Pubdate: Mon, 09 Oct 2000
Source: San Diego Union Tribune (CA)
Copyright: 2000 Union-Tribune Publishing Co.
Contact:  PO Box 120191, San Diego, CA, 92112-0191
Fax: (619) 293-1440
Website: http://www.uniontrib.com/
Forum: http://www.uniontrib.com/cgi-bin/WebX

BABIES AND DRUGS

Pregnant Addicts Pose Serious Risks

Before wading into the privacy-rights thicket that is before the Supreme 
Court over the constitutionality of a South Carolina hospital's policy of 
calling the cops on pregnant drug abusers, let's stipulate a few things:

Substance abuse is our nation's No. 1 health problem, consuming one of 
every five dollars spent on Medicaid hospital care.

Substance abuse costs society close to half a trillion dollars each year, 
and causes untold human suffering through increased violent crime; by 
destroying families; by leading to child abuse, teen pregnancy, traffic 
accidents and injuries; and by contributing to or directly causing a host 
of illnesses, from AIDS to cancer.

Children whose parents abuse drugs and alcohol are three times more likely 
to be physically and sexually abused and four times more likely to be 
neglected.

Children of drug-and alcohol-addicted parents are more likely to become 
criminals, more likely to become addicts themselves, more likely to have 
psychological problems and less likely to finish school.

Considering these facts, it would seem incumbent on a hospital -- a 
community's primary health center -- to do all it can to fight the nation's 
No. 1 health problem.

The argument before the Supreme Court is whether drug testing pregnant 
women and turning the information over to police violates privacy rights 
and harms the doctor-patient relationship. As for the issue of 
constitutional rights, we'll wait for the court's decision. But doctors and 
other hospital personnel already are required to report any evidence of 
child abuse to the police. Whether drug testing a patient amounts to 
illegally gathering evidence is the issue at hand. We hope it's found to be 
constitutional.

As for the argument that it harms the doctor-patient relationship, consider 
the greater harm when a doctor does nothing about his pregnant patient's 
drug abuse. First of all, drug abuse can cause damage to a fetus. But even 
worse is the threat posed to a newborn child by a drug-addicted mother. An 
overwhelming majority of professionals at child welfare agencies say 
substance abuse is behind most cases of child abuse and neglect. And a 
child abused by addicted parents is more likely to grow up to be a 
trou-bled adult -- a drug abuser, an abusive parent, even a criminal.

So by alerting police to a pregnant patient's drug abuse, a doctor is 
actually committing a very therapeutic act, considering the risks an 
addicted mother poses to her children and to society.

Of course, it all depends on what police do with that information. If it's 
used to leverage an addicted, pregnant mother into treatment, with the 
promise of remaining with her child and getting full custody once she 
completes an effective recovery program, everybody wins.

In South Carolina, pregnant drug addicts were turned over to police only if 
they refused treatment or failed drug tests twice while in treatment. That 
seems reasonable.

Many people believe drug abuse is benign, equating it with drug dabbling by 
middle-class college kids, or they think drug addicts don't hurt anybody 
but themselves. But addiction to cocaine, heroin, methamphetamine, alcohol 
and other drugs is usually more damaging to the people around the addict.

It creates risks to the lives of children, family members and even perfect 
strangers who fall victim to the hazardous behavior of the addict. And all 
of society pays the costs.

If the Supreme Court finds the South Carolina hospital did not violate 
pregnant women's constitutional rights, then other hospitals should follow 
suit by drug testing pregnant women and, if necessary, using the 
information to leverage them into treatment. Combatting our nation's No. 1 
health problem requires nothing less.
- ---
MAP posted-by: Jo-D