10 June 1999
The Honorable James Jeffords
United States Senate
Washington, DC 20510
Dear Senator Jeffords:
I write as chair of the Domestic Policy Committee at the United States Conference of Catholic Bishops to urge you to include in S. 976, the Youth Drug and Mental Health Services Act, provisions which would allow states to expand the treatment resources available to pregnant women and mothers.
This issue is especially important because it impacts the lives of children. There is no reliable national data on how many pregnant women get substance abuse treatment. The data that is available indicate that only a small fraction are getting treatment. Pregnancy can be an ideal time to intervene in the life of a woman who is addicted to alcohol or other drugs. Concern for her own health and the desire to have a healthy baby are powerful motivators for recovery. Unfortunately, data show that very few women suffering from addiction are identified and referred to substance abuse treatment by physicians or nurses who cared for them during their pregnancies.
According to the 1991 South Carolina Prevalence Study of Drug Use Among Women Giving Birth, 12% of pregnant women had used alcohol or at least one illegal drug in the week prior to delivery. If this experience holds true for all women and can be extrapolated to the 4 million births that occur annually, then nearly one half million pregnant women used drugs during the last week of pregnancy.
Each year the federal government provides about $3 billion to fund drug abuse prevention and treatment activities. More than $1 billion in block grant funds are distributed to states for planning, implementing, and evaluating activities to prevent and treat substance abuse. However, women-specific programs comprise only a small fraction of the programs available. Only 6% of the Substance Abuse and Mental Health Services Administration (SAMHSA) budget, 15% of the National Institute on Drug Abuse (NIDA) budget, and 19% of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) budget is specifically designated for women's programs. This at a time when studies indicate that between 1990 and 1996 emergency room visits by women because of drug-related problems rose 35%, the number of visits related to heroin and marijuana rose more rapidly for women than for men, and the percentage of women substance abusers grew from one-quarter of all those in treatment to one-third.
Treatment is available to only about one-third (37%) of all those who need treatment. There is evidence that treatment saves money and improves people's lives. In Washington state, a five year follow-up study of clients receiving publicly funded substance abuse treatment found that treated clients incurred lower Medicaid medical expenses than did a group of people who were eligible but did not receive treatment. The majority of this cost savings is from a reduction in inpatient hospital costs. According to a Washington state treatment evaluation, indigent clients who completed the full continuum of treatment had higher levels of employment than did a group of clients who did not receive treatment. The conclusion of the evaluation was that by helping clients overcome their dependence on alcohol and other drugs, treatment provides a critical function that moves clients on a trajectory toward increased economic independence.
In their statements, New Slavery, New Freedom (1990) and Putting Children and Families First (1991), the bishops recognized that substance abuse creates many casualties, the most tragic are the children, putting unborn and other children at risk. Many children are placed in foster care as substance abusing parents are no longer capable of providing home or family. Others are born addicted themselves, heirs of the drug slavery destroying their mothers. Abuse of alcohol and other drugs also victimizes hundreds of thousands of other children in their own homes when it fuels the gratuitous violence and anger of their parents. The bishops called for expanded national efforts at education and prevention, prenatal and other health care, and treatment and rehabilitation of abusers of alcohol and other drugs. System-wide reform was called for, including special attention to families where there is substance abuse.
The bishops also noted that our nation's continuing failure to guarantee access to quality health care for all people exacts its most painful toll in the preventable sickness, disability, and deaths of our infants and children. They called for extension of access to quality health care to all, beginning with our children and their mothers and stressed that there can be no excuse for the failure to ensure adequate health care and nutrition for pregnant women since nothing would make a greater contribution to reducing infant mortality than progress in this area.
I ask that you consider the clear need for more comprehensive services that are not only more readily accessible but also designed to aid pregnant as well as parenting women.
Thank you for your consideration and assistance.
Cardinal Roger Mahony
Archbishop of Los Angeles
Chairman, Domestic Policy Committee