Pubdate: Mon, 28 Apr 2014
Source: Tennessean, The (Nashville, TN)
Copyright: 2014 The Tennessean
Author: Tony Gonzalez


The top White House drug policy czar said Monday in Nashville that he 
couldn't comment on the decision Gov. Bill Haslam must make today 
about whether to sign legislation that would criminalize women who 
use drugs while pregnant.

Then he let fly.

"Under the Obama administration, we've really tried to reframe drug 
policy not as a crime but as a public health-related issue, and that 
our response on the national level is that we not criminalize 
addiction," said Michael Botticelli, acting director of the White 
House Office of National Drug Control Policy. "We want to make sure 
our response and our national strategy is based on the fact that 
addiction is a disease."

Botticelli spent the afternoon at Vanderbilt's Monroe Carell Jr. 
Children's Hospital, touring the neonatal intensive-care unit and 
talking candidly for almost an hour with a room full of doctors, 
nurses and administrators about the epidemic of babies born drug-dependent.

Botticelli learned that Tennessee last year counted 921 cases of 
neonatal abstinence syndrome - a painful type of drug withdrawal that 
infants can experience when born to drug-addicted mothers. Forty-one 
percent of those were using legal drugs prescribed by doctors.

He praised the state's approach to studying the epidemic, collecting 
data and reducing the rate at which Tennessee doctors prescribe 
painkillers that contribute to the problem, as well as Vanderbilt's 
research and treatment advances.

"Quite honestly, when you talk about what are the forward-leaning 
states and places that are doing (neonatal abstinence syndrome), you 
always hear Tennessee, Tennessee, Tennessee," he said.

What Botticelli wouldn't comment on - specifically, anyway - is a 
competing idea about what to do with drug-using mothers that gained 
traction in Tennessee this year. Legislation awaiting the governor's 
signature would allow prosecutors to charge women with assault if 
they believe they can prove that prenatal drug use harmed the newborns.

The governor, through a spokeswoman, promised a statement today - his 
deadline to act.

The proposal has garnered national attention and vocal state and 
nationwide opposition from constitutional and reproductive rights 
groups. More than 10,500 people signed a petition asking for the 
governor's veto.

Opponents worry criminalization will scare women away from the kind 
of treatment that Botticelli praised Monday, and reverse last year's 
state Safe Harbor Act. That law protected the custody rights of 
mothers and gave them priority placement into the state's limited 
treatment programs.

"What's important is that we create environments where we're really 
diminishing the stigma and the barriers, particularly for pregnant 
women, who often have a lot of shame and guilt about their substance 
abuse disorders," Botticelli said. "We know that it's usually a much 
more effective treatment and less costly to our taxpayers if we make 
sure that we're treating folks."

Last year, Vanderbilt treated 52 babies with neonatal abstinence 
syndrome in its intensive care unit, out of 1,300 infants admitted there.

Pediatrician Stephen Patrick introduced Botticelli to one mother 
struggling with drug addiction during the tour and said that's key to 
getting a firsthand understanding.

"My hope is that will continue to inform policy, that you can take 
what's relevant to us - that we see clinically at the patient bedside 
- - to federal and state policy," Patrick said.


Law enforcement group opposes bill

The national Law Enforcement Against Prohibition group announced 
Monday its opposition to Tennessee's proposal to criminalize women 
who use drugs while pregnant.

The group of about 5,000 law enforcement officials opposes the war on 
drugs and said treating drug use as a crime instead of a public 
health problem "wastes public safety resources and endangers the 
health of those affected."

The group said Tennessee's proposal would deter women from seeking 
treatment and could stop them from dealing honestly with doctors.
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