Here’s a short preview of our video interview:

BMC has done this since 2021 & our study showed we reduced reporting by **45%**!

If the rest of the state can employ similar interventions, the impact will be huge — thousands of families who would otherwise have automatically had DCF cases opened.
jamanetwork.com/journals/jam...

Thanks for reading!! I did not know about this, but can certainly understand why it might have made the DDx for the one-liner and clinical symptoms!

Gratitude as well to our @bostonchildrens.bsky.social team collaborating on this case (Drs. Patricia Stoeck, Ryan Gise, and Mary Beth Son), and to our lovely patient, whose resilience has stuck with me since I cared for them as a PGY-1 💙. Hope you learn something from this case!
#MedSky #PedsSky

8/ Adding relevant #BlueSky tags -- someone help make sure I'm doing this right, this is my first thread #onhere! 😅🤓

#MedSky #PedsSky #ObGynSky #HealthPolicy #HealthEquity #Bioethics #AcademicSky #PublicHealth

7/ Many people to thank for this long-needed reform -- personally, very grateful for thoughtful collaborators at BMC, and LOTS of admiration for the experts & patients who have advanced this work for years. Has been an honor to help tell this story.

Bill announcement:
www.mass.gov/news/governo...

6/ The new MA bill would essentially require that all birthing hospitals replicate BMC's approach.

In short, this bill helps move our state from mandated reporting to *mandated SUPPORTING* for families navigating SUD treatment during pregnancy.

Our op-ed from July '24:
www.wbur.org/cognoscenti/...

5/ In May '24 in JAMA Peds (@jama.com), we published a quasi-experimental analysis showing that BMC's approach reduced #ChildProtectiveServices reporting for prenatal substance exposure by 45pp (95%CI -52.6, -37.2), relative to *every other hospital in the state*!!
jamanetwork.com/journals/jam...

4/ In May '21, after a multi-year & multi-disciplinary process, Boston Medical Center became the first in MA to implement trauma-informed guidelines for when to report prenatal substance exposure.

TL;DR: reports should be filed only in the presence of expert-identified protective concerns.

3/ Researchers in MA & nationwide have proven punitive approaches to address prenatal substance use don't work.

Coupling evidence-based SUD treatment w/CPS reporting exacerbates stigma, loss to follow-up, & more.
link.springer.com/article/10.1...

So, how do we change reporting systems safely?

2/ For parents w/SUD, joyful first moments with their newborns are often shaped by fears of CPS reporting.

Mandated reporting is driven by #CAPTA - a vague federal law. Most birthing hospitals still report for exposure to:
💊 Illegal/non-prescribed opioids
💊 MOUD
💊 Rx'd opioids for chronic pain

#MedSky #PedsSky #HealthPolicy