I have to be the devil's advocate on this:

With the policy described from Arizona, there is no stipulation for moms who 
abuse alcohol or moms who abuse prescription drugs (opiates such as Oxycontin, 
Vicodin).   Both are "legal drugs" that when they are abused can cause 
problems for both mom and babe.   A mom on methadone maintenance may have a positive 
"tox screen" but is using the methadone in a controlled setting.

It also doesn't stipulate at what time would the mother have a positive tox 
screen (at delivery, at any time during the pregnancy?).   So a mom who binges 
but avoids use around the time of delivery could easily slip under the 
"radar."   By the same token the mom who may have used early on in pregnancy may be 
stigmatized.

What support in this kind of environment is given for the mom with a history 
of substance abuse who is actively abstinent and seeking recovery?

I ask this as a pediatrician who has worked extensively with mothers and 
children in recovery programs in my area (for the last 10 years).

Best,

Pierrette Mimi Poinsett, MD FAAP
Modesto CA (but soon to be from Petaluma CA)


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