Legal and medical experts discussed how to support families struggling with addiction during a virtual panel on Tuesday co-hosted by the Center for Law, Brain, and Behavior at Massachusetts General Hospital and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics from Harvard Law School.
Stephanie Tabashneck – senior researcher in law and applied neuroscience at the centers – moderated the discussion and began her presentation with an anecdote about an expectant mother of three who suffers from opioid use disorder, anxiety and depression.
“Julie wants to have a healthy pregnancy but feels ambivalent about going to hospital for treatment at the moment and worries about how her pregnancy will be perceived by [the Department of Children and Families]“said Tabashneck.
Former family court judge Beth A. Crawford, a panelist at the event, noted that people struggling with addiction — like Julie — rarely have the resources to keep their treatment plan on track.
“Julie received a service plan to address her opioid use disorder and was provided with contact information on how to do so,” Crawford said. “Her substance use disorder and her lack of housing in town, the lack of a phone made it really impossible for her to do what she needed to do.”
Crawford said the introduction of family drug court would have made Julie much more “successful”.
“Julie would have worked with the program’s family social worker to learn skills to raise her children safely and also to understand her children’s experience with substance use disorder,” Crawford said. “She would have been in the program for about 18 months before graduating.”
Panelist Davida M. Schiff, Director of Perinatal and Family Care for Substance Use Disorders at the MGH, focused on medical care that could help people recover quickly during pregnancy.
Schiff began her presentation by discussing the MGH Support for Opioid and Substance Use Disorders in Pregnancy and Infancy, or HOPE Clinic, which provides care for pregnant women with to substance use.
The effectiveness of early intervention programs like the HOPE Clinic, according to Schiff, is multifaceted and is directly linked to “improved maternal and neonatal outcomes with fewer preterm births, less placental abruption, and fewer fetal deaths.”
On the role of the law, Schiff commented on the ineffective and harmful prosecution of pregnant women struggling with addiction.
“The pursuit of pregnant women with substance use disorders causes them to drop out of treatment, and that risks poor outcomes — for both mother and baby,” Schiff said. “While almost every professional organization is affirming the need for a public health response, we are actually seeing an increasing number of punitive responses from states. [toward] perinatal substance use.
Schiff also criticized the “stigmatizing” nature of Massachusetts Statute 51A – a law that mandates reporting of suspected cases of child abuse.
“This is detrimental to the health of pregnant women and their infants because we know that this mandatory reporting causes people to avoid recommended care for themselves and their babies,” Schiff said.
Crawford emphasized empathy when dealing with drug-addicted parents.
“It was very clear to me that these parents who came into our program with a substance use disorder had a long history of trauma like Julie did,” she said. “I always said to myself, how lucky I was, I could very easily have been in the same situation. And how would I like to be treated in this situation? »