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Health Inequities Among People Who Use Drugs in a Post-Dobbs America: The Case for a Syndemic Analysis

Published online by Cambridge University Press:  13 December 2023

Jennifer J. Carroll ,
Bayla Ostrach  and
Taleed El-Sabawi
Jennifer J. Carroll
Affiliation:
NORTH CAROLINA STATE UNIVERSITY, RALIEGH, NC, USA
Bayla Ostrach
Affiliation:
BOSTON UNIVERSITY, BOSTON, MA, USA
Taleed El-Sabawi
Affiliation:
FLORIDA INTERNATIONAL UNIVERSITY, MIAMI, FL, USA
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Abstract

Punitive policy responses to substance use and to abortion care constitute direct attacks on personal liberty and bodily autonomy. In this article, we leverage the concept of “syndemics” to anticipate how the already synergistic stigmas against people who use drugs and people who seek abortion services will be further compounded the Dobbs decision.

Keywords

PregnancySubstance UseOverdoseSyndemicsAbortion
Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 51 , Issue 3: Seeking Reproductive Justice in the Next 50 Years , Fall 2023 , pp. 549 - 553
Copyright
© 2023 The Author(s)

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References

Carroll, J.J. et al., “The Harms of Punishing Substance Use During Pregnancy,” International Journal of Drug Policy 98, no. 103433 (2021): 1–6, at 1–2, 4.CrossRefGoogle ScholarPubMed
Bulled, N. et al., “Syndemics and Intersectionality: A Response Commentary,” Social Science & Medicine 295, no. 114743 (2022): 1–3, at 1.CrossRefGoogle Scholar
Singer, M. and Ziegler, J., “The Role of Drug User Stigmatization in the Making of Drug-Related Syndemics,” in Foundations of Biosocial Health Stigma and Illness Interactions, eds. Lerman, S., Ostrach, B. and Singer, M. (Lexington Books, 2017): at 1–24.Google Scholar
4. C.L. Everson and B. Ostrach, “Pathologized Pregnancies & Deleterious Birth Outcomes: Iatrogenic Effects of Teen Pregnancy Stigma,” in Stigma Syndemics: New Directions in Biosocial Health, eds. B. Ostrach et al. (Lexington Books, 2017): at 61-94 B.Google Scholar
Singer, M. et al., “Syndemics and the Biosocial Conception of Health,” Lancet 389, no. 10072 (2017): 941–950, at 942.CrossRefGoogle ScholarPubMed
See Carroll, supra note 2, at 2-4.Google Scholar
National Advocates Pregnant Women, “Arrests and Other Deprivations of Liberty of Pregnant Women,” available at <https://shorturl.at/eouw7> (last visited August 17, 2023).+(last+visited+August+17,+2023).>Google Scholar
Martin, N., “Take a Valium, Lose Your Kid, Go to Jail,” ProPublica, Sept. 23, 2015.Google Scholar
Human Rights Watch, “U.S.: Family Separation Harming Children, Families 5-Year-Olds Held Without Adult Caregivers,” available at <https://shorturl.at/iyzPT> (Last visited August 17, 2023); J. Bouza et al., “The Science is Clear: Separating Families has Long-term Damaging Psychological and Health Consequences for Children, Families, and Communities,” Society for Research in Child Development (2018): 1-7, at 3.+(Last+visited+August+17,+2023);+J.+Bouza+et+al.,+“The+Science+is+Clear:+Separating+Families+has+Long-term+Damaging+Psychological+and+Health+Consequences+for+Children,+Families,+and+Communities,”+Society+for+Research+in+Child+Development+(2018):+1-7,+at+3.>Google Scholar
Meinhofer, A. et al., “Parental Drug Use and Racial and Ethnic Disproportionality in the U.S. Foster Care System,” Children Youth Services Research 118, no. 105336 (2020): 1–4, at 2, 4; S.C.M. Roberts and A. Nuru-Jeter, “Universal Screening for Alcohol and Drug Use and Racial Disparities in Child Protective Services Reporting,” Journal for Behavioral Health Services Research 39, no. 1 (2012): 3-16, at 12.Google ScholarPubMed
Atkins, D.N. and Durrance, C.P., “State Policies That Treat Prenatal Substance Use as Child Abuse or Neglect Fail to Achieve Their Intended Goals,” Health Affairs 39, no. 5 (2020): 756–763, at 758.CrossRefGoogle ScholarPubMed
Faherty, L.J., “Association Between Punitive Policies and Neonatal Abstinence Syndrome Among Medicaid-Insured Infants in Complex Policy Environments,” Addiction 117, no. 1 (2022): 162–171, at 163-164.CrossRefGoogle ScholarPubMed
See Carroll, supra note 2, at 2-4.Google Scholar
Patrick, S.W. et al., “Barriers to Accessing Treatment for Pregnant Women with Opioid Use Disorder in Appalachian States,” Substance Abuse 40, no. 3 (2019): 356–362, at 357-359.CrossRefGoogle ScholarPubMed
Lensch, A.C. et al., “Pregnant Patients Using Opioids: Treatment Access Barriers in the Age of COVID-19,” Journal of Addiction Medicine 16, no. 1 (2022): e44-e47, at e45e–46.CrossRefGoogle ScholarPubMed
Ostrach, B.M. and Leiner, C.B., “‘I didn’t want to be on Suboxone at first…’” — Ambivalence in Perinatal Substance Use Treatment,” Journal of Addiction Medicine 13, no. 4 (2019): 264–271, at 269.CrossRefGoogle ScholarPubMed
Frazer, Z. et al., “Treatment for Substance Use Disorders in Pregnant Women: Motivators and Barriers,” Drug Alcohol Dependence 205, no. 107652 (2019): 1–6, at 3.CrossRefGoogle ScholarPubMed
See Earp, supra note 1, at 4-5.Google Scholar
See Rosenthal, supra note 1, at 368-369.Google Scholar
Tyndall, M. and Dodd, Z., “How Structural Violence, Prohibition, and Stigma Have Paralyzed North American Responses to Opioid Overdose,” AMA Journal of Ethics 22, no. 8 (2020): E723–E728, at E725.Google ScholarPubMed
Radi, B., “Reproductive Injustice, Trans Rights, and Eugenics,” Sexual Reproductive Health Matters 28, no. 1 (2020): 396-407, at 396-97.CrossRefGoogle ScholarPubMed
Artiga, S. et al., Racial Disparities in Maternal and Infant Health: An Overview, available at <https://shorturl.at/gnQY8> (last visited August 17, 2023).+(last+visited+August+17,+2023).>Google Scholar
Cohen, S.A., “Abortion and Women of Color: The Bigger Picture,” Guttmacher Policy Review 11, no. 3 (2008): 2–12, at 2.Google Scholar
Drug Pol’y All., The Drug War, Mass Incarceration and Race, available at <https://shorturl.at/nuA48> (last visited August 17, 2023).+(last+visited+August+17,+2023).>Google Scholar
El-Sabawi, T. and Oliva, J., “The Influence of White Exceptionalism on Drug War Discourse,” Temple Law Review 94 no. 4 (2022): 649–661, at 650.Google Scholar
Singer, M., “A Dose of Drugs, A Touch of Violence, A Case of Aids: Conceptualizing the Sava Syndemic,” Hispanic Health Council 24, no. 2 (1996): 99–110, at 99.Google Scholar
Castro, K.G., “ Tuberculosis as an Opportunistic Disease in Persons Infected with Human Immunodeficiency Virus,” Clinical Infectious Diseases 21, no. 1 (1995): S66–S71, at s67.CrossRefGoogle ScholarPubMed
Corbett, E.L. et al., “The Growing Burden of Tuberculosis Global Trends and Interactions with the HIV Epidemic,” Archives Internal Medicine 163, no. 9 (2003): 1009–21, at 1009.CrossRefGoogle ScholarPubMed
Singer, M. et al., “Whither Syndemics? Trends in Syndemics Research, A Review 2015-2019,” Global Public Health 15, no. 7 (2020): 943–955, at 943.CrossRefGoogle ScholarPubMed
Angelotta, C., “A Moral or Medical Problem? The Relationship between Legal Penalties and Treatment Practices for Opioid Use Disorders in Pregnant Women,” Womens Health Issues 26, no. 6 (2016): 595–601, at 597, 599-600.CrossRefGoogle ScholarPubMed
Lawn, R.B., “Homicide is a Leading Cause of Death for Pregnant Women in US,” British Medical Journal 379, no. 2499 (2022): 1–2, at 2.Google ScholarPubMed
Roberts, S.C.M. et al., “Risk of Violence from the Man Involved in the Pregnancy After Receiving or Being Denied an Abortion,” BMC Medicine 12, no. 144 (2014): 1–7, at 6.CrossRefGoogle ScholarPubMed
Tobin-Tyler, E., “A Grim New Reality: Intimate Partner Violence After Dobbs and Bruen,” New England Journal of Medicine 387, no. 14 (2022): 1247–1249.CrossRefGoogle ScholarPubMed
Rodriguez, M. et al., “Intimate Partner Violence and Barriers to Mental Health Care for Ethnically Diverse Populations of Women,” Trauma Violence Abuse 10, no. 4 (2009): 358–374, at 359.CrossRefGoogle ScholarPubMed
Rosenblum, A. et al., “Distance Traveled and Cross-State Commuting to Opioid Treatment Programs in the U.S.,” Journal of Environmental Public Health 2011, no. 948789 (2011): 1–10, at 6-9.CrossRefGoogle Scholar
Committee on Obstetric Practice, American Society Addiction Med., Committee Opinion No. 711: Opioid Use and Opioid Use Disorder in Pregnancy, Obstetrics Gynecology 130, no. 2 (2017): e81-e94, at e87.CrossRefGoogle Scholar
See National Advocates, supra note 10; see also L. Paltrow, “The Dangerous State Laws that are Punishing Pregnant People,” Think Progress, Sept. 28, 2016, available at <https://shorturl.at/nuR57> (Last visited August 17, 2023).+(Last+visited+August+17,+2023).>Google Scholar
Ranapurwala, S.I. et al., “Opioid Overdose Mortality Among Former North Carolina Inmates: 2000-2015,” American Journal of Public Health 108, no. 9 (2018): 1207–1213, at 1209-12.CrossRefGoogle ScholarPubMed
American Society of Addiction Medicine, National Practice Guideline 2020 Focused Update, available at <https://shorturl.at/kuw05> (Last visited August 17, 2023).+(Last+visited+August+17,+2023).>Google Scholar
B. Ortutay, EXPLAINER: Data Privacy Concerns Emerge After Roe Decision, Associated Press, June 29, 2022.Google Scholar
Id. Google Scholar
McCarthy, M., “Predictors of Timing of Pregnancy Discovery,” Contraception 97, no. 4 (2018): 303–308, at 305-306.CrossRefGoogle ScholarPubMed
Grossman, D. et al., “Complications After Second Trimester Surgical and Medical Abortion,” Reproductive Health Matters 16, no. 31 Supplement (2008): 173–182, at 173.CrossRefGoogle ScholarPubMed
Kapp, N., “Medical Abortion in The Late First Trimester: A Systematic Review,” Contraception 99, no. 2 (2019): 77–86, at 77.CrossRefGoogle ScholarPubMed
Jones, R.K. and Jerman, J., “Abortion Incidence and Service Availability In the United States, 2014,” Perspectives Sexual Reproductive Health 49, no. 1 (2017): 17-27, at 24-25; U.D. Upadhyay et al., “Denial of Abortion Because of Provider Gestational Age Limits in the United States,” American Journal of Public Health 112, no. 9 (2022): 1687-1694, at 1687.CrossRefGoogle Scholar
See Everson and Ostrach, supra note 8, at 1-34.Google Scholar
Id. Google Scholar
Carroll, J.J., “The Protective Effect of Trusted Dealers Against Opioid Overdose in the U.S.,” International Journal of Drug Policy 78, no. 102695 (2020): 1–9, at 7-8.CrossRefGoogle ScholarPubMed
See McCarthy, supra note 42, at 2.Google Scholar
O’Donnell, F.T. and Jackson, D.L., “Opioid Use Disorder and Pregnancy,” Modern Medicine 114, no. 3 (2017): 181–186, at 183.Google ScholarPubMed
Jarlenski, M. et al., “Association of Duration of Methadone or Buprenorphine Use During Pregnancy With Risk of Nonfatal Drug Overdose Among Pregnant Persons With Opioid Use Disorder in the US,” Journal of American Medical Association 5, no. 4 (2022): 1–4, at 2-3.Google ScholarPubMed