How Social Policies Make Matters Worse: The Case of Maternal Substance Abuse

• Author: Maureen A. Norton Hawk
• Published date: 01 July 1994
• Date: 01 July 1994
• DOI: 10.1177/002204269402400311
• Subject Matter: Article

The Journal of Drug Issues

24(3),517-526

1994

HOW SOCIAL POLICIES MAKE MATTERS WORSE: THE

CASE OF MATERNAL SUBSTANCE ABUSE

Maureen A. Norton Hawk

This

article

addresses

the

issue

of

maternal

substance

abuse

and the

consequences

of our

current

punitive

approach.

The

article

initially

presents

information

that

defines

the

scope

of the

problem

and

then

offers

case

illustrations

of the court's

attempt

to deal

with

women

who

use

drugs

and

alcohol

when

pregnant.

The

article

then

focuses

on

characteristic

of

interventions

that have the

potential

for

bringing

about

a

deterioration

of

the

problem

of

maternal

substance

abuse.

In

an attempt to address maternal substance abuse evolving social policy is

relying on the criminal justice system. In fact since 1987 there have been more

than 160 criminal prosecutions against women for their drug or alcohol use during

pregnancy (Paltrow 1992). However, the prosecution of these women fails to

rectify the problem

of

substance-abusing pregnant women and, in fact, this policy

exacerbates the problem of drug and alcohol use during pregnancy.

Each year approximately 739,200 women use one or more illegal drugs during

pregnancy (Gomby and Shiono 1991). Calculations by the National Association

for Perinatal Addiction Research and Education (NAPARE) indicate that maternal

drug use annually affects 375,000 newborns (Chasnoff 1989). Studies have

indicated that a relationship exists between the use of various illicit drugs and

lower birth weight and smaller head circumference, irritability, neurobehavioral

dysfunction, sudden infant death syndrome (Zuckerman 1991), negative responses

to multiple stimuli (Howard and Beckwith) 1989), and a potential for

malformation of developing systems (Zuckerman 1991). It is important to note

that while there exists a correlation between illicit drug use and

physiological/psychological problems in newborns, neither causality nor a

complete understanding of the potential harm

of

specific substances has been

established. This difficulty in confirming a direct link between drug use and drug

effect in pregnant addicts is due in part to the involvement of other extraneous

variables such as the lack of prenatal care (Kronstadt 1991), poor maternal health,

inadequate maternal nutrition, and polydrug use (Zuckerman 1991).

These physiological/psychological effects on newborns, if accurate, can result

in dramatic social and medical costs. The General Accounting Office (1990)

found that in one hospital the median cost for the medical care of a newborn was

$4,100 higher for drug-exposed infants with the cost rising as high as $135,000 for

adrug-exposed, premature infant needing intensive care for several months

Maureen Norton Hawk is a doctoral candidate at Northeastern University. She holds a masters degree in Social

Work and Rehabilitation Counseling and has done extensive work with drug addicts and alcoholics. Her current

interest and the focus of her dissertation will be on the effects of our social policy on pregnant addicts. Address

reprint requests to Maureen Norton Hawk. P.O. Box 654. Norfolk. MA 02056.

©Journal of Drug Issues, Inc. 002-0426/94/03/517-526 $1.00

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