Do U.S. Policies That Punish Pregnant Women for Drug Use Actually Work?

To tackle drug use during pregnancy, several states have enacted punitive laws (defined as criminalization, grounds for civil commitment, or child abuse or neglect) or reporting laws (defined as duty to report to authorities). To examine the potential adverse effects of such mandates, investigators examined rates of neonatal abstinence syndrome (a proxy for maternal opioid use) in 8 states among >4.5 million births from 2003 through 2008.

Adjusted rates of neonatal abstinence syndrome were 46 per 10,000 live births in states without punitive policies, 57 per 10,000 in states during the first year after enactment of punitive policies (odds ratio, 1.25), and 60 per 10,000 more than 1 year after enactment (OR, 1.33). States with reporting laws …