BABIES AND DRUGS Pregnant Addicts Pose Serious Risks Before wading into the privacy-rights thicket that is before the Supreme Court over the constitutionality of a South Carolina hospital's policy of calling the cops on pregnant drug abusers, let's stipulate a few things: Substance abuse is our nation's No. 1 health problem, consuming one of every five dollars spent on Medicaid hospital care. Substance abuse costs society close to half a trillion dollars each year, and causes untold human suffering through increased violent crime; by destroying families; by leading to child abuse, teen pregnancy, traffic accidents and injuries; and by contributing to or directly causing a host of illnesses, from AIDS to cancer. Children whose parents abuse drugs and alcohol are three times more likely to be physically and sexually abused and four times more likely to be neglected. Children of drug-and alcohol-addicted parents are more likely to become criminals, more likely to become addicts themselves, more likely to have psychological problems and less likely to finish school. Considering these facts, it would seem incumbent on a hospital -- a community's primary health center -- to do all it can to fight the nation's No. 1 health problem. The argument before the Supreme Court is whether drug testing pregnant women and turning the information over to police violates privacy rights and harms the doctor-patient relationship. As for the issue of constitutional rights, we'll wait for the court's decision. But doctors and other hospital personnel already are required to report any evidence of child abuse to the police. Whether drug testing a patient amounts to illegally gathering evidence is the issue at hand. We hope it's found to be constitutional. As for the argument that it harms the doctor-patient relationship, consider the greater harm when a doctor does nothing about his pregnant patient's drug abuse. First of all, drug abuse can cause damage to a fetus. But even worse is the threat posed to a newborn child by a drug-addicted mother. An overwhelming majority of professionals at child welfare agencies say substance abuse is behind most cases of child abuse and neglect. And a child abused by addicted parents is more likely to grow up to be a trou-bled adult -- a drug abuser, an abusive parent, even a criminal. So by alerting police to a pregnant patient's drug abuse, a doctor is actually committing a very therapeutic act, considering the risks an addicted mother poses to her children and to society. Of course, it all depends on what police do with that information. If it's used to leverage an addicted, pregnant mother into treatment, with the promise of remaining with her child and getting full custody once she completes an effective recovery program, everybody wins. In South Carolina, pregnant drug addicts were turned over to police only if they refused treatment or failed drug tests twice while in treatment. That seems reasonable. Many people believe drug abuse is benign, equating it with drug dabbling by middle-class college kids, or they think drug addicts don't hurt anybody but themselves. But addiction to cocaine, heroin, methamphetamine, alcohol and other drugs is usually more damaging to the people around the addict. It creates risks to the lives of children, family members and even perfect strangers who fall victim to the hazardous behavior of the addict. And all of society pays the costs. If the Supreme Court finds the South Carolina hospital did not violate pregnant women's constitutional rights, then other hospitals should follow suit by drug testing pregnant women and, if necessary, using the information to leverage them into treatment. Combatting our nation's No. 1 health problem requires nothing less.
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