Punishing pregnant drug users: enhancing the flight from care

Poland, Marilyn L.; Dombrowski, Mitchell P.; Ager, Joel W.; Sokol, Robert J.

doi:10.1016/0376-8716(93)90001-7

Cited by 89 publications

(53 citation statements)

References 2 publications

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“…Typically, this form of user involvement presumes an adversarial method of selection that may be problematic in a culturally diverse society where not everyone shares a common understanding of dialecticbased approaches. Others may not trust the democratic process or public organisations such as those who have been homeless, used street drugs or have experienced mental illness [32][33][34].…”

Section: Local Democracy-accountability To Users Of the Service Delivmentioning

confidence: 99%

The snakes and ladders of user involvement: Moving beyond Arnstein

2006

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Section: Local Democracy-accountability To Users Of the Service Delivmentioning

confidence: 99%

The snakes and ladders of user involvement: Moving beyond Arnstein

2006

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“…The desire to guard fetal health and outcomes is understandable; however, pregnant women who fear prosecution and the potential loss of their children will rarely seek essential prenatal and medical care. We already discovered the negative consequences of such practices during the peak of maternal cocaine exposures in South Carolina from 1989-1994, before their prosecution of these women was forced to cease (Annas, 2001;Budetti, 1993;Ferguson v. City of Charleston, 2001;McKnight v. State of South Carolina, 2008;Poland et al, 1993). Physicians and scientists need to better engage and educate the public on these complex issues.…”

Section: Future Directions and Clinical Implicationsmentioning

confidence: 99%

Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn

Ross

Graham

Money

et al. 2014

Neuropsychopharmacol

342

241

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Most drugs of abuse easily cross the placenta and can affect fetal brain development. In utero exposures to drugs thus can have long-lasting implications for brain structure and function. These effects on the developing nervous system, before homeostatic regulatory mechanisms are properly calibrated, often differ from their effects on mature systems. In this review, we describe current knowledge on how alcohol, nicotine, cocaine, amphetamine, Ecstasy, and opiates (among other drugs) produce alterations in neurodevelopmental trajectory. We focus both on animal models and available clinical and imaging data from cross-sectional and longitudinal human studies. Early studies of fetal exposures focused on classic teratological methods that are insufficient for revealing more subtle effects that are nevertheless very behaviorally relevant. Modern mechanistic approaches have informed us greatly as to how to potentially ameliorate the induced deficits in brain formation and function, but conclude that better delineation of sensitive periods, dose-response relationships, and long-term longitudinal studies assessing future risk of offspring to exhibit learning disabilities, mental health disorders, and limited neural adaptations are crucial to limit the societal impact of these exposures.

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“…Qualitative research performed in pregnant women with substance use disorders shows that women may avoid prenatal care for fear of being reported to the police and child protective services. 23, 64 -66 In addition, surveys of pregnant women found that punitive laws targeted at pregnant women who use drugs are a significant deterrent to obtaining regular prenatal care and agreeing to drug testing, 67 and women who deliver without receiving any prenatal care are more likely have a history of substance use. 68 For these reasons, the AAP supports an approach toward substance use in pregnancy that focuses on a public health approach of primary prevention, improving access to treatment, and promoting the provider-patient relationship rather than punitive measures through the criminal justice system.…”

Section: Criminal Justice Approaches To Substance Use In Pregnancymentioning

confidence: 99%

A Public Health Response to Opioid Use in Pregnancy

Patrick¹,

2017

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The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefi ts for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs. A public health response, rather than a punitive approach to the opioid epidemic and substance use during pregnancy, is critical, including the following: a focus on preventing unintended pregnancies and improving access to contraception; universal screening for alcohol and other drug use in women of childbearing age; knowledge and informed consent of maternal drug testing and reporting practices; improved access to comprehensive obstetric care, including opioidreplacement therapy; gender-specifi c substance use treatment programs; and improved funding for social services and child welfare systems. The American College of Obstetricians and Gynecologists supports the value of this clinical document as an educational tool (December 2016).

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Punishing pregnant drug users: enhancing the flight from care

Cited by 89 publications

References 2 publications

The snakes and ladders of user involvement: Moving beyond Arnstein

The snakes and ladders of user involvement: Moving beyond Arnstein

Developmental Consequences of Fetal Exposure to Drugs: What We Know and What We Still Must Learn

A Public Health Response to Opioid Use in Pregnancy

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