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Policies towards Pregnancy and Addiction: Sticks without Carrots
Wendy Chavkin1, Paul H Wise1, Deborah Elman1
1Columbia University, Center for Population and Family Health, New York, New York 10032, USADepartment of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA.
Abstract:
Throughout this century in the United States, tension has existed between those who believe drug abuse is best combatted through the criminal justice system and those who emphasize a medical/public health model of prevention and treatment. In the last decade this debate has centered around the person of the pregnant addict. The former have construed her addiction as willful harm to the fetus punishable on criminal and child abuse grounds. The latter have countered that pregnancy is a moment of increased motivation for treatment and focused on expansion and improvement of treatment options. Both managed care and welfare reform have exacerbated conditions between these opposing policy approaches. The addicted woman is increasingly caught between policies that punish her drug use without options for overcoming addiction.
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