States’ substance-use policies linked with reports of infant maltreatment

A new paper published in Health Affairs examines how states’ substance use policies relate to child maltreatment reports there. The authors find that adopting a “punitive” policy that treats prenatal substance use as criminal or as child maltreatment produces a 19 percent increase in infant maltreatment reports, driven by a 38 percent increase in substantiated reports against the mother. No changes in unsubstantiated reports were observed. In comparison, states that adopt “supportive” policy, identifying pregnant people as a priority access population for substance use disorder treatment, see no change in infant maltreatment reports. The authors point out that reporting from health care providers, who are mandated to report substance-exposed newborns, drove most of the increase in maltreatment reports, and suggest that “punitive policies may affect patient trust, damaging the provider-patient relationship. This, in turn, could deter health care and SUD treatment use during pregnancy and postpartum” (710).