R/S Ashley 1991 Case Study

* Mother attended her community drug and alcohol team (CDAT) were she was on a methadone programme. Referral was made by her key worker stated concerns that she may be pregnant and concealing it

The use of heroin, cocaine, and other illicit drugs has become a public health concern especially during pregnancy. Maternal substance abuse has become an issue during the crack epidemic in the 1980’s; however, there is an alarm rate of infants born addicted to heroin. More than 3.7% women have indicated the uses some form of illicit drugs during their pregnancy, as well as 1.9 % reports binge drinking (Bhuvaneswar el at., 2008; Grant el at., 2009). With this in mind, more than 375,000 infants are born to maternal substance abusers each year costing over $100,000 in medical expenses covered by the state (Reitman, 2002).

In 1989, a public hospital in Charleston, South Carolina began implementing a policy to randomly test women for drugs who came for prenatal care or delivery without their informed consent. If the women tested positive, they were arrested and not given the opportunity to seek drug treatment. In 1990, the policy was modified to allow the women to avoid being arrested if they entered into a drug treatment program, attended all their counseling appointments, and passed all their subsequent drug tests. Ten women tested positive for cocaine were arrested and responded by suing the hospital and the state. In 2001, the U.S. Supreme Court ruled in favor of the women because the tests were administered without their consent.

Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.

Through the years, substance misuse in the United States has turned into an industrious issue influencing numerous people. In 2008, it was assessed that 17.8 million Americans beyond 18 years old where substance subordinate. Women who use medications during pregnancy can have an enduring impact on fetal. Medications can have an impact of maternal and child wellbeing, yet there are a lot of different variables, which influence it, poor social environment, nourishment, cleanliness, and sexual abuse. Regenerative interruption connected with heroin utilization has been shown in both and women and even low dosages of opiates can impede ordinary ovarian capacity and ovulation. The harm that goes hand in hand with substance utilization comes either straightforwardly from the impact of the medication itself or from issues identified with development and/or unexpected labor. The entanglements of jumbling components clamorous way of life, poor nourishment, liquor utilization and cigarette smoking influence the appraisal of the impacts of cocaine in pregnancy. In obstetric practice, 100% of pregnant women utilizing cocaine or heroin are cigarette smokers. Cigarette smoking is presumably the most well known manifestation of substance utilizes and is noteworthy corresponding considering ladies who use unlawful medications. Babies whose moms smoked in pregnancy have a tendency to have lower conception weights and diminished length, cranial and thoracic

The use of controlled substances throughout pregnancy is a very prevalent issue among society today. Controlled substances have devastating effects on not only the mothers using the substances, but also infants while they are in utero and after they are born. Many infants born to mothers, who are abusing drugs, suffer from life threatening illnesses and are forever affected through adulthood. Specifically, heroin is a common drug form that is often used during pregnancy and results in the life threatening effects mentioned above.

The U.S. Supreme Court has upheld in the past that a person cannot be prosecuted for being a drug addict. People can be prosecuted for the sale or possession of an illegal drug but prosecuting someone for the illness of drug addiction is a breach of the 8th Amendment’s bar on cruel punishment. Usually cases involving pregnant drug-addicted women arise when a doctor reports that a woman tested positive or appears to have a drug problem. Rarely are there cases where the woman is arrested for possession and then charged with child abuse. For example, if I told my doctor I had a drug addiction, I wouldn’t get reported. Just as

In the fall of 1988, with the concerns to the escalation use of cocaine among pregnant patients whom were receiving prenatal treatment, the Medical University of South Carolina (MUSC) begun to order drug screenings to be accomplished on the urine samples of the patients. The pregnant patients that tested positive were referred by the MUSC staff to the county substance abuse commission for counseling and treatment. This would lead to a relationship of MUSC staff and the Solicitor of Charleston, which would then lead to a policy outlining the legal actions to be taken

R/s Trisita (mom) delivered a baby boy at 38 weeks. R/s Trisita tested positive for Benzodiazepine. R/s Trisita attends the methadone clinic in Florence, SC.

R/s Sofia’s drug screen was positive for opiates but they were prescribed for a knee injury. R/s Sofia

The patient also tells me she uses lorazepam very intermittently. She is almost out of that medication would like a refill today. I did write her for lorazepam 0.5 mg to use p.r.n. #20 with no refills.

More details: Sarah Robinson was arrested Friday by U.S Marshals on a grand jury indictment filed in early July stemming from an alleged incident in eastern Missouri in March 2014.Robinson accused of being in possession of a detectable amount of methamphetamine with the intent to distribute it. She was still in Wyandotte County Jail in federal custody Sunday evening and is expected to have her first court appearance Monday. Sarah says “My life had taken a downturn since my husband's sudden death three years ago, while she was pregnant with twins. I lost my job and my house and was living in my car.”

R/s Mattie went to the doctors last week and Andrea didn’t pick Mattie’s meds, so she picked the meds up today. R/s Monica has marks on her arm from when she uses heroin. R/s Andrea and Mattie has been living at Monica’s residence for about two months.

R/s Jamison doesn’t want to stay with his father James because his father has been beating him. R/s it was reported that James is fighting Jamison by body slamming and punching him. R/s Jamison visits his father every other weekend and on holidays. R/s most of the time Jamison is left alone at his father’s house.

(n.d.) also conducted a study focused on infants that were exposed to buprenorphine or methadone while in utero. Unlike MacMullen et al. (2014) their focus was on predicting how the symptoms of NAS might manifest in the exposed newborns. Since the 1970s (MacMullen et al., 2014) methadone has been the treatment of choice for mothers with opioid dependence during pregnancy, the use of this drug allows for a decrease in withdrawal symptoms for the child after birth. The main categories of symptoms include central nervous system hyperirritability, gastrointestinal dysfunction, respiratory distress and vague autonomic symptoms (MacMullen et al., 2014). Although methadone has been being used for many years buprenorphine has only been used since 2002 in the United States (MacMullen et al., 2014). Their research was consistent with Kaltenbach et al. (n.d.) in that infants born to buprenorphine-exposed mothers had lower scores for NAS than those born to methadone-exposed mothers, but still had varying severities of symptoms and scores across all infants. For at least 10 days after birth, an expert scored the newborns on a modified Finnegan scale every 4 hours. The results showed that high birth weight was often a predictor for high NAS scores, along with lower NAS scores for infants delivered by cesarean section. MacMullen et al. (2014) were unable to find any connection between the use of methadone and buprenorphine to indicators of symptoms of NAS. The main