Methadone maintenance is the treatment of choice for addicts trying to wean themselves off opiates, but, for pregnant women, methadone can provide judges and caseworkers with the evidence needed to arbitrarily separate recovering addicts from their children. The Daily Beast's Rachel Blustain chronicles the struggle that pregnant women undergoing methadone treatment sometimes face in trying to keep custody of their children.
Though methadone is prescribed precisely to treat opiate addiction, Jocelyn Woods of the National Alliance for Medication Assisted Recovery notes that "there is confusion among some doctors, child welfare workers and judges that using it is just substituting one drug for another." New mothers tend to get caught in the web of confusion about methadone maintenance, since on the one hand their doctors are insisting that they undergo methadone treatment to wean themselves off of opiates, and on the other an entire legal apparatus holds deep prejudices against methadone, unfairly casting methadone use as simply a leap to a new lily pad of drug addiction. That, however, is largely a misconception, brought on partly by the stigmatizing shadow cast by drug addiction — methadone, in some cases, can save a fetus' life, notes Blustain, "since going cold turkey can bring on premature birth or in some cases a miscarriage."
From 2000 to 2009, there has been a fivefold increase in pregnant women using opiates, a figure that owes itself partly to the increase of prescription painkiller abuse. This figure has raised some alarms within the Office of National Drug Control Policy, which convened a meeting in August to shift policy in the face of what appears to be a growing crisis. Critics of the study, however, say that such talk of "crisis" could be overblown, and, what's more, that such fear could unfairly penalize pregnant women who are simply following their doctors' orders by undergoing methadone maintenance. Separating mothers from children can have negative impacts that echo through an entire lifetime, and, rather than using methadone as a pretext for splitting up a family, caseworkers and judges alike should be showing more discretion.
According to Barry Lester, the director of the Center for the Study of Children at Risk at Brown Alpert Medical School's Women and Infants Hospital, mothers on methadone stop getting high and tend to lead more stable lives, which means that they are liable to receive more diligent prenatal care. There is, however, no evidence to show what the long-term risks are to children exposed to methadone in utero. Infants exposed to methadone in utero often experience withdrawal symptoms hours, days and occasionally weeks after birth, with is part of the reason why child protective workers err on the side of removing such children from their mothers early on.
Some of the impetus to remove babies from mothers undergoing methadone maintenance owes itself to the crack epidemic of the 1980s. Though there's now a greater effort to keep mothers and children together, judges and caseworkers sometimes make seemingly arbitrary custody decisions, which in turn makes opiate-addicted mothers more mistrustful of the legal system. Rather than go in for methadone treatment, then, some women choose instead to hide their drug problems, fearing that, once they begin methadone treatment, social services will be more likely to take their children. Obviously, that is the worst possible intersection of child welfare laws and methadone maintenance, where the system breaks down because it stubbornly continues to stigmatize drug addiction.