Pubdate: Fri, 04 Mar 2016
Source: Herald Bulletin, The (Anderson, IN)
Copyright: 2016 The Herald Bulletin
Contact:  http://www.theheraldbulletin.com/
Details: http://www.mapinc.org/media/3877
Author: Maureen Hayden

CALL FOR DRUG-TESTING OF PREGNANT WOMEN COMES WITH A CAVEAT

But Doctors Need Court Order to Give Results to Police

INDIANAPOLIS - A surge in heroin and painkiller abuse - and a related 
spike in the number of drug-dependent newborns - has doctors calling 
for drug tests for all pregnant women.

But, first, doctors and health officials want lawmakers to shield 
addicted, expectant mothers from punishment.

The Legislature has taken a first step, quietly passing a measure to 
prohibit doctors from giving results of a pregnant woman's drug tests 
to police without a court order.

Members of a task force working on policies for drug screenings worry 
that, without such protection, their program will deter addicts from 
seeking prenatal care.

Dr. Maria Del Rio Hoover, an Evansville neonatologist, told lawmakers 
that could have "devastating health consequences."

In addition to harming the mother, drug addiction poses heightened 
risks of premature birth, low birth weight and death to newborns.

Also, drug-dependent newborns often end up in neonatal intensive care 
units for six weeks or longer, suffering costly, painful withdrawals.

"Their care is very labor intensive because they're nearly 
inconsolable," said Dr. Mark Gentry, an obstetrician at Hendricks 
Regional Health in Brownsburg. "It's heart-jerking and becoming much 
more prevalent."

Gentry's hospital is one of four in the state that will soon start a 
pilot project testing pregnant women for drugs, with the aim of 
getting care for addicts. Women may opt out of the screenings; they 
legally cannot be forced to take the tests.

"If women think this can be used against them punitively, they'll 
avoid care, and that compounds the problem," Gentry said.

Under current law, doctors must call child welfare authorities if 
they believe a child is abused. That could include cases where a 
child was exposed to drug use while in the womb, though no law 
specifically addresses the issue.

The state doesn't track the number of drug-dependent newborns.

But Gentry said hospitals in communities that have seen a spike in 
heroin and illegal opiate arrests - including his own - have also 
seen a fast rise in drug-dependent babies.

A 2015 study published in New England Journal of Medicine found the 
rate of intensive-care admissions for babies suffering from drug 
dependency nearly quadrupled from 2004 to 2013.

Those babies now make up 27 of every 1,000 intensive-care admissions 
nationally.

Legislation protecting results of drug tests for pregnant women marks 
a significant departure from a more punitive approach taken 
elsewhere, said Sen. Jim Merritt, R-Indianapolis, the bill's author.

Lawmakers in Tennessee last year increased drug screenings of 
expectant mothers and passed a law allowing prosecutors to charge a 
woman with aggravated assault against her unborn baby if she was 
caught using illicit drugs. The penalty is up to 15 years in prison.

Merritt said he wrote his bill in direct response to Tennessee's law.

But Tennessee isn't alone. Alabama and South Carolina have similar 
statutes, and legislators in North Carolina and Oklahoma have 
introduced their own versions in hopes of reducing the number of 
babies born with drug dependency.

Gentry said those states are getting it wrong. "And, as a result, 
they're scaring women away from the care they need," he said.

Merritt's bill got widespread support in both the 
Republican-controlled House and Senate.

That may not have happened in years past, when legislators took a 
harder tack toward drug crimes. But there's been a shift in thinking 
toward treating addiction as a public health issue, with lawmakers 
now willing to devote more resources to treatment.

"We're understanding a lot more about the science of addiction," said 
Dr. Tim Brown, a family physician and Republican chairman of the 
House Ways and Means Committee.

The Indiana State Medical Association agrees and supports the proposal.

So does Rep. Ed Clere, R-New Albany, a member of the House Public 
Health Committee, who calls it part of a "harm-reduction" effort that 
acknowledges how difficult it is for addicts to quit drug use on their own.

"We shouldn't put up barriers to people getting help," he said.

The bill's backers say the proposal is not enough, however, given a 
lack of treatment facilities in the state and their reluctance to 
take in pregnant women who require more complex medical care.

"We have a tsunami of addiction that has gripped the state," Clere 
said. "It's going to take a much greater amount of resources for a 
sustained period of time to combat it."
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MAP posted-by: Jay Bergstrom