State Approaches to Treating Prenatal and Postpartum Drug Use Need Improvement, Study Finds

April 7, 2023

Image of a pregnant woman walking on the street

WASHINGTON, DC (March 13, 2023)—State approaches to maternal drug use include both laws to give pregnant and postpartum people priority access to treatment and laws that punish drug use during pregnancy. In a study selected as the Editor's Choice for the March/April issue of Women's Health Issues, authors mapped the overlap between state priority access and punitive laws and interviewed 51 state leaders to understand the laws’ implementation. They found that punitive laws may counteract priority access laws by making pregnant people less likely to seek treatment and that more resources are necessary to treat this population effectively.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Sarah A. White, a research associate at the Johns Hopkins Bloomberg School of Public Health, and colleagues examined laws in states and Washington, D.C. from 1974 to 2019. The researchers identified laws that give pregnant and postpartum people priority access to public drug treatment programs as well as punitive laws — those that deem prenatal drug use to be child maltreatment, require health care providers to report diagnosed or suspected prenatal drug use to child protective services, or make prenatal drug use a crime. The research team then conducted interviews with leaders involved with implementation and/or enforcement in the 12 states that had passed one or more of these laws between 2009 and 2019. 
The authors found that 34 jurisdictions (33 states and the District of Columbia) had priority access laws; among that group, 28 also had at least one punitive law. “State leaders responsible for priority access law implementation perceived limited treatment availability, stigma, and lack of funding as key implementation barriers,” White and her colleagues report. “In addition, results suggest that state prenatal drug use laws may counteract priority access laws by impeding treatment seeking.”
“This study’s findings demonstrate that having a priority access law is not on its own enough to achieve high rates of successful drug treatment for pregnant people,” said Karen McDonnell, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “State decisionmakers should keep these findings in mind when allocating resources and considering the future of both existing and potential new laws addressing prenatal and postpartum drug use.”
Implementation of State Laws Giving Pregnant People Priority Access to Drug Treatment Programs in the Context of Coexisting Punitive Laws” has been published in the March/April 2023 issue of Women’s Health Issues.