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首页> 外文期刊>Contemporary ob/gyn >'Policing' pregnant women during the opioid epidemic Getting to good medicine and good law
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'Policing' pregnant women during the opioid epidemic Getting to good medicine and good law

机译：在阿片类药物流行期间“监管”孕妇 获得良药和良法

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Every 15 minutes a baby is born with neonatal abstinence syndrome (NAS), a condition whose incidence has increased 5-fold since 2004. There are also increasing reports of opioid overdoses in breastfed babies whose mothers are ultrarapid metabolizers of codeine and tramadol.2 The opioid epidemic clearly has hit obstetricians and pediatricians full bore. However, lost in discussions about how to mitigate the problem has been a growing state policy divide that pits protecting infant health against preserving maternal autonomy. There is now an increasingly bright line in state policies between states that have enacted punitive laws treating drug use during pregnancy as child abuse, and a possible crime, and states that have laws emphasizing supportive or preventive policies and practices. Advocates of criminalization note that failure to impose strict and clear expectations and consequences for illicit use of opioids has had the dual social impact of enabling bad behaviors and recklessly endangering the health of innocent newborns, thereby warranting a punitive policy response. Moreover, they note, care for these infants consumes $1.5 billion per year in health care costs that are frequently borne by state Medicaid coffers. In contrast, critics of punitive policies argue that criminalizing prenatal opioid use deters mothers from seeking appropriate care; brands women with a criminal stigma; and in some cases, destroys families by removing the newborn from the custody of the mother.
机译：每 15 分钟就有一名婴儿出生时患有新生儿戒断综合征 （NAS），自 2004 年以来，这种疾病的发病率增加了 5 倍。关于母乳喂养的婴儿服用阿片类药物过量的报道也越来越多，这些婴儿的母亲是可待因和曲马多的超快速代谢者.2 阿片类药物的流行显然已经对产科医生和儿科医生造成了极大的打击。然而，在关于如何缓解这一问题的讨论中，人们忽视了日益扩大的国家政策分歧，将保护婴儿健康与维护产妇自主权对立起来。现在，在颁布惩罚性法律的州之间，各州将怀孕期间吸毒视为虐待儿童和可能的犯罪行为，而各州的法律则强调支持性或预防性政策和做法。刑事定罪的倡导者指出，未能对非法使用阿片类药物施加严格和明确的期望和后果，产生了双重社会影响，即助长不良行为和鲁莽地危害无辜新生儿的健康，因此需要采取惩罚性政策应对措施。此外，他们指出，照顾这些婴儿每年要花费15亿美元的医疗保健费用，这些费用通常由州医疗补助金库承担。相比之下，惩罚性政策的批评者认为，将产前阿片类药物使用定为刑事犯罪会阻止母亲寻求适当的护理;给女性打上犯罪污名的烙印;在某些情况下，通过将新生儿从母亲的监护权中带走来摧毁家庭。

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