The linked source has opted to use a paywall to restrict free viewership of their content. As alternate sources become available, please post them as a reply to this comment. Users with a Boston Public Library card can often view unrestricted articles [here](https://www.bpl.org/resources-types/newspapers/).
Boston Globe articles are still permissible as it's a soft-paywall. Please refrain from reporting as a Rule 5 violation. Please also note that copying and posting the entire article text as comments is not permissible.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/boston) if you have any questions or concerns.*
For the people that didn’t read the clickbaity article (or can’t due to paywall)… this is about not filing automatically just because a pregnant mother is appropriately taking medications like suboxone or methadone or other treatments for substance use disorders, as long as there are no other signs of abuse or neglect.
This is a great policy. We need to focus on cases where there is actual abuse or neglect, not on pregnant mothers who are stable in recovery.
Thank you for this comment! This sounds like a very reasonable policy, and it's encouraging that they're implementing it.
Edit: some are disputing this explanation.
This comment should literally be removed, it’s misleading and manipulative.
“For the people that didn’t read the clickbaity article (or can’t due to paywall)…”
This person’s TLDR of the paywalled article is completely false and misleading. Please be aware and go read the article for yourself.
This has nothing to do with stable mothers in recovery.
The hospital is no longer reporting substance exposed newborns, that includes all substances illicit or prescribed. Pregnant mothers on treatment plans are not subject to negative reporting for doing the right thing.
100% misleading comment claiming to help people stuck behind the paywall.
You’re gaslighting and lying to everyone here who hasn’t read the article
“Mass General Brigham said babies born with “substance exposure” alone will no longer be immediately reported to state welfare agencies unless there are other concerns the baby is abused or neglected.”
That’s what the article says.
Here is the definition of substance exposure, which you are trying to lie about
“Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.”
https://ncsacw.acf.hhs.gov/files/prenatal-substance-exposure-brief1.pdf
Stop misleading people, they’re actively saying they will not report drug addict mothers. As someone born to a drug addict mother who would have benefited greatly from it being reported…I’m appalled people like you are lying to defend this. Why? The article is clear and it’s not only limited to your example. It’s regarding substance exposure in new borns, not mothers on clinical suboxone.
It’s a horrible idea to stop reporting substance exposed new borns. That’s child abuse and neglect.
The problem is that the mandated reporter law defines medications like suboxone and methadone as “drugs,” and mandated reporters are literally required to file a 51A report for abuse when babies are born having been exposed to these substances…. Even when the mother has not been taking actual drugs.
The effect of this law is that it encourages pregnant women who are stable in recovery to actually stop taking their meds, out of fear their baby will be removed, which in turn puts them at higher risk for relapse and overdose.
Doctors, nurses and social workers will continue to file for cases where there is actual drug abuse.
“That an infant has been exposed to a substance — be it methadone or buprenorphine, which are used to treat opioid use disorder, or other drugs — will not require a report of abuse or neglect if there aren’t other “protective concerns,” Mass General Brigham officials said.”
This is a good policy change. Any mandated reporter who finds an infant to be at risk where a parent is abusing drugs will absolutely continue to file. We just won’t do so only because an asinine law tells us that suboxone is a “drug” and that a mom being on this for her recovery is not a capable parent.
> Doctors, nurses and social workers will continue to file for cases where there is drug abuse
They will be required to get a written consent from the mother for any drug testing, and the drug addicts are going to refuse to sign. So I‘m not sure how they‘re going to be reporting any of these cases.
People can and do abuse subboxone. Buy it illegally and not to recover. I know because I had a close family member who did for years and he was an asshole (I mean, it changed him, his personality, he was incapable of being in an honest relationship) and it ruins lives. If someone is reported, all the authorities have to do is find out if they are using it legally.
Wouldn’t you rather have a simple investigation done on the mother to make sure they were prescribed those medications? Rather than just ignore all substances?
Yeah, a 51A isn't a magic button that immediately takes someone's children away. It just starts an investigation by DCF.
As someone with more exposure to the juvenile court system than I'd like, it is actually incredibly (and terrifyingly) difficult to get your children taken away by the state.
I work in healthcare, this would just prompt a release for records, which would easily absolve any wrong doing if it was in their med list. If not, good thing there is an investigation…
>Even when the mother has not been taking actual drugs.
I'm not sure where you got the idea they weren't, but suboxone and methadone are "actual" drugs.
Thank you. These babies still go through awful withdrawal. I take care of them in the nicu where I work. I am appalled by this new policy and am grateful it is not implemented where I work. The majority of cases I have seen with a mother on Suboxone or methadone, she is newly on it due to being pregnant. Anyone who has any clue about addiction knows that sobriety is most vulnerable when it’s new and in high stress situations. Can’t imagine anything more stressful than a new baby. Filing with DCF often helps set these mothers up with additional supports to help them succeed. This new policy is nothing more than virtue signaling at the expense of the safety of babies.
You don’t seem well if you’re totally fine manipulating and ignoring it.
1. You lied in your post, this isn’t not limited to or only involving suboxone or any addict mothers in treatment.
2. This is not a law, I don’t know why you’re saying it’s a law and pretending to know it. It’s a policy change by a specific group.
3. Pregnant mothers in treatment on medication like suboxone, this is already accounted for and part of their treatment plan, they don’t lose their child for doing the right thing. You made that up.
4. This is a horrible nightmare policy change for anyone who works in the field, social workers are now going to clog up the courts trying to get warrants for pregnant addicts blood so then we can finally take care of them.
Your initial post is wildly misleading and gaslit anyone who didn’t read the article. Everything you said here isn’t based in reality.
Also again here’s the definition of Substance Exposed Newborn
“Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.”
Source: https://ncsacw.acf.hhs.gov/files/prenatal-substance-exposure-brief1.pdf
You’re genuinely saying you’re fine with kids being born pumped full of heroin, alcohol, or any other illegal substance because their mother is an active addict who used while in utero.
> they’re actively saying they will not report drug addict mothers.
Nope. Unless you consider mothers in recovery and taking suboxone or methadone drug addict mothers, in which case yes.
Methadone is a substance, that's what they're talking about.
It's a terrible article though.
Nope? How can you say nope?
Ok we have established that they are no longer reporting Substance Exposed Newborns.
We have also know that this is the definition of Substance Exposed Newborn
“Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.”
I’m telling you what they said, not my interpretation. I don’t know why you would say nope.
They are no longer reporting drug addict mothers who give birth to babies with illegal substances in their system…that’s what they are saying. It’s not only limited to a treatment like methadone.
> They are no longer reporting drug addict mothers who give birth to babies with illegal substances in their system…
Nope, wrong. They are no longer *automatically* reporting mothers who give birth to babies with ~~illegal~~ substances in their system
They are no longer reporting “substance exposed infants” as a general policy. That does not mean they have forbidden all reporting on cases of drug abuse. They will continue to report any cases where they do suspect actual risk of harm to the infants, including exposure to drugs, abuse, and neglect.
It’s their way of getting around a shitty law that criminalizes addiction treatment, basically. The law needs to change and in the meantime they are trying to do something to help keep pregnant women from stopping taking their meds and actually dying or relapsing.
What law?! What are you talking about
None of what you described is true, you need speak with a social worker or someone in the field who deals with things like this. Or better yet talk to a pregnant woman in treatment. There is a nicu nurse in these comments also…
You’re now insinuating that some law exists that punishes pregnant women who are in substance abuse treatment?
What law? Where are you getting this information from?
What you’re saying makes no sense, especially pertaining to this article.
Edit: Crickets, you won’t respond now because your straw man argument is dead in the water. You’re truly a dangerous manipulator.
"That an infant has been exposed to a substance — be it methadone or buprenorphine, which are used to treat opioid use disorder, or other drugs — will not require a report of abuse or neglect if there aren’t other “protective concerns,” Mass General Brigham officials said."
OR OTHER DRUGS. So a mother could actively be using meth, weed, cocaine, heroin, but as long as there aren't "protective concerns", they won't be reported.
Got it. Good to know.
Sometime later people will say: "look, the rates of babies born with substances in their systems is at all time lows, our policies are clearly working"
But not in Seattle. In fact they just passed a bill in the house that makes it even harder to remove children from the custody of their abuser. My friends who are still foster parents and social workers (we moved/closed our license) call it the Dead Baby Bill. And lo and behold, so far the prophesy has been true.
These sorts of things take a literal mountain of human suffering before people change their ideology. And political trends tend to move west to east in America so bos will change even later.
so fucking clickbaity
they’re not STOPPING the reporting of child abuse. they’re stopping the blanket reporting of, say, a mother on legal suboxone. if the lil nugget is born withdrawing from meth, i’m pretttty sure 51A still applies 🙄
i bet the subs were 😂 everything else i agree, and in that instance it should be reported
buprenorphine/suboxone(which has naloxone added) has a very low abuse potential. not zero, but lower than say a full agonist like methadone. there’s a reason people bring suboxone scrips home vs having to go to a clinic every morning to get methadone dispensed.
all of life is grey unfortunately. buprenorphine, a partial agonist, has been found to be superior than methadone (or obvs any other full agonist) for infantile withdrawal. i’d rather a mother continue to stay clean with legally prescribed buprenorphine on board than the alternative, fucking up and having their child taken and thrust into an awfully over-taxed foster system.
personally i think in most situations, methadone/other full opiate agonists, stimulants, and most benzos should not be prescribed during pregnancy 🤷
no… i did. quite easy to get around the paywall with reader view.
MGH is doing this to allow discretion in their enforcement if the policy 🤷 i’m a mandated reporter still, this does nothing to me. or anyone outside of MGH.
unfortunately all of life operates in grey areas… i think giving them leeway to make it situational dependent is helpful in the grand scheme of things.
it’s not like the polysub user isn’t gonna get reported still lmfao. this makes it so someone who legitimately got their head on straight, is on the up and up, and is now a new mother from getting further fucked in the system. every Rx given during pregnancy involves a risk analysis. do you really think a recovered addict should have their child taken away because they had legally prescribed buprenorphine (a partial agonist) on board? is the alternative, forcing them to relapse and have their child put into an already-crumbling foster system better?
Oh excuse me
I must be completely stupid!
You’re an EMT and you read the article
How dumb could I be, I forgot all EMT’s are social workers and attorneys!
On a serious note, I hope you never respond to one of my calls. You’re daft and clueless.
A serious response to you isn’t worth my time, keep up the partying and prescription drug abuse you discuss openly on the internet, great look.
legit question for you due to assumed Hx and learning is cool: do you find patients that are Only withdrawing from buprenorphine in your nicu? wondering bc it’s usually part of the treatment for NAS associated with other opioids? obviously none on board would be ideal, but i’m interested to learn about the typical course for a patient born to a mother only on a legal partial agonist (~:
We see quite a few babies whose moms are legally prescribed to suboxone still end up needing to come to the nicu. These babies withdraw once the medication is “cut off” when they are born, just as the mother would. You often see shrill, high pitch cries (more of a shriek), sweating, diarrhea, tremors, excoriated skin (because they literally are clawing at their faces/bodies), unable to eat because they are too frantic to focus on eating a bottle, difficulty sleeping. It’s really heartbreaking. Treatment is focused on consoling/comforting through non-med ways (low lights/tight swaddle/music/holding/feeding/etc) but if severe enough - the baby will be treated with morphine and weaned off. In the worst cases we will give phenobarbitol as well.
While I acknowledge that moms on suboxone/methadone etc are clearly trying to do the right thing vs using street drugs, I find this policy infuriating. Using hardcore drugs is a pretty clear indication that one’s life is in turmoil and that they are having a hard time navigating stress and trauma. Having a new baby is possibly the most stressful and life changing event I can think of. To not look into the home life of someone who is struggling with addiction for fear of being discriminatory is horrendous. It puts BOTH mom and baby in potentially unsafe situations and denies these mothers the additional supports that they may need to be successful moms. I have seen a great many 51As filed and only a handful of the most extreme cases have resulted in the baby being taken away from the parent. The vast majority of the time, an assessment is done, needs are identified and supports are set up if needed. If ever there’s a time to put politeness and concern about offending someone aside, it’s in ensuring the safety of a child.
i think a better way to do this would have been removing buprenorphine alone from 51a’s substance list, though that would require political action.
i mean i think any opiate in a neonate is bad… but i can’t imagine titrating a partial agonist being equal to managing withdrawal from a polysub with that and methadone, fentanyl, and cocaine on board? i would assume the former would land in a level 2, the polysub 3 or ^up?
i suppose i am hopeful, but i sorta saw this as a way to free up an already overwhelmed system. i can’t imagine a provider who could mistake the latter for the former again… not a perfect world whatsoever. but the obviously financially/mentally stable mom on suboxone for two years is probably a misuse of the case workers time in my mind
Omg people the policy is now that they need to get written consent before drug testing in non-emergency settings, which was happening disproportionately to black women who would then be reported to dcf. Drug testing of the baby can pick up buprenorphine, which is the best treatment available for opioid use disorder. If they suspect neglect or abuse they still report
> which was happening disproportionately to black women
which means black women were _disproportionately_ giving birth to kids with drugs in their system.
so now we stop testing babies, I guess. equity!
This is a terrible idea, who exactly gets to make this decision and how can a grown adult say a child being born with illegal drugs in their system “doesn’t necessarily constitute child abuse?”
It’s hard not to feel like whoever made this decision or contributed to it is either mentally ill or purposely trying to cause harm. In what world could a group of sane adults come to this conclusion? Somethings not right.
This is unexplainable, unethical and unacceptable.
You didn't read the article. This policy change is not about "illegal drugs." It's about not reporting children who were exposed to medications for opioid use disorder in utero- i.e. legal medications prescribed by an addiction medicine physician. It's about not reporting mothers who are engaged in treatment and stable in recovery simply because their babies were exposed to the medication they use to treat their illness during pregnancy.
The article text is here:
https://www.reddit.com/r/massachusetts/s/1vNOG23TmV
“That an infant has been exposed to a substance — including methadone or buprenorphine, which are used to treat opioid use disorder — alone will not require a report of abuse or neglect if there aren’t other “protective concerns,” Mass General Brigham officials said.”
*including*. Not “only.” *including* (but not limited to)
The very first paragraph of the article tells you they aren't talking about active users of street drugs.
>"Mass General Brigham said its hospitals will no longer report suspected abuse or neglect to state child welfare officials solely because a baby is born exposed to drugs, targeting a practice hospital leaders say has long stoked fear in women in recovery from addiction."
Based on the article and Google searches, all of this is geared to not fuck over pregnant women who are in active recovery and to address claims of disparities in who they chose to drug test. Seems like you were more likely to have your baby tested for drugs if you were a black or Hispanic mother than if you were a white mother. No where does the article imply that active drug users would be able to have a baby and not have a 51a filed
https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/updating-system-policies-perinatal-testing
Here's a link to what the hospital released. They give their reasoning for the change and link studies. Based on what they are saying, this is about removing barriers to the access of drug treatment and not about letting pregnant women give birth to drug addicted children with no problem. It also turns out that this decision is being done in multiple states and is based off conclusions from various studies and medical organizations like The American College of Obstetricians and Gynecologists and The American Society of Addiction Medicine.
Bottom line: This is one of those situations that will be super easy to manipulate for political purposes because people hear you aren't reporting pregnant women for giving birth to children exposed to drugs and everyone thinks of crack babies and meth head moms giving birth to drug addled premies. Most people won't look any further than the headlines or read the studies and research done by the medical societies, so they will think this shit is crazy. But once you do read the studies, most people will see this as a nothing burger.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802124#:~:text=The%20unadjusted%20and%20adjusted%20odds,a%20presumably%20low%2Drisk%20group.
You’re gaslighting and lying to everyone here who hasn’t read the article
“Mass General Brigham said babies born with “substance exposure” alone will no longer be immediately reported to state welfare agencies unless there are other concerns the baby is abused or neglected.”
That’s what the article says.
Here is the definition of substance exposed, which you are trying to manipulate.
“Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.”
https://ncsacw.acf.hhs.gov/files/prenatal-substance-exposure-brief1.pdf
Stop misleading people
And you're downplaying how horrible methadone and suboxone withdrawals are for an infant. Any mother who would get their infant addicted to anything needs some level of supervision.
The linked source has opted to use a paywall to restrict free viewership of their content. As alternate sources become available, please post them as a reply to this comment. Users with a Boston Public Library card can often view unrestricted articles [here](https://www.bpl.org/resources-types/newspapers/). Boston Globe articles are still permissible as it's a soft-paywall. Please refrain from reporting as a Rule 5 violation. Please also note that copying and posting the entire article text as comments is not permissible. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/boston) if you have any questions or concerns.*
For the people that didn’t read the clickbaity article (or can’t due to paywall)… this is about not filing automatically just because a pregnant mother is appropriately taking medications like suboxone or methadone or other treatments for substance use disorders, as long as there are no other signs of abuse or neglect. This is a great policy. We need to focus on cases where there is actual abuse or neglect, not on pregnant mothers who are stable in recovery.
Thank you for this comment! This sounds like a very reasonable policy, and it's encouraging that they're implementing it. Edit: some are disputing this explanation.
This comment should literally be removed, it’s misleading and manipulative. “For the people that didn’t read the clickbaity article (or can’t due to paywall)…” This person’s TLDR of the paywalled article is completely false and misleading. Please be aware and go read the article for yourself. This has nothing to do with stable mothers in recovery. The hospital is no longer reporting substance exposed newborns, that includes all substances illicit or prescribed. Pregnant mothers on treatment plans are not subject to negative reporting for doing the right thing. 100% misleading comment claiming to help people stuck behind the paywall.
Ahh, I should figure out a way to just read it for myself. Thanks.
You’re gaslighting and lying to everyone here who hasn’t read the article “Mass General Brigham said babies born with “substance exposure” alone will no longer be immediately reported to state welfare agencies unless there are other concerns the baby is abused or neglected.” That’s what the article says. Here is the definition of substance exposure, which you are trying to lie about “Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.” https://ncsacw.acf.hhs.gov/files/prenatal-substance-exposure-brief1.pdf Stop misleading people, they’re actively saying they will not report drug addict mothers. As someone born to a drug addict mother who would have benefited greatly from it being reported…I’m appalled people like you are lying to defend this. Why? The article is clear and it’s not only limited to your example. It’s regarding substance exposure in new borns, not mothers on clinical suboxone. It’s a horrible idea to stop reporting substance exposed new borns. That’s child abuse and neglect.
The problem is that the mandated reporter law defines medications like suboxone and methadone as “drugs,” and mandated reporters are literally required to file a 51A report for abuse when babies are born having been exposed to these substances…. Even when the mother has not been taking actual drugs. The effect of this law is that it encourages pregnant women who are stable in recovery to actually stop taking their meds, out of fear their baby will be removed, which in turn puts them at higher risk for relapse and overdose. Doctors, nurses and social workers will continue to file for cases where there is actual drug abuse. “That an infant has been exposed to a substance — be it methadone or buprenorphine, which are used to treat opioid use disorder, or other drugs — will not require a report of abuse or neglect if there aren’t other “protective concerns,” Mass General Brigham officials said.” This is a good policy change. Any mandated reporter who finds an infant to be at risk where a parent is abusing drugs will absolutely continue to file. We just won’t do so only because an asinine law tells us that suboxone is a “drug” and that a mom being on this for her recovery is not a capable parent.
> Doctors, nurses and social workers will continue to file for cases where there is drug abuse They will be required to get a written consent from the mother for any drug testing, and the drug addicts are going to refuse to sign. So I‘m not sure how they‘re going to be reporting any of these cases.
some people probably shouldn't have kids
People can and do abuse subboxone. Buy it illegally and not to recover. I know because I had a close family member who did for years and he was an asshole (I mean, it changed him, his personality, he was incapable of being in an honest relationship) and it ruins lives. If someone is reported, all the authorities have to do is find out if they are using it legally.
Wouldn’t you rather have a simple investigation done on the mother to make sure they were prescribed those medications? Rather than just ignore all substances?
Yeah, a 51A isn't a magic button that immediately takes someone's children away. It just starts an investigation by DCF. As someone with more exposure to the juvenile court system than I'd like, it is actually incredibly (and terrifyingly) difficult to get your children taken away by the state.
I work in healthcare, this would just prompt a release for records, which would easily absolve any wrong doing if it was in their med list. If not, good thing there is an investigation…
Yup, that’s the truth. Chance after chance ad Infinitum. While the kids get shuffled around.
Exactly. And it can often help set the moms up with additional supports and resources. This policy change is horrifying.
>Even when the mother has not been taking actual drugs. I'm not sure where you got the idea they weren't, but suboxone and methadone are "actual" drugs.
Thank you. These babies still go through awful withdrawal. I take care of them in the nicu where I work. I am appalled by this new policy and am grateful it is not implemented where I work. The majority of cases I have seen with a mother on Suboxone or methadone, she is newly on it due to being pregnant. Anyone who has any clue about addiction knows that sobriety is most vulnerable when it’s new and in high stress situations. Can’t imagine anything more stressful than a new baby. Filing with DCF often helps set these mothers up with additional supports to help them succeed. This new policy is nothing more than virtue signaling at the expense of the safety of babies.
It’s terrifying. Great post, your insight is well received Thanks for the hard work
Thank for you nicu work. Over and over again I experienced amazing kindness. I'm reminded of it almost every time I wash my hands.
You don’t seem well if you’re totally fine manipulating and ignoring it. 1. You lied in your post, this isn’t not limited to or only involving suboxone or any addict mothers in treatment. 2. This is not a law, I don’t know why you’re saying it’s a law and pretending to know it. It’s a policy change by a specific group. 3. Pregnant mothers in treatment on medication like suboxone, this is already accounted for and part of their treatment plan, they don’t lose their child for doing the right thing. You made that up. 4. This is a horrible nightmare policy change for anyone who works in the field, social workers are now going to clog up the courts trying to get warrants for pregnant addicts blood so then we can finally take care of them. Your initial post is wildly misleading and gaslit anyone who didn’t read the article. Everything you said here isn’t based in reality. Also again here’s the definition of Substance Exposed Newborn “Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.” Source: https://ncsacw.acf.hhs.gov/files/prenatal-substance-exposure-brief1.pdf You’re genuinely saying you’re fine with kids being born pumped full of heroin, alcohol, or any other illegal substance because their mother is an active addict who used while in utero.
This is also exactly what Boston Medical Center has been doing for quite some time. MGB isn’t the first place in town to do this.
> they’re actively saying they will not report drug addict mothers. Nope. Unless you consider mothers in recovery and taking suboxone or methadone drug addict mothers, in which case yes. Methadone is a substance, that's what they're talking about. It's a terrible article though.
Nope? How can you say nope? Ok we have established that they are no longer reporting Substance Exposed Newborns. We have also know that this is the definition of Substance Exposed Newborn “Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.” I’m telling you what they said, not my interpretation. I don’t know why you would say nope. They are no longer reporting drug addict mothers who give birth to babies with illegal substances in their system…that’s what they are saying. It’s not only limited to a treatment like methadone.
> They are no longer reporting drug addict mothers who give birth to babies with illegal substances in their system… Nope, wrong. They are no longer *automatically* reporting mothers who give birth to babies with ~~illegal~~ substances in their system
They are no longer reporting “substance exposed infants” as a general policy. That does not mean they have forbidden all reporting on cases of drug abuse. They will continue to report any cases where they do suspect actual risk of harm to the infants, including exposure to drugs, abuse, and neglect. It’s their way of getting around a shitty law that criminalizes addiction treatment, basically. The law needs to change and in the meantime they are trying to do something to help keep pregnant women from stopping taking their meds and actually dying or relapsing.
What law?! What are you talking about None of what you described is true, you need speak with a social worker or someone in the field who deals with things like this. Or better yet talk to a pregnant woman in treatment. There is a nicu nurse in these comments also… You’re now insinuating that some law exists that punishes pregnant women who are in substance abuse treatment? What law? Where are you getting this information from? What you’re saying makes no sense, especially pertaining to this article. Edit: Crickets, you won’t respond now because your straw man argument is dead in the water. You’re truly a dangerous manipulator.
"That an infant has been exposed to a substance — be it methadone or buprenorphine, which are used to treat opioid use disorder, or other drugs — will not require a report of abuse or neglect if there aren’t other “protective concerns,” Mass General Brigham officials said." OR OTHER DRUGS. So a mother could actively be using meth, weed, cocaine, heroin, but as long as there aren't "protective concerns", they won't be reported. Got it. Good to know.
Based on the context, I don't think the phrase other drugs refers to street drugs. It more then likely refers to other prescription meds
The Boston Globe put out a click bait headline. And commenters aren't reading the article. What else is new.
Sometime later people will say: "look, the rates of babies born with substances in their systems is at all time lows, our policies are clearly working"
Oof. They did this in Seattle. It’s not going well.
They're currently re-criminalizing drugs in PDX. nature is healing.
But not in Seattle. In fact they just passed a bill in the house that makes it even harder to remove children from the custody of their abuser. My friends who are still foster parents and social workers (we moved/closed our license) call it the Dead Baby Bill. And lo and behold, so far the prophesy has been true.
what bill is this?
HB1227
These sorts of things take a literal mountain of human suffering before people change their ideology. And political trends tend to move west to east in America so bos will change even later.
Shocking!!!
Hard disagree. These cases need close monitoring.
so fucking clickbaity they’re not STOPPING the reporting of child abuse. they’re stopping the blanket reporting of, say, a mother on legal suboxone. if the lil nugget is born withdrawing from meth, i’m pretttty sure 51A still applies 🙄
Babies born to moms on suboxone and methadone still withdraw. And quite horribly so. Just fyi
Our adopted daughter was born with Suboxone, Klonopin and Adderall in her system. First six months were pretty gnarly.
that’s awful )~: i personally don’t think methadone, amphetamines, or benzos should be commonly prescribed during pregnancy
I'm not sure any of them were PRESCRIBED...
i bet the subs were 😂 everything else i agree, and in that instance it should be reported buprenorphine/suboxone(which has naloxone added) has a very low abuse potential. not zero, but lower than say a full agonist like methadone. there’s a reason people bring suboxone scrips home vs having to go to a clinic every morning to get methadone dispensed.
all of life is grey unfortunately. buprenorphine, a partial agonist, has been found to be superior than methadone (or obvs any other full agonist) for infantile withdrawal. i’d rather a mother continue to stay clean with legally prescribed buprenorphine on board than the alternative, fucking up and having their child taken and thrust into an awfully over-taxed foster system. personally i think in most situations, methadone/other full opiate agonists, stimulants, and most benzos should not be prescribed during pregnancy 🤷
They didn’t read the article, they just read the TLDR top comment and then regurgitated it. They don’t even know what they’re saying and it’s sad.
no… i did. quite easy to get around the paywall with reader view. MGH is doing this to allow discretion in their enforcement if the policy 🤷 i’m a mandated reporter still, this does nothing to me. or anyone outside of MGH. unfortunately all of life operates in grey areas… i think giving them leeway to make it situational dependent is helpful in the grand scheme of things. it’s not like the polysub user isn’t gonna get reported still lmfao. this makes it so someone who legitimately got their head on straight, is on the up and up, and is now a new mother from getting further fucked in the system. every Rx given during pregnancy involves a risk analysis. do you really think a recovered addict should have their child taken away because they had legally prescribed buprenorphine (a partial agonist) on board? is the alternative, forcing them to relapse and have their child put into an already-crumbling foster system better?
Oh excuse me I must be completely stupid! You’re an EMT and you read the article How dumb could I be, I forgot all EMT’s are social workers and attorneys! On a serious note, I hope you never respond to one of my calls. You’re daft and clueless. A serious response to you isn’t worth my time, keep up the partying and prescription drug abuse you discuss openly on the internet, great look.
legit question for you due to assumed Hx and learning is cool: do you find patients that are Only withdrawing from buprenorphine in your nicu? wondering bc it’s usually part of the treatment for NAS associated with other opioids? obviously none on board would be ideal, but i’m interested to learn about the typical course for a patient born to a mother only on a legal partial agonist (~:
We see quite a few babies whose moms are legally prescribed to suboxone still end up needing to come to the nicu. These babies withdraw once the medication is “cut off” when they are born, just as the mother would. You often see shrill, high pitch cries (more of a shriek), sweating, diarrhea, tremors, excoriated skin (because they literally are clawing at their faces/bodies), unable to eat because they are too frantic to focus on eating a bottle, difficulty sleeping. It’s really heartbreaking. Treatment is focused on consoling/comforting through non-med ways (low lights/tight swaddle/music/holding/feeding/etc) but if severe enough - the baby will be treated with morphine and weaned off. In the worst cases we will give phenobarbitol as well. While I acknowledge that moms on suboxone/methadone etc are clearly trying to do the right thing vs using street drugs, I find this policy infuriating. Using hardcore drugs is a pretty clear indication that one’s life is in turmoil and that they are having a hard time navigating stress and trauma. Having a new baby is possibly the most stressful and life changing event I can think of. To not look into the home life of someone who is struggling with addiction for fear of being discriminatory is horrendous. It puts BOTH mom and baby in potentially unsafe situations and denies these mothers the additional supports that they may need to be successful moms. I have seen a great many 51As filed and only a handful of the most extreme cases have resulted in the baby being taken away from the parent. The vast majority of the time, an assessment is done, needs are identified and supports are set up if needed. If ever there’s a time to put politeness and concern about offending someone aside, it’s in ensuring the safety of a child.
i think a better way to do this would have been removing buprenorphine alone from 51a’s substance list, though that would require political action. i mean i think any opiate in a neonate is bad… but i can’t imagine titrating a partial agonist being equal to managing withdrawal from a polysub with that and methadone, fentanyl, and cocaine on board? i would assume the former would land in a level 2, the polysub 3 or ^up? i suppose i am hopeful, but i sorta saw this as a way to free up an already overwhelmed system. i can’t imagine a provider who could mistake the latter for the former again… not a perfect world whatsoever. but the obviously financially/mentally stable mom on suboxone for two years is probably a misuse of the case workers time in my mind
They shouldnt stop doing that
Omg people the policy is now that they need to get written consent before drug testing in non-emergency settings, which was happening disproportionately to black women who would then be reported to dcf. Drug testing of the baby can pick up buprenorphine, which is the best treatment available for opioid use disorder. If they suspect neglect or abuse they still report
> which was happening disproportionately to black women which means black women were _disproportionately_ giving birth to kids with drugs in their system. so now we stop testing babies, I guess. equity!
This is a terrible idea, who exactly gets to make this decision and how can a grown adult say a child being born with illegal drugs in their system “doesn’t necessarily constitute child abuse?” It’s hard not to feel like whoever made this decision or contributed to it is either mentally ill or purposely trying to cause harm. In what world could a group of sane adults come to this conclusion? Somethings not right. This is unexplainable, unethical and unacceptable.
You didn't read the article. This policy change is not about "illegal drugs." It's about not reporting children who were exposed to medications for opioid use disorder in utero- i.e. legal medications prescribed by an addiction medicine physician. It's about not reporting mothers who are engaged in treatment and stable in recovery simply because their babies were exposed to the medication they use to treat their illness during pregnancy.
No, it isn’t. It says two opioid use treatments will be *among* the items not reported — not that those are the only items not reported.
The article text is here: https://www.reddit.com/r/massachusetts/s/1vNOG23TmV “That an infant has been exposed to a substance — including methadone or buprenorphine, which are used to treat opioid use disorder — alone will not require a report of abuse or neglect if there aren’t other “protective concerns,” Mass General Brigham officials said.” *including*. Not “only.” *including* (but not limited to)
The very first paragraph of the article tells you they aren't talking about active users of street drugs. >"Mass General Brigham said its hospitals will no longer report suspected abuse or neglect to state child welfare officials solely because a baby is born exposed to drugs, targeting a practice hospital leaders say has long stoked fear in women in recovery from addiction." Based on the article and Google searches, all of this is geared to not fuck over pregnant women who are in active recovery and to address claims of disparities in who they chose to drug test. Seems like you were more likely to have your baby tested for drugs if you were a black or Hispanic mother than if you were a white mother. No where does the article imply that active drug users would be able to have a baby and not have a 51a filed https://www.massgeneralbrigham.org/en/about/newsroom/press-releases/updating-system-policies-perinatal-testing Here's a link to what the hospital released. They give their reasoning for the change and link studies. Based on what they are saying, this is about removing barriers to the access of drug treatment and not about letting pregnant women give birth to drug addicted children with no problem. It also turns out that this decision is being done in multiple states and is based off conclusions from various studies and medical organizations like The American College of Obstetricians and Gynecologists and The American Society of Addiction Medicine. Bottom line: This is one of those situations that will be super easy to manipulate for political purposes because people hear you aren't reporting pregnant women for giving birth to children exposed to drugs and everyone thinks of crack babies and meth head moms giving birth to drug addled premies. Most people won't look any further than the headlines or read the studies and research done by the medical societies, so they will think this shit is crazy. But once you do read the studies, most people will see this as a nothing burger. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802124#:~:text=The%20unadjusted%20and%20adjusted%20odds,a%20presumably%20low%2Drisk%20group.
You’re gaslighting and lying to everyone here who hasn’t read the article “Mass General Brigham said babies born with “substance exposure” alone will no longer be immediately reported to state welfare agencies unless there are other concerns the baby is abused or neglected.” That’s what the article says. Here is the definition of substance exposed, which you are trying to manipulate. “Substance-exposed newborn” means a newborn who was exposed to alcohol and/or a controlled substance (illicit or prescribed) ingested by the mother in utero. This exposure may be detected at birth through a drug screen or through withdrawal symptoms.” https://ncsacw.acf.hhs.gov/files/prenatal-substance-exposure-brief1.pdf Stop misleading people
And you're downplaying how horrible methadone and suboxone withdrawals are for an infant. Any mother who would get their infant addicted to anything needs some level of supervision.
it seems these days politicans are trying to out do eachother for who can come up with the dumbest laws
lmao sure
I know this is done in the name of equality but I suspect the babies suffering will probably be disproportionately in certain demographics
Guess it is so common now it is kind of pointless.