ABSTRACT

The study involved the investigation of the causes, effects and remedi of drug abuse among pregnant women with reference to Winners clinic, Lagos, Nigeria. A case research strategy wa because the investigation involved a real life problem which cannot distanced from the main agents and therefore it was important to identify which could fulfill the research objectives or answer the research exhaustively. Methods of data collection were observation, in-depth int distribution of questionnaire.

 The data obtained were presented by u histograms, and frequency polygons. Data were analyzed and interpret based on the patterns reflected by the statistics. The statistical pa debated and challenges to the current practices and the following ‘ every family is vulnerable to drug abuse by pregnant women regardless of m lack of adequate time for socialization amongst family members controle abuse among pregnant women, drug abuse among pregnant women can start as early a years of age. It was concluded that drug abuse can be eradicate collaboration between families, community, government and hospitals that it has been recommended that pregnant women should go to school roaming around, be involved in sports to avoid idling, be selective in inte peers and be inspired with parents’ ideals and ethics. Among others, 

CHAPTER ONE

1.1 INTRODUCTION

1.1 Background of study

Pregnant women who misuse substances (alcohol, tobacco, and prescription and illicit drugs) are positioned at the nexus of public health and criminal justice intervention. The impact of their substance use on their personal health and the health of their fetuses is a public health concern, as professionals in this field are dedicated to improving maternal and infant health. In addition, the past three decades have seen prenatal substance use become a criminal justice issue as the fetal protectionism movement spurred the increasing use of criminal sanctions for socioeconomic brackets, are subject to increased surveillance and may face arrest, prosecution, conviction and/or child removal (Banwell & Bammer, 2006; Boyd, 1999; Chasnoff et al. 1990; Figdor & Kaeser, 1998; Murphy & Rosenbaum, 1999; Paltrow, 1999; Paltrow & Flavin, 2013; Roberts, 1991).

Figures from the most recently-published report from the National Survey of Drug Use and Health (Substance Abuse and Mental Health Services Administration, 2012) state that, of pregnant women aged 15–44, 9.4% reported current alcohol use, 2.6% reported binge drinking, and 0.4% women in the same age group has decreased slowly but significantly each year. Of pregnant women aged 15–44, 5% report current illicit drug use, a proportion not that represents a small, nonsignificant increase from the 2009–2010 and 2008–2009 findings. The percentage of pregnant women in this age group who report smoking tobacco in the last month has not changed significantly in the last decade, while tobacco use among nonpregnant significantly different than in the previous study year. The rate of illicit drug use varies widely with the woman’s age. Teenaged pregnant women have the highest rates of illicit drug use (15–17, 20.9%), followed by young adult women (18–25, 8.2%) and adult women (26–44, 2.2%). There are no reliable nationwide estimates of the annual number of infants born after prenatal substance exposure. For example, the CDC website reports that the rate of Fetal Alcohol Syndrome (FAS) is 0.2-1.5 cases per 1,000 live births (CDC, 2014), although this estimate appears to be based on research from the 1990s. A recent study found the rate of FAS in one Midwestern community to be 6–9 per 1,000 children, and more general Fetal Alcohol Spectrum Disorder (FASD) as high as 24–48 per 1,000 children (May et al. 2014). Some infants prenatally exposed to opioids exhibit symptoms of Neonatal Abstinence Syndrome (NAS), including hyperirritability and dysfunction of the nervous system, gastrointestinal tract, and respiratory system (Finnegan & Kaltenbach, 1992). Between 2000 and 2009, the incidence of NAS among hospital-born newborns increased from 1.20 to 3.39 per 1,000 live births per year. Total hospital charges for NAS during this time period are estimated to have increased from $190 million to $720 million, adjusted for inflation (Patrick et al. 2012). While it is possible that some of the increase in NAS diagnoses could be attributed to growing recognition of NAS symptoms and increased surveillance of pregnant women, it appears that prenatal exposure to substances is a significant public health problem.

Concerns about fetal drug exposure have given rise to new laws and applications of existing laws that seek to deter women from using substances during their pregnancies and to punish those who do. The enforcement of these laws raises questions of fetal personhood and the extent to which the government may regulate pregnant women’s bodies. Substance abuse during pregnancy is considered child abuse under civil child welfare statutes in seventeen states, and in three states (Minnesota, South Dakota, Wisconsin) it is grounds for civil commitment (Murphy, 2014). 36 states recognize embryos or fetuses as potential victims of crime, although 24 of these expressly exempt pregnant women from prosecution for causing injury to their own fetuses (Murphy, 2014). In many cases, prosecutors have used laws written to target for child abuse, child neglect, contributing to the delinquency of a minor, causing the dependency of a child, child endangerment, delivery of drugs to a minor, drug possession, assault with a deadly weapon, manslaughter, and homicide (Paltrow, 1992) despite, in some cases, the aforementioned provisions protecting pregnant women from punishment (Flavin, 2009; Paltrow & Flavin, 2013). In some states, the protection from prosecution is incomplete, e.g. in Arkansas, women are exempt from being prosecuted for the homicide of their own fetuses, but may be prosecuted for battery of their fetuses (Murphy, 2014: 865).

In South Carolina, the ruling in Whitner v. State affirmed the conviction of criminal child neglect for a mother whose newborn tested positive for cocaine metabolites. The South Carolina Supreme Court stated that “the plain meaning of “child” as used in [the child endangerment statute] includes a viable fetus” (Whitner v. State, 1997). The court reaffirmed its stance on the issue in State v. McKnight (2003), when it upheld Regina McKnight’s 2001 conviction for homicide by child abuse after her pregnancy ended in a stillbirth attributed to Knight’s use of crack cocaine. In 2008, the same court unanimously ruled that McKnight did not have a fair trial, recognizing that McKnight’s counsel failed to make use of existing evidence from “recent studies showing that cocaine is no more harmful to a fetus than nicotine use, poor nutrition, lack of prenatal care, or other conditions commonly associated with the urban poor” (McKnight v. State, 2008). McKnight was released from prison after serving more than eight years (NAPW, 2008). McKnight’s case is similar to the ongoing case of Rennie Gibbs of Mississippi, who was indicted in 2007 for “depraved heart murder” when she delivered a stillborn daughter whose blood showed traces of a cocaine byproduct. Gibbs was only 16 at the time. Experts who later examined the autopsy reports concluded that the more likely cause of death was umbilical cord compression. Murder charges against Gibbs were dropped in April, 2014, after more than seven years of legal entanglements. Charges were dismissed without prejudice, leaving the possibility for charges to be refiled (Fowler, 2014).

In 2013, Alabama became the second state to explicitly allow pregnant women who use drugs to be charged with criminal child abuse when the Supreme Court of Alabama held that a viable fetus is considered a “child” for the purposes of the state’s criminal statute prohibiting the chemical endangerment of a child (Murphy, 2014: 862). Most recently, in April, 2014, Tennessee became the first state to explicitly criminalize drug use during pregnancy through legislation.

1.2 Statement of The Problem

Drug abuse in Nigeria is growing problem although there is no national data to provide exact figures on the magnitude of this problem, (Possi, 1996:178).  Problems associated with drug abuse include among others, significant morbidity and mortality, (Drug Control Commission Report, 2010:2).  Globalization and growth of information technology has increased access to amplified drug abuse among pregnant women. In addition, report from Prime Minister’s Office (2005:1) mentioned that Nigerian Government has laid down strategies which will be used to minimize the problem of drug abuse. 

The strategies have been categorized into long term and short term. Long term strategies deal with supply which is on strengthening observation/security of its boundaries and arresting drug smugglers, provision of severe punishment to the sellers and provision of health education and treatment for the addicts. Short term strategies lie on doing frequent operations in areas which grow illicit drugs and burning of illicit plants. On looking to the above theories and knowledge, there is a strong need of solving the problem of drug abuse among the pregnant women by going direct to the users that are individuals, groups, communities and society at large, interviewing them and develop theory and knowledge basing from the results of interviews rather than relying on knowledge borrowed from western countries which does not meet local needs of indigenous populations.  

Also according to the study which has been carried out at Lagos Municipality and Zanzibar earmarked that pregnant women from age 10 – 19 years uses cigarette, alcohol and sniffing cannabis and the reason for first use is acceptance curiosity enjoyment, health stress relief, hunger fatigue, religious customs and sex boosting.  Mdeme, quoted police antidrug unit (2002:34). This study sought to look at pregnant women abusing drugs and come out with the causes, effects and remedial measures which will assist in drugs informing individual, group and community at large so that they can avoid abusing.

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