Pregnant addicts need help, not jail

Since North Carolina has four towns ranked in the top 20 nationally for opioid abuse, it should not be surprising that opioid abuse among pregnant North Carolina women has also grown rapidly over the past decade.

Substance use disorder is the excessive use of legal, illegal, prescription and non-prescription drugs which causes social dysfunction and mental and physical impairment. There are some who believe prosecuting and incarcerating pregnant women with SUD will deter drug use. However, as a registered nurse and pediatric nurse practitioner with more than 21 years of nursing experience, I have cared for families struggling with SUD, and I stand with organizations like the American Nurses Association, the American Academy of Pediatrics, The American Congress of Obstetricians and Gynecologists, and the Association of Women’s Health, Obstetric and Neonatal Nurses that recognize substance use disorder as a treatable health condition that should not be criminalized.

Like many, I admit to once being angry and judgmental toward these women. I felt that they deserved to be punished, especially after I provided care for the tiny addicted babies going through withdrawal. But one day, I chose to put my biases aside long enough to realize and accept that addiction is a disease like any other disease and that these women need support and encouragement rather than judgment and jail.

Though some would like to believe that prosecution and incarceration deter illicit drug use, it does the exact opposite. Fear of prosecution results in avoidance of prenatal care and decreased likelihood that women would seek substance abuse treatment. And because of testing and reporting laws, it undermines health professionals’ encouragement for pregnant women to seek prenatal care and treatment. We can look to Tennessee and other states where fetal assault laws backfired.

Instead of criminalization, lawmakers should instead increase funding for treatment programs (including those that allow infants and mothers to reside together), social services to support families, and specialized education for nurses who work with pregnant and breastfeeding women with SUD. For these reasons, North Carolina lawmakers should vote “no” to Senate Bill 297: An Act to Create the Criminal Offense of Prenatal Narcotic Drug Use.

The annual cost of prison incarceration in North Carolina for one year is $89.30 per day or $32,594 per year. Compare those costs to the $6,552 per year for Methadone treatment and $5,980 per year for Buprenorphine treatment. Neonatal Abstinence Syndrome is the term used to describe babies born addicted to opioids. From 2004 to 2012 NAS cases in N.C. increased 511 percent per 100,000 live births. This is significant because the average cost of NAS treatment is $66,700 compared to $3,500 for a well-baby birth.

And what happens to the baby while the mother is in jail? The cost of foster care in North Carolina from birth to six years is approximately $475 per day. I am frustrated that lawmakers are willing to separate families and spend thousands of dollars each year on the criminal justice and foster care systems when dedicating more funding to prevention and treatment can keep families together.

In 2014, the total costs of the opioid crisis in North Carolina reached an estimated $2 billion: $582 million in health care costs from opioid abuse and $1.5 billion in loss of future productivity and medical costs from overdose deaths. According to 2012 data, every dollar invested in addiction treatment programs would yield a return of between $4 and $7 in reduced drug-related crime, criminal justice costs and theft. This benefits, mothers, babies and society.

Last year Tennessee repealed its fetal assault law because lawmakers discovered what health professionals have always believed; it caused more harm than good. Similar laws in other states are also being challenged based on privacy and physical liberties laws. I urge you to contact your senators and representatives and request that they vote “no” to Senate Bill 297. If this bill passes, we can expect negative health related outcomes for mothers and their babies and a continued opioid crisis. The women of North Carolina should not be forced to choose between risking their health and risking punishment.

This story was originally published November 25, 2017 at 11:00 AM with the headline "Pregnant addicts need help, not jail."