A new epidemic of hype won’t help ‘drug-dependent’ infants

December 14, 2015
Donnie Gooding and Katy Yeager Gooding hold their baby Kennedy Gooding in Barboursville, West Virginia, October 18, 2015. Picture taken October 18, 2015. To match Special Report BABY-OPIOIDS/ REUTERS/Jonathan Ernst - RTX1XMZG

Donnie Gooding and Katy Yeager Gooding hold their baby Kennedy Gooding in Barboursville, West Virginia, October 18, 2015. REUTERS/Jonathan Ernst

Every few years we are told about a new “drug plague” in which the drug use of pregnant women supposedly dooms their children – unless, of course, we take the children away. The media said it about crack, and they were wrong. They said it about methamphetamines and they were wrong. Now there’s a new epidemic of hype around pregnant women who use drugs both legal and illegal, from heroin to prescription painkillers. Those stories are wrong, too.

The stories include graphic descriptions of infants going through withdrawal and horror stories about the ones who died after being sent home with their mothers. When we read or see such reports, all most of us want to do is take away the children and put them in foster care.

But whenever we try to take a swing at “bad mothers” the blow lands on the children. We know there are better answers — and if we really care about the children, we’ll turn to those answers instead.

First, we need to understand the true nature of the problem.

The horror stories are not the norm. And ironically, the Reuters/NBC News series “Helpless and Hooked,” which demonstrates many of the failures of this kind of journalism by highlighting them, also proves that point.

A graphic accompanying the stories suggests that since 2010 there have been at least 140,000 infants born “drug-dependent.” During that same time period, Reuters and NBC found 110 who died of “preventable” causes.

Let’s assume, as the reporters claim, that this is an underestimate and double those figures. That still would mean under two-tenths-of-one percent of the infants died.

Every one of those deaths is the worst kind of tragedy; the reporters were right to be horrified, all of us should be. But every death in the terror attacks in Paris and San Bernardino was also the worst kind of tragedy. Just as “solutions” based on ignorance and fear, solutions that backfire — are unacceptable in the war against terror, they should be unacceptable in the war against child abuse.

Too many news accounts, including the Reuters/NBC stories, get the solutions wrong. Even if Reuters claims they are merely presenting the problem, anyone watching or reading these stories can’t help but demand that hospitals turn in the mothers to child protective services — as West Virginia does.

But West Virginia illustrates exactly why this approach fails. The state tears apart families at a rate higher than all but two others, a rate more than two-and-a-half times the national average, according to my group’s research. Nationwide, in 2014, children were taken from their parents 264,000 times. But if every state were like West Virginia, the foster-care system would be flooded with 680,000 entries into foster care – year after year after year.

The reason this is a problem is illustrated by lessons we should have learned from a previous drug “plague.” A landmark study compared two groups of children born with cocaine in their systems — one group left with their mothers, the other placed in foster care. At six months of age the children were compared using the normal measures of infant development, sitting up, reaching out, rolling over. Consistently the children left with their birth mothers did better. For the foster children, the separation from the mothers seems to have been more toxic than the cocaine.

That’s just the beginning. Study after study, as compiled by my group, has found abuse in one-quarter to one-third of foster homes.

How are caseworkers, who in most of the country are overloaded now, supposed to investigate all these new reports? By spending less time on each case — making it more likely that they will overlook more children in real danger.

Meanwhile, once the word gets around that they’ll automatically be tested and turned in, pregnant women who use both legal and illegal drugs will avoid prenatal care, and avoid giving birth in a hospital. It’s already happening where states have imposed criminal penalties on these mothers.

In short, the take-the-child-and-run approach makes all children less safe.

There are better alternatives.

For the infants, let them stay with their mothers in the hospital — research suggests that’s likely to be far more comforting for the infant than isolation.

For the mothers:

  • The fact that the infant has drugs in her or his system does not necessarily mean mom is an addict. She may have been taking legally prescribed painkillers or even certain over-the-counter medications. In those cases, what the newborn may need most is for the various policing agencies of government to leave her or his mother alone.
  • In other cases, the mother is in recovery — the symptoms caused not by heroin, for example, but by the methadone she takes to address her drug dependency. Those mothers may be struggling with all sorts of problems, often related to poverty. We need to offer an array of voluntary help for these mothers.
  • Where the mother still has a drug dependency problem, there should be immediate access to drug treatment — including, where necessary, inpatient treatment where mother and baby can live together.

All of this, by the way, costs less than foster care.

And finally, there is that much smaller group of mothers who really are a danger to their children. In those cases, medical professionals should have the discretion to call in child protective services.

When they use their discretion now, instead of automatically reporting every case they see, it’s probably because they understand all of these realities and used their professional judgment to weigh the risks.

On very rare occasions, they get it wrong. That’s no reason to cave into fear mongering and make everything worse.

Back when so many others were caught up in an earlier epidemic of hype, the one about crack cocaine, columnist Ellen Goodman got it right. “You can’t save the babies,” she wrote, “by throwing away the mothers.”

3 comments

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The National Center on Addiction and Substance Abuse agrees that automatic reporting of Neonatal Abstinence Syndrome to child protective services agencies is not the right response to dealing with addiction and substance use by pregnant and postpartum women. Involving CPS for the sole reason that a mother is drinking or using drugs can do more harm than good for children. First, the threat of punishment causes women to avoid prenatal care and addiction treatment, dramatically increasing the risk of harm for mothers and babies. Second, removing the child often leads to poorer outcomes than offering services that can help keep families healthy and intact. The use of a punitive approach like mandatory reporting also erodes trust between the provider and patient. If we want to improve outcomes for these children, we must expand access to addiction treatment and social supports for women in the pre-conception, prenatal, and postpartum stages. Addiction treatment should be a standard part of prenatal care; unfortunately, treatment options for pregnant women are extremely limited. This includes access to methadone and buprenorphine, which, as the author points out, are appropriate treatments for pregnant women with opioid addiction. Providing treatment and support in prenatal care and postpartum can help keep families together and promote the best outcomes for mother and child alike.

Posted by mconley | Report as abusive

Number of Cases per 100,000 children in the United States. The National Center on Child Abuse and Neglect (NCCAN) in Washington D. C. reports:

Children in CPS custody: Physical Abuse (160)
Children in Parent’s custody: Physical Abuse (59)
Children in CPS custody: Sexual Abuse (112)
Children in Parent’s custody: Sexual Abuse (13)
Children in CPS custody: Neglect (410)
Children in Parent’s custody: Neglect (241)
Children in CPS custody: Medical Neglect (14)
Children in Parent’s custody: Medical Neglect (12)
Children in CPS custody: Child deaths (6.4)
Children in Parent’s custody: Child deaths (1.5)

Posted by MalindaS | Report as abusive

I have posted two comments to this article attempting to give voice/another perspective to a silenced, massive group of parents and their children, we as court watchers and child advocates have been working with, for over 20 years… Neither of my statements have passed the Reuters gatekeepers.

Only one comment on this important article, on Reuter’s comment page? Seriously? There are 500,000 children in the foster care/group homes/on their way to forced adoptions scams in this country. The problem has reached the tipping point…critical mass…with angry, non offending, law abiding families losing their children to the state on very thin evidence and too often, NO evidence that parents have done any harm, to their children… and you only have one comment? This is a multi billion dollar child custody industry that rivals the defense budget… and deserves a deep looking into by the main stream press.

I laid out a chart from a report by The National Center on Child Abuse and Neglect (NCCAN) in Washington D. C. showing clearly the relative harm to children in the hands of the state vs.their own homes. NOT posted here. Why?

Posted by MalindaS | Report as abusive