Innocent until proven guilty is the law of the land — unless you’re a parent. Recently in Alabama, a mother of a newborn temporarily lost custody of her children when she was unknowingly tested for drugs after giving birth. A false positive on the test, caused by consumption of poppy seeds, led to the removal of both her infant and toddler.
While this case is traumatic for one mother, she is not alone. The hospital tests all new mothers for drugs, knowingly or not.
This policy, known as universal screening, proactively screens all new mothers regardless of whether drug use is suspected. Those who favor universal screening argue that its alternative, risk-based screening may lead to unfair targeting of low-income women. In states such as Iowa and Minnesota, drug testing is required by law if there is suspected drug use during pregnancy.
But drug testing is not a solution for parental substance abuse; it is simply a test confirming the presence of a substance in the body. The Department of Justice cautions that a positive drug test alone does not indicate important information such as “abuse or addiction, recency, frequency, or amount of use; or impairment.” In Texas, a positive drug test does not even always meet the evidentiary burden for child removal. Yet, Texas has some of the highest numbers of child removals in the nation for drugs and alcohol, with 68% of all cases citing substance use.
In most cases, testing produces unreliable results at best. Most hospitals use maternal urine screenings, which are susceptible to false positives and do not indicate chronic usage. Gwen McMillin, the director of the toxicology laboratory and pharmacogenetics at ARUP Laboratories, agrees that “universal screening is extremely expensive and diagnostic yield poor.”
As a rising number of parental substance use cases cross the desks of child protective services investigators, spending state funds on drug testing and punitive interventions helps no one. Our goal, instead, should be to support the health and recovery of parents. This is especially true for expecting mothers, who often report that the focus on screening and surveillance deters them from seeking treatment and prenatal care.
Women have described efforts to minimize the risk of arrest or punishment through social isolation, withholding relevant medical information, avoiding prenatal care, skipping treatment appointments, or avoiding treatment all together. This means our efforts to protect children are actually placing them and their parents at greater risk of harm.
Punitive deterrents come not only from the criminal justice system but also from the child welfare system. Consider the example of Taylor County, Texas. Under Texas law, substance use alone is considered maltreatment and sufficient for removal, even if there is no evidence of actual child abuse or neglect. In Taylor County, this punitive approach has led to one of the highest removal rates in the state, with roughly 10 per every 1,000 children placed into foster care.
During a recent Texas House Human Services Committee meeting, the county’s chief prosecutor in the child protective services division of the district attorney’s office attributed the high numbers to a change in local policy around 2013. This policy change required dollars to be spent on drug testing the children in any case of suspected parental substance abuse. The county’s removal numbers have since skyrocketed.
Despite more removals, the county does not have much to show with respect to public health improvements. Drug usage is still high, with 85% of county jail inmates booked on substance charges. Child protective services cases still make up the majority of the district court docket. The accidental overdose death rate is 12-14 per 100,000 people.
Drug screens become data with consequences. Using substance abuse findings and punitive approaches when a test comes back positive does not help communities, parents, or children. It is a misuse of valuable state dollars to drug test mothers for the purpose of prosecution or removal of children instead of focusing on effective treatment and supporting parents who make the responsible decision to seek help.
Charissa Huntzinger is a policy analyst for the Center for Families and Children at the Texas Public Policy Foundation.
