[1] NIDA. Illinois state law does not prohibit drug testing. Yet I felt for the new mothers and realized that heart-wrenching custody loss is not the best approach. Two modes of testing are available: umbilical cord tissue and meconium. These results are for the calendar year 2018 births. Policy makers must place emphasis on the safety of the patient and baby rather than the cessation of substance use. They must treat these mothers with the same empathy and respect as any other patient, even if they are experiencing withdrawal. States need to enact laws that protect these women from being reported to authorities. In Minnesota and North Dakota, a test is required if there are drug-related complications at birth. Unless otherwise noted, you can republish our stories for free if you follow these rules. The Illinois Department of Public Health supports two Maternal Mortality Review Committees, which: Reviews deaths suspected to be medically related to pregnancy. Int J Drug Policy. To progress as a society, physicians and interprofessional teams must work together to truly understand the needs of patients with substance use disorders and provide support from prenatal to postnatal care. Intranasal Oxytocin Blocks Alcohol Withdrawal in Human Subjects. Preadolescent behavior problems after prenatal cocaine exposure: Relationship between teacher and caretaker ratings (Maternal Lifestyle Study). Meconium is the earliest stool of an infant composed of materials ingested while the infant is still in the uterus. If a Tennessee woman with substance use disorder decides to seek an abortion after six weeks, she may need to travel to a neighboring state. Most states do not have a law that requires hospitals to test infants and new moms for controlled substances. Antiviral treatment should be initiated as early as possible because studies show that treatment initiated early (i.e., within 48 hours of illness onset) is more likely to provide benefit. At the federal and state levels, ACOG supports policy prescriptions that prioritize a healthy outcome for both mother and baby including: Routine urine drug screening is controversial. Support ProPublica's award-winning investigative journalism. [15] Smoking can impede the development of the lungs and brain and lead to preterm deliveries or sudden infant death syndrome. During this period, I saw a teenager brought to the pediatric floor due to worsening psychiatric symptoms. J Addict. During the two years this law was in effect, officials arrested 124 women. Marijuana During Pregnancy - Know the Risks | SAMHSA Exciting advances in HIV treatment and prevention make pregnancy a safe possibility for women living with HIV. Please also see our Voices in Bioethics Podcast (columbia.edu) where we interview thought leaders with an eye to projecting personal stories as well as addressing professional ethical dilemmas. As for illegal substances like cocaine, marijuana, and methamphetamine (and more) - the mother may not have long-lasting effects on drug use, but the fetus is likely to endure a variety of development problems. A charge of discrimination was filed with the Illinois Department of Human Rights on Ms. F.s behalf. by Leticia Miranda, Vince Dixon and Cecilia Reyes Additionally a flu shot given during pregnancy has been shown to lower risk of flu illness and flu-related hospitalizations in their infants for the first several months of life. IDPH is funding local organizations to increase the number of women receiving well-woman exams. Breastfeed Med Off J Acad Breastfeed Med. [4] However, it is worth noting that one can trace the roots of this initiative back further. I predict that the increase in opioid and polysubstance use during the pandemic will increase the number of newborns with neonatal abstinence syndrome, thereby significantly increasing the public burden and cost. Ms. F. v. St. Alexius Medical Center | ACLU of Illinois [32] For someone who may or may not have access to reliable transportation, traveling to another state might be impossible. As of 2010, only 19 states have drug treatment programs for pregnant women, and only nine give priority access to pregnant women 1. Many different definitions of maternal mortality are used to track and analyze deaths in different contexts, but Illinois uses the following standard definitions from the Centers for Disease Control and Prevention (CDC): Pregnancy-Associated Death- the death of a woman during pregnancy or within one year of the end of a pregnancy from any cause. Introduced 9/3/2021, by Rep. Bob Morgan - Kambium Buckner - Kelly M. Cassidy . Siccing Cops on Pregnant Drug Users Isn't Helping - Reason.com They probably would have cried less and suffered fewer withdrawal symptoms had they been given the opportunity to breastfeed. Yu, C. (2023). SB 25: ILLINOIS REPRODUCTIVE HEALTH ACT Pediatrics. PDF 2018 Maternal Marijuana Use - Illinois Laws on drug testing of infants and new mothers vary, but the stakes are always high. Appointment reminders and an immunization tracker can be used to support a woman in getting the vaccines she needs for herself during pregnancy and for her new baby. In most states, there is no law that requires hospitals to test infants and new moms for illicit substances. Illinois Drug Use and Pregnancy Laws and Other Rulings 3 IDPH is expanding funding and increasing awareness of the state perinatal depression MOMS hotline. Women who reported receiving a provider recommendation for and offer of vaccination, are more than twice as likely to be vaccinated compared with women who received only a recommendation but no offer of vaccination, and six times more likely to be vaccinated compared with women who did not receive a recommendation or an offer for vaccination. However, some women experience pregnancy complications, which may be minor or severe, and may cause significant short- and/or long-term consequences to a womans health. Drug Testing in Illinois Testing locations are available in all areas. Unfortunately, policy makers did not heed these recommendations. How States Handle Drug Use During Pregnancy - ProPublica The few drug treatment facilities in the United States accepting pregnant women often do not provide child care, account for the woman's family responsibilities, or provide treatment that is affordable. Drug Testing During Pregnancy | Quest Diagnostics Giving a newborn a drug test might seem like its a strange process to perform, but there is a reason for it. Voices in Bioethicsbrings together diverse views through an academically rigorous online format and seeks to identify issues and present workable long-term solutions. . Elizabeth Nolan Brown | 4.23.2021 8:30 AM. Alabama and South Carolina have interpreted existing child endangerment and chemical endangerment statues to all prosecution of drug-using pregnant women. The flu shot is not only safe, it could help to reduce pregnancy problems that can arise from having the flu. Illinois Drug Testing Laws - Workplace Drug Testing By what objective standard could a jury be guided in determining whether a pregnant woman did all that was necessary in order not to breach a legal duty to not interfere with her fetus' separate and independent right to be born whole?". Pregnancy, Law, Abortion, Opioids, Baby, Alcohol, Substance Use Disorder, Neonatal Abstinence Syndrome, Newborn, Addiction, Medicine, Supreme Court, Roe v Wade, Smoking, Medication Assisted Treatment, Safe Harbor, Development, Mother, States, War on Drugs, Pediatrics, OBGYN, Reproductive Ethics, Bioethics. For example, Virginia considers substance use during pregnancy child abuse and mandates that healthcare providers report it. It only takes 15 minutes for water-soluble alcohol to get to the fetus and make the fetus' blood alcohol content that of the mothers. Therefore, under the CPSL, a mother who was addicted to substances . Thus, laws intended to deter people from using substances through various punishments and incarceration may be doing more harm than good. And even if the mothers were lethargic and unresponsive while going through withdrawal, it would still have been possible to breastfeed with proper support. Emily Hirsch, Ameri Klafeta (ACLU-IL) Emma Roth (NAPW), Ultimately, DCFS subjected Ms. F. and her husband to a, How The Local Elected Offices On Your 2023 Ballot Impact Civil Liberties, With The Patient and Provider Protection Act, Illinois Shows Once Again That It Trusts Patients, Black and Brown Chicagoans Testify in Court About Police Harassment, Violent Home Raids, and Harm to People with Disabilities. PMID: 31567599. [2], As a medical student, I have observed the importance of a rehabilitative approach to addiction medicine. 2022;99(2):316-327. doi:10.1007/s11524-022-00610-0, [23] Mayes LC, Granger RH, Bornstein MH, Zuckerman B. 2020 May/Jun;14(3):185-192. doi: 10.1097/ADM.0000000000000562. Using a variety of data sources, the Illinois Department of Public Health identifies all deaths of women while pregnant or within one year of pregnancy (pregnancy-associated deaths). Just a few feet away from his room, behind the nurses station, were the two newborns feeling the same withdrawal symptoms that this teenager likely experienced in the first few hours of his life. As always,Voices in Bioethics will publish works by leaders in the bioethics field as well as those with perspectives from fields outside of medical ethics and outside the sciences. A common flu symptom is fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby. Due to mandatory reporting, they were not confident that physicians would protect them from the law. Voices in Bioethics operates in partnership with Columbia University Libraries. or call toll-free from U.S.: (800) 762-2264 or (240) 547-2156 Public Health Surveillance of Prenatal Opioid Exposure in Mothers and Infants. Universal testing will generate more positive results that require follow-up by the laboratories and patient care teams, as well as may increase referrals to social services and play an increased burden on governmental agencies for relatively low-risk mothers. Risk-based testing uses hospital-defined criteria such as maternal history or signs of drug use, social risk factors, limited or absent prenatal care, and symptoms of withdrawal. [26] Long-term follow up from the study showed that at seven years old, children with high intrauterine cocaine exposure were more likely to have externalizing behavior problems such as aggressive behavior, temper tantrums, and destructive acts. Those currently serving sentences in prisons and jails can treat their substance use disorder through medication assisted treatment, cognitive behavioral therapy, and programs like Self Taught Empowerment and Pride (STEP). J Urban Health Bull N Y Acad Med. Intensive oral hygiene regimens decrease the incidence of gingivitis among pregnant women. The medical community has long recognized that substance use disorder is not simply a character flaw or social deviance, but a complex condition that requires adequate medical attention. Exposure to maternal drug use during pregnancy may lead to adverse effects such as poor neonatal development and acute adverse effects such as infant mortality and neonatal abstinence syndrome (NAS). The Healthcare worker must report drug abuse and direct you to Drug & Alcohol Detox & Rehabilitation Centers For Pregnant Women. Click here to learn more about flu vaccine safety and pregnancy: The Centers for Disease Control and Prevention (CDC, 2017) Flu Vaccine Safety and Pregnancy. A woman can be found guilty of child abuse or neglect in Illinois if the child's blood, urine, or meconium tests positive for drugs at birth. Efforts to inform health professionals about the connection between oral health and overall health during pregnancy should focus on effectively disseminating strategies that translate evidence-based guidelines into clinical practice, with the ultimate goal of improving oral-systemic health among women and children. A.R., Respondent-Appellant still happens. [13] These hospitals are facing the consequences of the worsening opioid pandemic. 2010;40(3):E11-E11. Due to hormone fluctuations during pregnancy, Oral health during pregnancy is important! [24] One of its studies revealed one month old newborns with cocaine exposure had lower arousal, poorer quality of movements and self-regulation, higher excitability, more hypertonia, and more nonoptimal reflexes.[25] Another study showed that at one month old, heavy cocaine exposure affected neural transmission from the ear to the brain. Instead, these laws have created a negative bias surrounding addiction and have negatively affected particularly vulnerable patient populations, including pregnant women with substance use disorder and newborns with neonatal abstinence syndrome. 2011;22(2):87-94. doi:10.1016/j.drugpo.2011.02.002, [8] Global Commission on Drug Policy, 2011, [9] Women NA for P. Tennessees Fetal Assault Law: Understanding its impact on marginalized women - New York. In Alabama, a positive drug test can have dire repercussions for pregnant women and new mothers. J Addict Med. [41] Association APH. Published July 21, 2021. https://www.cdc.gov/pregnancy/opioids/basics.html, [19] Honein MA, Boyle C, Redfield RR. Neonatal Abstinence Syndrome Incidence and Health Care Costs in the United States, 2016. Pregnant women with low incomes and those who are Hispanic have higher rates of tooth decay than those with higher incomes and those who are white, respectively. Substance Abuse Reporting and Pregnancy: The Role of the - ACOG Providers should ensure women are connected to mental health services. Womens Health Issues Off Publ Jacobs Inst Womens Health. After withdrawal, those struggling with substance use disorder may still have cravings and the likelihood of relapsing remains high without proper medical intervention. Voices in Bioethicsapplies a strong process of editing and peer review to produce academic pieces with novel arguments while encouraging students pursuing an MS in bioethics at Columbia University to engage in the research process. The Illinois Perinatal Quality Collaborative is planning a Birth Equity Initiative for birthing hospitals to address bias, racism, and social factors influencing maternal health. View Drug Testing Services Marijuana Laws for Illinois Marijuana considerations are important and marijuana laws often update often, check out Marijuana in the Workplace. Illinois newborn drug testing laws mandate cases to be reported to the Department of Children and Family Services (DCFS) and the Department of Public Health (DPH), where an investigation will begin. Across the country, hundreds of pregnant women and new mothers have been accused of child abuse or other crimes when they or their newborns tested positive for controlled substances. In 2014, Tennessees legislature passed a Fetal Assault Law, which made it possible to prosecute pregnant women for drug use during pregnancy. In 2016-2017, PRAMS added a marijuana and prescription drug supplement in selected states that included indicators of opioid use and misuse. The penalty is up to 15 years in prison." Recognizing that many drug policies were of political opinion, it called for drug policies that were grounded in scientific evidence, health, security, and human rights.[8]. Drug Testing Laws In Illinois 2022: Everything We Know - Uritox, LLC Future interventions should focus on improving the oral health knowledge of dentists and other health professionals about the importance of comprehensive oral health care, including periodontal treatment when needed, for all pregnant women. How States Handle Drug Use During Pregnancy http://projects.propublica.org/graphics/maternity-drug-policies-by-state, [30] NCDAS: Substance Abuse and Addiction Statistics [2023]. Pregnancy Justice and ACLU of Illinois File Human Rights Complaint on Behalf Of New Mother Who Endured Non-Consensual and Discriminatory Drug Testing, Reporting to DCFS Because of Poppy Seed Consumption - New York | Pregnancy Justice ACOG recommends testing be performed only with the patients consent and a positive test not be a deterrent to care, a disqualifier for coverage under publicly-funded programs, or the sole factor in determining family separation. Maternal morbidities may cause significant short- and/or long-term consequences to a womans health. From December 2017 through March 2019, a 12-question marijuana and drug use supplement was added to the PRAMS survey. The Maternal Lifestyle Study (MLS): effects of prenatal cocaine and/or opiate exposure on auditory brain response at one month. Yes! NCDAS. There should be advocation for legislative change, not by providing an opinion but by highlighting the facts and conclusions of scientific studies grounded in scientific evidence, health, security, and human rights. Safe Harbor and Medication-Assisted Treatment. [3] All stories have been fictionalized and anonymized. National Institute on Drug Abuse. (Monday through Friday, 8:30 a.m. to 5 p.m. If a woman cannot take care of herself, one might wonder how she can take care of another human being. Rather than family medicine, OB/GYN, or emergency medicine healthcare workers having to refer their patients to an addiction specialist, they could treat patients with methadone for maintenance or detoxification where they would deliver their baby. 102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 HB4116 . doi:10.1542/peds.2018-3801, [20] Winkelman TNA, Villapiano N, Kozhimannil KB, Davis MM, Patrick SW. [7], The Commission recommended that drug policies focus on reducing harm caused by drug use rather than solely on reducing drug markets. The Pregnancy Risk Assessment Monitoring System (PRAMS) collects state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy. Laws Pertaining to Pregnant Women Who Use Drugs ABCS Health Sciences, 46, e021215-e021215. And for example, see Crack Babies: Twenty Years Later : NPR https://www.npr.org/templates/story/story.php?storyId=126478643, [15] Williams JF, Smith VC, the Committee on Substance Abuse. NPR. Treating Women Who Are Pregnant and Parenting for Opioid Use Disorder and the Concurrent Care of Their Infants and Children: Literature Review to Support National Guidance. Their newborns can be taken from them. Mandatory Drug-Testing in Pregnancy: Lesson learned. . [40] Drug Related Crime Statistics [2023]: Offenses Involving Drug Use. IDPH remains committed to identifying and reviewing maternal deaths and morbidities and will build upon these findings and recommendations over the coming years. There are advantages and disadvantages to both universal and risk-based testing. Centers for Disease Control and Prevention. 409 12th Street SW, Washington, DC 20024-2188, Privacy Statement Health outcomes during pregnancy and the postpartum period occur across a continuum. Substance Use While Pregnant and Breastfeeding. County hospitals that mainly serve lower socioeconomic patients encounter more patients without consistent health care access and those with substance use disorders. This pervasive societal bias sets them up for failure from the beginning and greatly inhibits their willingness to change and mend their relationship with their providers. She cried out of fear and confusion, but her tears were ignored by the medical staff. Resource lists for health care providers are available inAppendix Bof the report. There are ways you and your partner can prevent passing HIV to one another or to your baby. At one county hospital where I recently worked, there has been a dramatic increase in newborns with neonatal abstinence syndrome born to mothers with untreated substance use disorders during pregnancy. ACLU of Illinois Responds to Decision by Texas Court on With The Patient and Provider Protection Act, Illinois Shows Once HB 4664: Patient and Provider Protection Act. All rights reserved. After repeal, the Judge did not want to terminate the respondent's parental rights because of the respondent's "outstanding" rehabilitation efforts. The subcommittees have started reviewing 2016 maternal deaths in an effort to identify changing trends and areas for statewide improvement with the ultimate goal of preventing maternal mortality. [33] Fortunately, studies suggest keeping mother and baby together has many benefits. Risk-Based Newborn Drug Testing in a Setting With a Low Prevalence of Pregnancy-Related Death- The death of a woman during pregnancy or within one year of the end of a pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy. In Minnesota and North Dakota, a test is required if drug-related complications occur at birth. Treatment decisions, especially those involving empiric treatments, should be informed by knowledge of influenza activity in the community. A.R., Respondent-Appellant, Newborns' exposure to drugs: Discrepancies in mandatory reporting, Laws about pregnant women and substance abuse questioned, Laws Pertaining to Pregnant Women Who Use Drugs, How States Handle Drug Use During Pregnancy, Substance Use While Pregnant and Breastfeeding, The Illinois Supreme Court calls it "legal fiction" that the fetus "is a separate legal person hostileto the woman. St. Alexius staff drew Ms. F.s blood and gathered her urine, which she assumed was for reasons related to her preeclampsia. Another proactive approach could be to have medical residency programs register with the Drug Enforcement Administration (DEA) as Narcotic Treatment Programs and incorporate suboxone clinics into their education and rotations. 2013;37(3):484-489. doi:10.1111/j.1530-0277.2012.01958.x, [38] Montana SB0289. https://drugabusestatistics.org/drug-related-crime-statistics/. Excessive alcohol consumption can result in fetal alcohol syndrome, characterized by growth deficiency, facial structure abnormalities, and a wide range of neurological deficiencies. Many of these deaths can be avoided, as medical interventions are well known. The Illinois Department of Human Services is piloting the Illinois Families in Recovery program for pregnant and postpartum women with substance use disorders in central Illinois. This routine practice, sometimes termed "test and report," disrupts bodily autonomy of the pregnant person and their newborn and is inconsistent with treating substance use disorder as a health condition with social and behavioral dimensions (See "Test and Report: Bad for Children and Families" at National Partnership for Women and Families. The Global Commission on Drug Policy. Nevertheless, hospital staff told Ms. F. that they were reporting the matter to DCFS. Providers should ensure all women are discharged from the hospital with an early postpartum visit within three weeks of pregnancy. Maternal mortality is the death of a woman during pregnancy, childbirth, or the postpartum period, and it serves as a sensitive indicator of the quality of the health and health care of a community. If an unplanned pregnancy occurs, one course of action could be to terminate the pregnancy. However, if an employee tests positive on a random drug test, no action can be taken if it can't be proven the substance was used in the workplace. Two modes of testing are available: umbilical cord tissue and meconium. Ms. F. arrived at the hospital on April 4, 2021, at 34 weeks pregnant when her blood pressure rose due to preeclampsia. Published April 11, 2022. https://www.cdc.gov/tobacco/basic_information/health_effects/pregnancy/index.htm, [17] Abuse NI on D. What are the risks of methamphetamine misuse during pregnancy? The maternal lifestyle study: effects of substance exposure during pregnancy on neurodevelopmental outcome in 1-month-old infants. J Pediatr.