![]() ![]() There is no current statute on the books that makes substance use during pregnancy a prosecutable crime in Tennessee. Many of those cases have been overturned and Public Chapter 820 has not been replaced with another law. Over 100 women were arrested in the two-year trial period until the “Fetal Assault Law” ended on March 23, 2016. In Tennessee in 2014, the Public Chapter 820 “Fetal Assault Law” was passed which made substance use during pregnancy a prosecutable crime in Tennessee. Tennessee Laws Regarding Pregnancy and Drug Use Some Ob/GYNs are considering removing THC from UDS. Physicians are hesitant to report the positive THC screens due to the many testing issues regarding THC and the potential removal of the child as a result of the positive test. In that state, a positive UDS during pregnancy (including THC) is considered child abuse and must be reported to the Dept of Health. This came from a large clinic in Missouri and may not be generalizable, but it is still a much higher incidence of positive UDS than most of us would imagine. 30.5% of samples were positive for THC ( marijuana) metabolite-Remember the THC metabolite can be present in urine for days after smoking-especially if repeated smoking has occurred.Benzoylecgonine (metabolite of cocaine)-11 samples.Number of samples positive for: (these are the most frequent positives) They then performed a descriptive analysis of the results. In 800 samples, 48 psychoactive substances, prescription meds, or drug metabolites were found. They excluded patients with substance abuse disorder. They obtained two samples from each patient. This group of investigators analyzed discarded urine from 400 pregnant patients. ACOG does not recommend routine urine drug screens (UDS). The American College of Obstetrics and Gynecology (ACOG) recommends using a questionnaire to screen all pregnant women regarding drug use. Next abstract from the American College of Medical Toxicology Meeting. SHOULD URINE DRUG SCREENS BE ROUTINELY OBTAINED ON ALL PREGNANT WOMEN? IF THEY ARE POSITIVE, THEN WHAT?
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