University of Michigan researchers examined rates of newborn drug testing patterns to determine if these rates varied by race and ethnicity of birth parents. The team published the findings in JAMA Open Network.
The researchers analyzed data from 26,366 births between 2014-2020 at the University of Michigan Health. They also compared drug testing rates by racial and ethnic groups and test results before and after the legalization of recreational cannabis in 2018.
The team found that racial inequities in newborn drug testing rates persisted during the seven-year study period before and after Michigan legalized cannabis in 2018. The most commonly identified substance was tetrahydrocannabinol (THC). Senior author Dr. Lauren Oshman explained, “We measured drug testing rates before and after cannabis legalization to see if the change in law improved or worsened these inequities and found it didn’t appear to make any difference.” Positive newborn drug tests for THC increased from 50% to 69% across all racial and ethnic groups after legalization. Roughly two in five newborn drug tests were positive only for THC, with Black newborns more likely to have a positive test than White newborns. This rise reflects national trends in cannabis use increasing in pregnancy - about 12% of people reported cannabis use in the first trimester from 2016 to 2017.
White newborns were 24% less likely to receive a drug test than Black newborns but were more likely to test positive for opioids. This finding suggests inconsistent and vague testing policies mean potentially missed opportunities to detect and treat opioid use disorder.
Many states have policies mandating health care professionals and social workers to report if a newborn tests positive for certain drugs to Child Protective Services. Guidelines on what should trigger these tests are usually unclear and inconsistent, contributing to racial inequities in testing practices.
Michigan Medicine has since implemented a new policy to help determine whether a drug test is warranted. New criteria include withdrawal symptoms or if the mother indicates that she has used drugs during pregnancy. The hospital will now be tracking data every month to gauge whether the changes have a positive impact.
Michigan researchers have partnered with other stakeholders, including advocacy and community groups, to address statewide policy improvements. Dr. Oshman described this collaborative effort: “Our leaders, doctors, researchers, nurses and staff are all committed to reducing biases in the health system that may lead to inequitable applications of laws and negatively impact treatment and care.” The research team hopes that this research helps other health systems explore how their policies or state policies may influence patient care and outcomes.
Sources: Eureka News Alert, JAMA Open Network
