Criminal Prosecution of Substance Use During Pregnancy: An Examination of Judicial and Public Perceptions

Abstract

As substance use disorders continue to impact society, the number of women who misuse substances during pregnancy has increased. The resulting growing prevalence of neonatal withdrawal has medical, legal, and child welfare implications. However, approaches to intervention have been met with a significant lack of consensus among treatment providers, the general public, policymakers, and the legal system. This study examined judges’ and the general public’s opinions on a legal and child welfare approach to prenatal substance use. Participants in the judge sample (N = 175), which consisted of United States judges who preside over state-level court, were randomized to one of three prenatal substance use conditions: 1) alcohol; 2) benzodiazepine; and 3) prescription opioid. Participants in the general public sample (N = 467), which consisted of voting-eligible United States citizens, were randomized to one of four conditions: 1) alcohol; 2) benzodiazepine; 3) prescription opioid; and 4) heroin. Overall, only 37.7% of judges recommended that the mother be criminally prosecuted after giving birth to a child with NAS, whereas the majority of the general public (72.2%) recommended prosecution. General public participants were significantly more likely to recommend ongoing monitoring for a woman who used benzodiazepines and loss of custody for a woman who used heroin. Significant differences in child welfare and criminal prosecution outcomes did not emerge among the judge sample as a function of type of substance use. Implications for research, policy, legal practice, and rehabilitation are discussed.Ph.D., Psychology -- Drexel University, 201