Pregnant moms addicted to drugs are terrified, and the system does not help. Even if it did, no true help is available.
House Bill 2530 will not change that.
HB 2530 is another example of public policy purporting to solve one of the most complex human problems because supporters like Darcy Olsen and herCenter for the Rights of Abused Children say so.
Decades of research tell us that the population of women with substance use disorder (SUD) is not homogeneous. Women of all ethnicities, racial groups, ages, social or economic status, and abilities need treatment for substance use disorder.
Their fear of the system stems from far more than concerns of being labeled negligent.
This won’t help addicted, pregnant women
Some women need treatment for a co-occurring mental illness and fear a court will find them unfit because there is no one to help them while they receive care.
Many women have histories riddled with traumatic experiences, mostly childhood physical or sexual abuse, domestic violence or rape.
They fear more of the same if the authorities get involved.
And yes, they fear someone will take their child.
This bill will not speed up help or keep families together.
HB 2530 does none of what addicted pregnant women need. It does precisely the opposite. The bill:
- directs the Department of Child Safety to merely give pregnant people who may be using drugs the phone number to AHCCCS, the state version of Medicaid.
- instructs health care professionals to refer the woman to substance use services and support to “facilitate maternal and infant safety.”
- exempts a woman’s medical information, history of substance use or participation in substance use services from being used as the basis of a report of suspected neglect made to DCS.
What they need is better access to care
What does this mean for a woman looking for help? Nothing.
Making clinicians refer a woman to treatment doesn’t mean she will get treatment.
Passing a law that makes clinicians tell people to voluntarily “go get some treatment” is useless, and while a woman’s information cannot be the basis of a report, it can be included in a report, a distinction that is being either overlooked or ignored.
The bottom line is that we are still criminalizing women.
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In late 2021, I completed an assessment regarding the gender-specific treatment services and practices for women with substance use disorder in AHCCCS’s system of care. The team:
- analyzed multiple years of utilization data.
- surveyed women with substance use disorder and treatment providers.
- conducted a thorough regulatory and literature review.
- produced a report identifying numerous barriers to care and recommendations to remediate these barriers that may be of interest to anyone who wants to help.
The biggest barrier: an acute lack of clinical care.
Don’t overlook sexual abuse in treatment
Multiple reports, including ours, identify the state’s severe shortage of obstetricians, gynecologists and behavioral health treatment providers trained to treat pregnant people with substance abuse disorder and possibly co-occurring mental illness.
Clinical capacity is a problem throughout the health care system, but the more specialized the care, the more acute the problem becomes.
If you live outside of Phoenix or Tucson, well, good luck.
What the 70-plus women shared about their life experiences sticks with me to this day.
- 64% experienced sexual abuse or assault before their 15th birthday.
- 63% experienced at least one instance of sexual abuse or assault after their 15th birthday.
- 50% of the women experienced sexual abuse and assault before and after their 15th birthday.
- 24% of women indicated they had been arrested more than six times.
- 13% indicated they had been arrested three times.
- Overall, 96% of the women had at least one arrest, with just under half reporting four or more arrests.
We know what works: Engaging women in treatment models that are strengths-based and consider all aspects impacting how they encounter this world.
That means we must name and acknowledge all their trauma, including sexual abuse and rape, and provide trauma-integrated care. This empty, short-sighted bill serves to only create more challenges for these women.
Regardless of its supporters’ intent, HB 2530 will not prevent substance-exposed newborns from entering this world.
It won’t get women the treatment they desperately need, and it won’t keep families together.
Helena Whitney is a health care consultant and health policy expert. Reach her firstname.lastname@example.org.
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