How state laws flag pregnant patients with opioid use disorder to protective services
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Some state policies that require reporting pregnant patients who use illicit drugs to child protective services also use treatment for opioid use disorder as a proxy for alleged child abuse and neglect.
Driving the news: That's led pregnant patients to face discrimination in health care settings, experience higher overdose risk due to stress and opt to discontinue the opioid addiction drug buprenorphine, according to a new report in Maternal and Child Health Journal from Massachusetts General Hospital.
- It also noted that most of the reporting policies exclude fathers who are in treatment for opioid use disorder while making mothers subject to immediate investigation.
- These legal consequences could lead to worse health outcomes for both the fetus and mother by driving pregnant patients to delay care or avoid treatment, per guidance from the Substance Abuse and Mental Health Services Administration.
By the numbers: Of the 26 participants interviewed for the study, 24 were receiving medication for opioid use disorder at the time of delivery.
- One was using non-prescribed substances and another discontinued buprenorphine during pregnancy.
- 24 of 25 who had a CPS report filed against them upon delivery were fully investigated and nearly half had their children removed.
- Of those 12 who lost custody, six were later reunited with their child.
What they're saying: Researchers wrote that mandated reporting for prenatal use of opioid use disorder treatment, which is considered safe for use during pregnancy by the CDC, "tangibly harms parents and children" more than it prevents potential future harm to kids.
Between the lines: A bill in the Massachusetts legislature that would have eliminated the mandatory reporting requirement to protective services failed to make it out of committee in January.
