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Mandatory Treatment for Drug Use During Pregnancy

Wendy Chavkin, MD, MPH
JAMA. 1991;266(11):1556-1561. doi:10.1001/jama.1991.03470110102041.
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THE CRACK epidemic is unique among American drug waves because of the high level of involvement of young women.1,2 In response to this, there have been attempts to impose criminal sanctions on pregnant women who use drugs or alcohol. To date, there have been 50 efforts to prosecute women for using drugs or alcohol while pregnant, with two convictions, and at least seven states have legislation pending that would alter child protective laws to encompass drug use during pregnancy under the rubric of fetal abuse.3,4 Fueled by hotly contested political controversies, such as the legal status of the fetus and the criminalization of addiction, the debate has generally polarized between therapy or sanction.

Some have proposed mandatory treatment for pregnant women as a compromise. This article examines other experiences with mandatory treatment to assess whether such treatment has proven efficacious, whether these


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