What is the role of state laws in screening for neonatal abstinence syndrome (NAS)?

Updated: Dec 20, 2017
  • Author: Ashraf H Hamdan, MD, MBBCh, MSc, MRCP, FAAP; Chief Editor: Santina A Zanelli, MD  more...
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Many state laws and policies have been established in an attempt to prevent and/or address prenatal substance use. Existent laws address the testing, reporting, prosecution, and receipt of welfare benefits for pregnant women who use drugs.

Historically, substance abuse testing and reporting laws differ among states, as in the following examples:

  • The Guttmacher Institute reported that 4 states (Iowa, Kentucky, Minnesota, and North Dakota) require health care professionals to test for prenatal drug exposure when prenatal drug abuse is suspected, and 14 states (Alaska, Arizona, Illinois, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, Montana, North Dakota, Oklahoma, Rhode Island, Utah, and Virginia) require reporting women to child protective services (CPS) for prenatal substance use. However, federal Public Law 108-36 (Keeping Children and Families Safe Act of 2003) attempted to create a uniform state response to prenatal substance abuse.

  • The 2003 reauthorization of the federal Child Abuse Prevention and Treatment Act (CAPTA) requires states receiving CAPTA grants to develop a plan for medical workers to notify CPS of infants identified at birth as affected by prenatal drug exposure. The law states that this referral, in and of itself, is not grounds for a child abuse and/or neglect determination and cannot be used for criminal prosecution. Rather, it is intended to provide a safety screening and to link the mother to voluntary community services. The law also requires that CPS develop a safe plan for infants in this situation. [45]

Each physician should be familiar with his state law regarding screening and reporting of prenatal substance abuse and neonatal exposure to substances in utero.

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