Abstract
Objective: Improve racial equity with routine universal drug screening / Study Design:
Commentary on the medicolegal and social history of the United States and the field
of obstetrics and gynecology regarding drug screening policy / Results: Critical aspects
to inform an equitable drug screening policy include (1) racial bias and stigma related
to substance use, (2) the legislative history surrounding substance use during pregnancy,
(3) the relationship between substance use and mass incarceration which disproportionately
affects persons of color, (4) propensity toward punitive measures for Black mothers
with substance use, including termination of parental rights, (5) the role of the
medical field in fostering mistrust among our patients / Conclusion: new practices
in screening for substance use during pregnancy are needed.
Key Points
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Increasing demand for racial justice warrants reframing the issue of urine drug screening.
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The current legal constructs continue to disproportionately impact women of color.
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Routine verbal screening can replace urine drug screening and diminish implicit biases.
Keywords
urine drug screening - racial justice - reproductive justice - ethics - substance
use disorder
