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Substance use during pregnancy: time for policy to catch up with research

Barry M Lester*, Lynne Andreozzi and Lindsey Appiah

Author Affiliations

Brown Medical School Infant Development Center Women and Infants' Hospital and Bradley Hospital Providence, RI 02903 USA

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Harm Reduction Journal 2004, 1:5  doi:10.1186/1477-7517-1-5

Published: 20 April 2004


The phenomenon of substance abuse during pregnancy has fostered much controversy, specifically regarding treatment vs. punishment. Should the pregnant mother who engages in substance abuse be viewed as a criminal or as someone suffering from an illness requiring appropriate treatment? As it happens, there is a noticeably wide range of responses to this matter in the various states of the United States, ranging from a strictly criminal perspective to one that does emphasize the importance of the mother's treatment. This diversity of dramatically different responses illustrates the failure to establish a uniform policy for the management of this phenomenon. Just as there is lack of consensus among those who favor punishment, the same lack of consensus characterizes those states espousing treatment. Several general policy recommendations are offered here addressing the critical issues. It is hoped that by focusing on these fundamental issues and ultimately detailing statistics, policymakers throughout the United States will consider the course of action that views both pregnant mother and fetus/child as humanely as possible.