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Criminal Justice

Under looming threat of criminalization, one new program seeks to help Oklahoma mothers with substance use disorders

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In Oklahoma, pregnant women with substance use disorders can face a number of criminal charges. One new program aims to address the issue in a better way.

Vanessa Gavino was 22 and struggling with drug use when she was pregnant with her son.

“I was just scared, you know, like, are they going to take him away from me?” Gavino said. “And then we won't have a bond? Is he going to be okay?”

When she gave birth to him in Longview, Washington, he tested positive for heroin and methamphetamine. Despite her fears, after 10 days in a neonatal intensive care unit, her son wasn’t taken by Child Protective Services. He joined her in the treatment facility where they would stay together for the next six months.

In fact, Gavino’s son stayed with her for most of his early childhood and still lives with her today.

This was possible in part because Gavino enrolled in the Parent Child Assistance Program, or PCAP, a few weeks before her son was born.

“I just feel like it was the support that I, you know, I didn't know that I needed,” Gavino said.

Aside from getting her detoxed and to an inpatient treatment facility where her son could stay with her, PCAP helped Gavino learn how to set boundaries with the members of her family who were still using drugs and get connected to a 12-step program.

A case manager stayed in touch with Gavino over the next three years as she made progress, relapsed, recovered, and eventually graduated the program in 2015. She went on to go back to school, get her own apartment and a job as an office assistant for PCAP.

“I’m grateful that I can be the mom that he needs,” Gavino said. “And I'm breaking the cycle, because I have history in my family of addiction.”

This program, which was developed at the University of Washington in 1991, has yielded many positive outcomes for the state including increased rates of employment and education, decreased use of public assistance, and prevention of future substance-exposed newborns.

These results attracted University of Oklahoma associate sociology professor Dr. Erin Maher to the program - and gave her the idea to bring PCAP to Oklahoma.

“We rank really poorly in terms of a lot of outcomes that are associated with well-being for children, for women, for families,” Maher said. “We have high rates of adverse childhood experiences, high rates of substance abuse, high rates of foster care.”

Maher will lead a five year study at OU to test the efficacy of PCAP. She said a designation as an evidence-based program could lead to federal funding for PCAP.

But adapting the program for Oklahoma could be challenging, particularly because of the state’s tendency to press criminal charges against people who use drugs while pregnant.

In Oklahoma, perhaps the highest profile case is that of Brittney Poolaw. In Poolaw’s case, her miscarriage lead to a manslaughter charge. In cases like Gavino’s, a person could be charged with felony child neglect.

“Every single professional society that has issued, you know, a statement related to drug use in pregnancy, opposes the criminalization of substance use in pregnancy,” said Dr. Mishka Terplan, an OB/GYN and the Director of the Friends Research Institute.

He said prosecuting people for drug use during pregnancy could prevent them from taking advantage of the resources available to them.

“If there's mandatory reporting, that's going to make some people less likely to come to prenatal care, to disclose substance use in prenatal care, to get treatment,” Terplan said. “Policy can have a direct effect on worsening birth outcomes.”

Michelle Jones, a former client and current employee of PCAP, said the threat of criminalization would have influenced her choice to seek help when she was pregnant with her son while struggling with a methamphetamine addiction.

“If I would have been sentenced to jail and got out of jail and my baby boy had been adopted out or something, I don't think that I would have ever overcame the guilt and shame from that, and I would have never felt strong and independent,” Jones said.

Maher — the OU professor — said the policymakers she has spoken to are interested in creating legislation that would protect people with substance use disorders who seek treatment while pregnant from criminal charges.

Still, she expects the threat of criminalization to impact her study. While PCAP is designed to assist people with substance use disorders during any part of their pregnancy, she suspects most volunteers for the study will be postpartum.

The study is set to launch in late summer.

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