispanic, differed from the rest of the nursery population, which was predominantly Hispanic. Twenty-six (46%) of the 53 infants were returned to their mothers within 1 week of birth; 39 (76%) of the infants were reunited with some relative within the first month of life. At 12 months of age, 10 infants (19%) remained in foster care; however, none remained in foster care beyond 18 months. The length of time infants were dependents of the court ranged from 1 month to >5 years; 70% of the cases were "closed" between 6 and 30 months of life. Nine (17%) were dependents of the court for >36 months. Final placement of the infants was 35 (66%) reunited with at least one parent, 9 (17%) in long-term guardianship relationships with other relatives, and 9 (17%) adopted. All of the mothers were ordered to complete a drug rehabilitation program; 24 mothers (44%) fully complied and had repeatedly drug-free urine tests; 2 others (4%) had drug-free urine tests after incomplete participation in drug rehabilitation. Twenty-two (42%) of the mothers never complied with drug rehabilitation. Subsequent drug use was evident in less than half of the mothers during the period of study. Only one mother was reported for child abuse. Characteristics that most strongly predicted failure in family reunification were a history of failed drug rehabilitation, previous involvement of Child Protective Services, or previous removal of a child because of substance abuse.Conclusion. Identifying and reporting newborns exposed to maternal substance abuse during pregnancy can be associated with beneficial changes in the environment of the infants and successful rehabilitation of many mothers. The use of judicial supervision, rehabilitative and supportive services, and long-term involvement of social services without criminal prosecution are key to successful outcome. This study supports the policy and recomme...

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“…This gap between the need for and receipt of services has substantial and long-term effects on the health of these pregnancies and leads to substantial unnecessary financial burden to the health care system (Andrulis & Hopkins, 2001;Chavkin, 1990).…”

Section: Chapter 1 Introductionmentioning

confidence: 99%

Toward Enhancing Treatment for Pregnant Smokers: Laying the Groundwork for the Use of Complementary and Alternative Medicine Approaches

Loree

Ondersma

Grekin

2017

Nicotine &Amp; Tobacco Research

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Drug addiction and pregnancy: policy crossroads.

Cited by 173 publications

References 20 publications

Harlem Service Providers' Perceptions of the Impact of Municipal Policies on Their Clients With Substance Use Problems

Harlem Service Providers' Perceptions of the Impact of Municipal Policies on Their Clients With Substance Use Problems

Perinatal Substance Abuse: The Impact of Reporting Infants to Child Protective Services

Toward Enhancing Treatment for Pregnant Smokers: Laying the Groundwork for the Use of Complementary and Alternative Medicine Approaches

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