Advocates for opioid addiction treatment, particularly methadone maintenance, could be forgiven if they assume they'll never completely be able to shed the stigma against their services.
In a case reflecting arguably one of the most egregious examples, a number of treatment and advocacy organizations are weighing in on a matter involving services to pregnant women—a legal issue that has gone all the way to the New Jersey Supreme Court. Groups that include the American Society of Addiction Medicine (ASAM), the American Psychiatric Association (APA), and national and state offices of the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) have filed a friend-of-the-court brief urging the New Jersey Supreme Court to overturn a ruling that applies state child abuse laws to methadone treatment for mothers-to-be.
The case involves a woman with opioid dependence who received methadone and other services after she discovered she was pregnant. According to a statement from the group National Advocates for Pregnant Women, the state Division of Child Protection and Permanency ruled that the woman had engaged in child abuse by pursuing the course of methadone treatment during pregnancy (her child was successfully treated for symptoms of neonatal abstinence syndrome that can result from maternal methadone or other medication use).
A lower court ruled that the state's child abuse laws do apply in such cases, and the state Supreme Court will hear an appeal during its current term. Robert Newman, MD, a nationally known methadone treatment expert and former director of the Beth Israel Baron Edmond de Rothschild Chemical Dependency Unit, said in the National Advocates for Pregnant Women statement, “As a matter of medicine and health care, it is simply nonsensical to regard methadone treatment as a form of child abuse.”
I asked NCADD's active New Jersey affiliate to comment on the case, and public information manager Daniel J. Meara said in reaction to what he termed a “troubling” matter, “That the lower court ruled as it did shows how little is understood about addiction and the treatment of it.”