Improving Public Health Systems for Substance-Affected Pregnancies

From 1999 to 2014, the number of pregnant women diagnosed with opioid use disorder grew more than fourfold,2 and the number ofinfants diagnosed with neonatal opioid withdrawal grew nearly sevenfold.3 The opioid crisis is exposing gaps in our public health system, and there is an urgent need for a comprehensive response that includes the needs of pregnant women and children. [...]policies, which were also employed in the crack cocaine epidemic of the early 1980s through the early 1990s, have not proven effective; they stigmatize pregnant women, creating an incentive to avoid needed care.5 We should focus on improving care for infants by keeping the infant and mother together, reducing variability in care, and providing a smooth transition to home. Because opioid use disorder is a chronic medical condition involving a likelihood of relapse, our responsibility to mothers and infants does not end at hospital discharge. [...]the services strategy includes improving access to family-centric treatment and developmental services (e.g., early intervention).