Like the early stories in the New York Times about prenatal exposure to cocaine, the recent New York Times story, Newly Born, and Withdrawing from Pain Killers relies on anecdote and innuendo to focus attention on pregnant drug users rather than actual facts, lessons learned, or the real economic and ethical issues that need to be addressed.
One paragraph leads with this alarming characterization: “As prescription drug abuse ravages communities across the country. . . .” When prescription drug use turns into dependency and addiction it can be extremely damaging to the individual and those around them. This piece, however, does not offer one shred of evidence connecting pregnant women’s drug use to community destruction or decay.
In contrast, there is a lot of evidence that communities in this country are being ravaged by unemployment, foreclosures, massive cuts to education, and by the ongoing transfer of wealth to the top two percent of Americans. Moreover, as researcher Earnest Drucker, PhD, documents, some communities are being ravaged by over-policing and the mass incarceration of young African-Americans.
It is these policies and practices that not only destroy communities, but that also lead some individuals to turn -- out of depression, despair and exhaustion – to drugs.
Indeed, the only mother who is given the chance to talk about why she was using drugs said she was introduced to the painkillers “while working the overnight shift at an industrial bakery an hour from her home.” This young mother who must leave her infant at home so that she can commute two hours each day to work an overnight shift said she found the drugs made it “a lot easier to get through life and have energy.”
Sadly, this New York Times story advances a popular and persistent political narrative that blames drugs, and particularly pregnant women’s drug use, on the destruction of communities rather than on our nation’s economic policy which, among other things, forces young parents lucky enough to have any job, to work a night shift far away from their homes and their children.
According to the story, “Like the cocaine-exposed babies of the 1980’s, those born dependant on prescription opiates – narcotics that contain opium or its derivatives- are entering a world in which little is known about the long term effects on their development.” This is another example of brilliant obfuscation. Rather than report on all that has been learned since the 1980’s – that the alarm about prenatal exposure to cocaine was never justified and that the predicted massive harms never materialized (facts finally so impossible to ignore that the New York Times, a major contributor to the alarm, ran The Epidemic that Wasn’t), the story suggests that when “little is known” we can, in the meantime blame mom and expect the worse.
The story goes to great lengths to describe newborns with strange cries, and stiff limbs, ones that need to be kept in dark rooms – exactly the same characteristics once ascribed to babies prenatally exposed to cocaine and later found not to be linked to that drug or any other.
The story claims that there is “no universally accepted standard of care for their babies” despite years of work by leading researchers including world-renowned Dr. Loretta Finnegan, who have helped establish such standards. Nor does the story mention the existence of federal pamphlets and guidelines recommending methadone treatment for pregnant women with addictions to opiates as healthful and responsible for both the pregnant woman and the newborn.
Moreover, the story fails to mention research that has found that allowing new mothers to hold their babies and to have skin-to-skin contact significantly reduces signs of neonatal abstinence syndrome and the need for medications. Yet, as written, this story paints a picture of children that must be kept in isolation, away from their mothers, and subject to often uninformed and over-medicalized responses. In fact, there are now decades of research regarding children prenatally exposed to drugs, and the vast majority of studies have either found subtle (small) effects or none at all.
The story also demonstrates how some issues are defined as “ethical” ones and others are not. According to the story, “Few doctors are even willing to treat pregnant opiate addicts.” While the writers of this story claim that those who “treat pregnant addicts face a jarring ethical quandary” about whether to prescribe certain medication to pregnant women, because of the effect it might have on their future children – the fact that most doctors will refuse to treat a pregnant patient begging for help is not described by the authors as an ethical issue at all.
The authors of this story also admit that there “are no national figures that document the extent of the problem,” yet claim that the problem “has grown rapidly,” describing Maine as “plagued” by prescription drug abuse. Such language, totally without supporting data, suggests a far-reaching, fast-growing problem.
National surveys, however, consistently find that at most 3-5 percent of all pregnant women use any controlled substances and most of those women are using marijuana-some to self medicate for extreme morning sickness. Since there is no data, only anecdotes, there is no reason to assume that pregnant women’s drug use has increased or comes close to the numerous other factors that are recognized as far more common and that carry greater risks including, obesity (>20%), inadequate prenatal care (>10%) and smoking cigarettes (10%) and most of all, poverty.
Perhaps then the real ethical quandary that should be addressed is why stories like these suggest that the greatest threat to children is their mothers – rather than the lack of universal health care, the economic policies undermining our communities, and the unethical doctors who turn away pregnant women seeking medical help.