Maternal Substance Abuse and Infant Health: Policy Options across the Life Course

Frohna, John G.; Lantz, Paula M.; Pollack, Harold A.

doi:10.1111/1468-0009.00151

Cited by 16 publications

(18 citation statements)

References 144 publications

(121 reference statements)

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“…The heightened concern about the public health and economic consequences of maternal substance abuse led to several social policy initiatives (Frohna, Lantz & Pollack 1999). In the most extreme cases, these responses have included efforts to criminalize drug use during pregnancy under existing child endangerment statutes, as occurred in South Carolina (Harris & Paltrow 2003).…”

Section: Policy Influences On the Provision Of Substance Abuse Treatmmentioning

confidence: 99%

From Generic to Gender-Responsive Treatment: Changes in Social Policies, Treatment Services, and Outcomes of Women in Substance Abuse Treatment

Grella

2008

Journal of Psychoactive Drugs

179

177

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In the past three decades, there has been increased recognition of the role of gender in influencing the course of substance use and treatment utilization. Concurrently, a substantial body of research on gender-related issues and substance abuse and its treatment has developed. This article reviews (I) policy initiatives that led to the growth of "specialized" treatment programs and services for women and recent policy changes that influence the provision of substance abuse treatment to women;(2) gender differences in the pre valence of substance use disorders and admissions to treatment; (3) gender differences in treatment needs, utilization, and outcomes, including long-term outcomes following treatment; ( 4) organizational characteristics of substance abuse treatment providers for women and the types of services provided in these programs; (5) treatment outcomes in gender-specific programs for women; and (6) the effectiveness of evidence-based treatment practices that have either been modified, or have the potential to be adapted, to address the treatment needs of women. This body of research is viewed within the context of a series of paradigm shifts from a generic treatment approach to a focus on gender differe nces and gender specificity and, most recently, to an emergent focus on gender responsiveness.

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Section: Policy Influences On the Provision Of Substance Abuse Treatmmentioning

confidence: 99%

From Generic to Gender-Responsive Treatment: Changes in Social Policies, Treatment Services, and Outcomes of Women in Substance Abuse Treatment

Grella

2008

Journal of Psychoactive Drugs

179

177

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“…28 Although prenatal smoking cessation services provide welldocumented benefits, they have only a small impact on the population incidence of SIDS. Enrolling all pregnant smokers in typical programs is estimated to avert 3.5% of all SIDS deaths, representing fewer than 12% of SIDS deaths within the smoking-exposed group.…”

Section: Discussionmentioning

confidence: 99%

Sudden infant death syndrome, maternal smoking during pregnancy, and the cost-effectiveness of smoking cessation intervention

2001

Am J Public Health

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A B S T R A C TObjectives. This study analyzed the relationship between prenatal maternal smoking and sudden infant death syndrome (SIDS) and examined the cost-effectiveness of smoking cessation interventions.Methods. All recorded US singleton SIDS deaths from the 1995 birth cohort with birthweight exceeding 500 g were investigated. Infants with available maternal smoking data were matched with controls who survived to 1 year. Conditional logistic regression was used to estimate SIDS risks and accompanying cost-effectiveness.Results. A total of 23.6% of singleton SIDS deaths appear to be attributable to prenatal maternal smoking. Typical cessation services available to all pregnant smokers could avert 108 SIDS deaths annually, at an estimated cost of $210 500 per life saved.Conclusions. Typical prenatal smoking cessation programs are highly costeffective but have limited impact on the population incidence of SIDS. (Am J Public Health. 2001;91:432-436) Requests for reprints should be sent to

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“…Most often the response came in the form of legislation [147]. Many different types of bills were introduced in an attempt to combat the problem on many different fronts and levels.…”

Section: Policy Optionsmentioning

confidence: 99%

“…There are questions today on whether a positive toxicology screen is enough to establish neglect, remove the child from the home, and ultimately terminate parental rights. The general "rules" the courts have established in deciding these cases are that children have the right to be born with a sound mind and body and past evidence of neglect and abuse is relevant in determining future harm [147]. …”

Section: Policy Optionsmentioning

confidence: 99%

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Untitled

2004

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The phenomenon of substance abuse during pregnancy has fostered much controversy, specifically regarding treatment vs. punishment. Should the pregnant mother who engages in substance abuse be viewed as a criminal or as someone suffering from an illness requiring appropriate treatment? As it happens, there is a noticeably wide range of responses to this matter in the various states of the United States, ranging from a strictly criminal perspective to one that does emphasize the importance of the mother's treatment. This diversity of dramatically different responses illustrates the failure to establish a uniform policy for the management of this phenomenon. Just as there is lack of consensus among those who favor punishment, the same lack of consensus characterizes those states espousing treatment. Several general policy recommendations are offered here addressing the critical issues. It is hoped that by focusing on these fundamental issues and ultimately detailing statistics, policymakers throughout the United States will consider the course of action that views both pregnant mother and fetus/child as humanely as possible. Overview and nature of the problem IntroductionThe purpose of this review is to summarize policy research findings in the area of maternal prenatal substance abuse to (1) inform and advance this field, (2) identify future research needs, (3) inform policy making and (4) identify implications for policy. As a review, this is a systematic analysis of existing data (findings) on maternal drug use during pregnancy for determining the best policy among the alternatives for dealing with drug using mothers and their children. We will address issues of efficacy (which policies work?), economics (how much does it cost?) and politics (who is it for or against?). For new policies we will also consider how they fit with existing policies or laws, the social impact, ethical issues and the feasibility of implementation and administration.

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Maternal Substance Abuse and Infant Health: Policy Options across the Life Course

Cited by 16 publications

References 144 publications

From Generic to Gender-Responsive Treatment: Changes in Social Policies, Treatment Services, and Outcomes of Women in Substance Abuse Treatment

From Generic to Gender-Responsive Treatment: Changes in Social Policies, Treatment Services, and Outcomes of Women in Substance Abuse Treatment

Sudden infant death syndrome, maternal smoking during pregnancy, and the cost-effectiveness of smoking cessation intervention

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