Addressing NAS: Carrot versus Stick
With all the attention the Neonatal Abstinence Syndrome (NAS) issue has gotten over
the past few years, there are lots of opinions on how the issue should be addressed in
Tennessee. NAS is a set of symptoms a newborn can exhibit at the time of birth due to
their mother’s drug use during pregnancy. Babies are born physically dependent on
these drugs. Once they are born their bodies go into physical withdrawal and are given
the diagnosis of NAS. Babies have to then be weaned slowly from the drugs to keep
them from experiencing painful withdrawal symptoms.
In 2013, the State Legislature passed a bill called the “Safe Harbor Act” which states
that if a woman enters both treatment and prenatal care prior to her 20 th week of
pregnancy that the Department of Children’s Services will not automatically take her
baby into custody. This law was designed to encourage (carrot) women to get the
medical services and help for their addiction.
In this current legislative session, there is a bill being proposed that would charge a
mother who’s baby is born with NAS or other medical conditions as a result of their
mother’s illegal use of a narcotic drug with an assaultive offense, which is a
misdemeanor offense that would have a maximum sentence of one year in jail. If the
child dies, the mother can be charged with criminal homicide (stick).
In looking at this particular issue, it caused me to pause and ask, “Why have we not
given the same attention to women who abuse alcohol or tobacco while pregnant?” In
looking at the data, many more newborns are negatively impacted by the maternal use
of these substances. An estimated 40,000 newborns each year are affected by Fetal
Alcohol Syndrome, with damage ranging from major to subtle. This condition affects
more babies than Down Syndrome, Cerebral Palsy, SIDS, Cystic Fibrosis, and Spina
Bifida combined.
Substance use during pregnancy is not a new issue in our community, but is 100
percent preventable. We have to think carefully about the best approach(s) to address
what we see as a threat to the health of our children. None of us want to see babies
suffer and have lifelong challenges, but what is the best solution? A lot to ponder.