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Brooke Morris

Professor Hunter

English 1201 Online

23 April 2017

Fig. 1 Ohio Starts Program to Help Pregnant Women Addicted to Heroin (The fix)

Drug Screening Pregnant Women

When a childs first days in this world are in agony, that certainly should be a

concern to all of us. There are thousands of women who are pregnant that need the

right guidance. Some live a hard life, and others suffer from depression or abuse.

These issues lead to even bigger problems. Women who become pregnant turn to

drugs or other harmful substances that can hurt the fetus. Most Doctors do not test a

mother for drugs when they go in for a check-up, I believe they should. Not

everyones welcome to that idea. Some pregnancy right Advocates that screening

may lead to punishment or loss of custody rather than treatment and sobriety. If we
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could test pregnant women for substance abuse we could save many lives of other

human beings. We could offer women help to come clean for their sake, and their

unborn child. (Ungar, USA Today)

Recent amendments to the Child Abuse Prevention and Treatment Act tie the

receipt of federal block grants to mandatory reporting of substance-exposed

newborns. To determine rates of screening, testing, and reporting of drug and

alcohol use at the time of delivery, they call for a telephone survey of nursing

managers and perinatal social workers at Maryland birthing hospitals. Of the 34

hospitals, 31 responded (response rate 91%). Although 97% of hospitals reported

universal screening, only 6% used a validated instrument. Testing was reported by

94% with 45% reporting universal maternal testing and 7% universal newborn

testing. Only 32% reported obtaining maternal consent prior to testing. There is

significant heterogeneity in screening and testing for substance use in birthing

hospitals. Given federal reporting mandates, state-level practices need to be

standardized. (Miller, 659-669)

Prenatal drug usage and the effects on the unborn fetus are important to

screen and diagnose maternal substance abuse early for improved outcomes to the

newborn, as prenatal drug exposure can lead to both short-term and long-term

adverse effects to the baby. There is discussion on how to screen and diagnose this

problem and how to manage both the mother and the baby once the diagnosis has

been made. The most commonly seen substances that are abused by pregnant

women are alcohol, tobacco, marijuana, opioids, cocaine

methamphetamines/amphetamines and benzodiazepines. (Dodich, 97)

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In a psychological perspective, a study examined the ability of the Drug Abuse

Screening Test (DAST-10) to identify prenatal drug use using hair and urine samples

as criterion variables. In addition, this study was the first to use best practices,

such as anonymity, ACASI technology, and a written screener, to facilitate disclosure

in this vulnerable population. 300 low-income, postpartum women (90.3% African-

American) were recruited from their hospital rooms after giving birth. Participation

involved a completing a computerized assessment battery that contained the DAST-

10 and providing urine and hair samples. Twenty-four percent of the sample had a

positive drug screen. The sensitivity of the DAST-10 was only .47. Nineteen percent

of the sample had a positive toxicology screen but denied drug use on the DAST-10.

Findings suggest that brief drug use screeners may have limited utility for pregnant

women and that efforts to facilitate disclosure via reassurance and anonymity are

unlikely to be sufficient in this population. The statistics show the raging growth of

women using substances while pregnant. We can utilize ways to stop this, we may

even be able to clean up the streets. Some women can disagree with the fact it is

their right their body. What about the human being growing inside of them? What

about their right? Just because they cant speak they do have a heartbeat. (Gerkin,

720)

The biggest issue with making this becoming an actual law is because of

HIPPA.We would be violating a patients rights. There was a court debate Ferguson

Vs. the City of Charleston. In response to an apparent increase use of cocaine

among prenatal patients, the Medical University of South Carolina (MUSC) began

drug screens. Those testing positives were referred for treatment. After that, MUSC
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began a relationship with the solicitor of Charleston, which lead to a policy outlining

legal action to be taken against pregnant addicts, including protocols for arrest, with

the hope that the threat of the law would get women into treatment. No consent was

given by the women for the drug screening. The Issue that raised with this was that

weather a state hospitals performance of diagnostic test to obtain evidence of a

patients criminal conduct of law enforcement purposes is an unreasonable search if

the patient had not consented to the procedure. The ultimate interest for them was

crime control. They favored the city due to the fact a Urine Sample was not a

violation of the Fourth Amendment. (Sealy, ABC News)

Drugs have gotten a lot easier to get a hold of in the United States. Marijuana,

heroin, and methamphetamines are three major drugs kids and adults are trying.

One major issue that I have a concern with is Women who are pregnant, and have a

drug problem, need to be taken care of. In 2015, there has been a major increase of

babies who are born prematurely, have birth defects, or are born crack babies. I

believe women that have annual doctors visits need to be screen tested for

narcotics. Not to put them in jail or get them in a significant amount of trouble, but to

help them with their addiction. If they test positive for drugs, there doctor can provide

them with the health or rehab they need to remain clean, and make sure no harm is

done to the fetus

Doctors and physicians need to give options to pregnant women who are

using substances. One of the options being rehab. If we offered to women maybe

there would be a less chance of premature babies being born. Not many people

give a drug user a chance. We have no idea what made them turn to drugs. We
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usually just jump to conclusions. They could have been raped, sexually harassed, or

their family /spouse could have been abusive. If we gave another option, as to

where they could go through counseling, I think we would be surprised in the

difference it could make.

In a recent interview on USA Today covering opioid addict Ashley Kirchhubel,

31, of Louisville, disagrees. She abused pain pills while pregnant with her now-3-

year-old son, Johnny, hiding her addiction from her obstetrician even when asked

about drug use. It raged on, and she briefly turned to heroin before entering drug

treatment early in her pregnancy with Isaiah, born Sept. 27. She says only by the

grace of God was neither born dependent. If the mother of four had undergone a

urine screen, she suspects she wouldve gotten treatment much sooner to avoid

losing her children. She had quoted "That would've been a good enough reason to

stop," she says as her newborn's tiny fingers curl around hers. "They should screen

everybody." (USA Today)

When a mother admits that she needed the help, and no one gave her an

option, goes to show we need to speak to mothers in the beginning of their first

trimester and speak to them about a drug screening. Explain to them the risks of the

child being taken away or possibly them getting in trouble. We need to explain the

health risks for the mother and the fetus. Doctors routinely screen pregnant women

for diseases such as HIV and hepatitis, and some say adding drug abuse to the list

would reduce the stigma of addiction and keep women from being singled out by

race, income and appearance. Many drug- dependent infants suffer from diarrhea,

vomiting, low-grade fevers, and seizures. They are extra sensitive to noise and light.
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Those born prematurely may experience respiratory distress and go on ventilators.

Screening could save babies from such suffering and works best when doctors are

non- judgmental, so moms feel safe enough to be honest about drug use says Paul

Jarvis Executive director of the health officials association. His group also suggests

removing financial obstacles to screening by covering it under Medicaid. (USA

Today)

Drug screening on annual doctors visits need to be legal in every state.

There is a law in certain states where they can get a consent form to drug screen if

they are suspicious, but I believe if we provide them with the help that they need to

become clean, we would have less women suffering from postpartum also less

children being born with health problems. This is a problem that has been on going

in the U.S since the 2000s, drugs have gotten worse and the rate of pregnant

woman using drugs while carrying a child have increase dramatically. Doing annual

drug tests and giving options from their healthcare provider for positive drug users

should pass as a law. It would make the world a better place.

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Work Cited

Dodich, Colleen. "Prenatal Drug Use and The Effects on The Newborn." Caring for the

newborn: A comprehensive guide for the clinician. 95-107. Hauppauge, NY, US:

Nova Biomedical Books, 2014.PsycINFO. Web. 13 Apr. 2015

Grekin, Emily R., et al. "Drug Use During Pregnancy: Validating the Drug Abuse

Screening Test Against Physiological Measures." Psychology of Addictive

Behaviors 24.4 (2010): 719-723. PsycARTICLES. Web. 13 Apr. 2015

Hand, Dennis J., et al. "Substance Use, Treatment, and Demographic Characteristics of

Pregnant Women Entering Treatment for Opioid Use Disorder Differ by United

States Census Region." Journal of Substance Abuse Treatment, 2017, p. 58.

EBSCOhost, doi:10.1016/j.jsat.2017.01.011.

Haug, Nancy A., et al. "Substance Abuse Treatment Services for Pregnant Women.

Psychosocial and Behavioral Approaches." Obstetrics and Gynecology Clinics of

North America, vol. 41, no. Substance Abuse During Pregnancy, 01 June 2014,

pp. 267-296. EBSCOhost, doi:10.1016/j.ogc.2014.03.001.

Laken, Marilyn Poland, et al. Recruitment and Retention of Substance-Using Pregnant

and Parenting Women: Lessons Learned. 01 Jan. 1995. EBSCOhost,

sinclair.ohionet.org:80/login?url=http://search.ebscohost.com/login.aspx?

direct=true&db=eric&AN=ED399492&site=eds-live.

Miller, Catherine, et al. "Screening, Testing, And Reporting for Drug and Alcohol Use on

Labor and Delivery: A Survey of Maryland Birthing Hospitals." Social Work in

Health Care 53.7 (2014): 659-669. SocINDEX with Full Text. Web. 13 Apr. 2015.
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"Ohio Starts Program to Help Pregnant Women Addicted to Heroin." The Fix. N.p., n.d.

Web. 27 Apr. 2017.

Pajulo, Helena, et al. "Substance-Abusing Pregnant Women: Prenatal Intervention

Using Ultrasound Consultation and Mentalization to Enhance the Mother-Child

Relationship and Reduce Substance Use." Infant Mental Health Journal, no. 4,

2016, p. 317. EBSCOhost, doi:10.1002/imhj.21574.

Sealey, Geraldine. ABC News. ABC News Network, 21 Mar. 1970. Web. 03 Apr. 2017.

Ungar, Laura. "Born addicted: Drug-screening pushed for pregnant women." USA Today.

Gannett Satellite Information Network, 09 Oct. 2014. Web. 03 Apr. 2017.

"Women's Health Care Physicians." Substance Abuse Reporting and Pregnancy: The Role of

the Obstetrician-Gynecologist - ACOG. N.p., n.d. Web. 03 Apr. 2017.