Birth control programs for the drug addicted

Melissa Martin, Ph.D.

Due to the opioid/heroin epidemic, is it time for Ohio Attorney Mike Dewine to explore, examine and discuss a voluntary, temporary, but long-term birth control program for addicted women? Would this program prevent neonatal abstinence syndrome by preventing pregnancy?

According to the National Institute on Drug Abuse, individuals struggling with addiction often experience one or more relapses over the course of their recovery journey. “One study examined heroin relapse rates among participants who were discharged after successfully completing an opiate detox program. Of them, 91% reported a relapse, 59% of which occurred within one week of discharge. Earlier relapse was associated with younger age, heavy use before treatment, a history of injecting and not following up with aftercare.” Do statistics favor a birth control program?

There are many questions about this issue: Would free and accessible birth control made available for opiate/heroin addicted women along with support prevent pregnancy? Would female addicts consider temporary birth control: intrauterine devices, surgical implants or pills? Nexplanon, a tiny rod inserted under the skin, prevents pregnancy for up to four years.

Could second pregnancies of addicted women be prevented if residential centers, outpatient counseling agencies, gynecologists, medical clinics, hospital maternity wards and health departments worked together to make birth control free and accessible? Are addicts active in their addiction able to make this decision? Is it ethical to offer voluntary and free contraception options to drug addicted women, or is it controversial?

The Bristol Herald Courier, a newspaper serving Virginia and Tennessee, featured a story about a birth control program for drug addicted women in 2017. The state health department in northeast Tennessee started a pilot program three years ago to offer the option of reversible birth control or an intrauterine device (IUD) to female inmates in jail. Dr. Stephen May, the department’s medical director, is onboard with the program. The Sullivan County Health Department in Tennessee has a neonatal abstinence nurse educator who works with the judicial system to provide contraception to the females. The program took off and expanded to 42 county jails in the state. Visit

Project Prevention is a nonprofit organization founded 20 years ago by Barbara Harris to prevent pregnancies in drug addicted women and, therefore, prevent neonatal abstinence syndrome. How does it work? Participants submit official letters or drug arrest recorders and receive money after a surgical implant or device is inserted or after they choose birth control pills. Harris has paid about 7,000 addicted women to take some form of birth control. Harris started Project Prevention after she adopted four infants with neonatal abstinence syndrome from the same drug-addicted mother.

In 2017, Judge Sam Benningfield in White County, Tenn., was interviewed by the TV show, “CBS This Morning.” Prior, Judge Benningfield initiated a voluntary program to reduce jail time if people with drug addictions underwent a birth control procedure and completed an educational course about addiction in newborns. But, he rescinded the controversial order when the ACLU in Tennessee got involved and declared the program unconstitutional.

Perhaps, a birth control deal by a judge in a courtroom is not feasible, but how do communities help prevent pregnancies?

The Ohio Syringe Exchange Program was controversial in the beginning. A needle-exchange program allows drug-addicted individuals to exchange used syringes for new ones. Research has shown needle-exchange programs can reduce the spread of HIV and Hepatitis C.

More questions need explored: Could a safe-sex agenda, within a birth-control program, help prevent AIDS/HIV, Hepatitis B and sexually transmitted diseases? Could health departments give out condoms along with new syringes to drug-addicted males and females? Could health departments visit women with drug arrests in jail to offer contraception options? Or drive a mobile unit to rural areas?

According to the Centers for Disease Control and Prevention, “Sharing needles, syringes and other injection equipment is a direct route of HIV transmission. Social and structural factors make it difficult to prevent and treat HIV among people who inject drugs. Pregnant women living with HIV may face more barriers to accessing medical care if they also use injection drugs, abuse other substances or are homeless, incarcerated, mentally ill or uninsured. Injecting drugs can reduce inhibitions and increase sexual risk behaviors, such as having sex without a condom or without medicines to prevent HIV, having sex with multiple partners or trading sex for money or drugs. If current rates continue, 1 in 23 women who inject drugs and 1 in 36 men who inject drugs will be diagnosed with HIV in their lifetime.” How many infants are born with both AIDS/HIV and neonatal abstinence syndrome?

Shelia gave birth to two heroin-addicted infants within two years. The children were in and out of the foster care system as Shelia had a history of rehab and relapse. Because she did not inject heroin into her veins, her faulty belief was “it’s not that bad.” Eventually, Shelia shot up heroin. Because she did not exchange sex for heroin, her faulty belief was “it’s not that bad.” Then Shelia had sex with a drug dealer for a heroin fix, and then sex with multiple partners for drugs.

Shelia came back to treatment and requested testing for AIDS/HIV, STDs, Hepatitis B or C, and pregnancy. Shelia, a health department nurse and I sat down together to discuss the devastating results and treatment options.

Society needs to help and not condemn heroin-addicted pregnant women and their unborn babies. However, at the same time, society does not need to disregard heroin drug use and multiple pregnancies. Could a birth-control program be an option? I think it’s worth a discussion.

Melissa Martin, Ph.D.

Melissa Martin, Ph.D., is an author, self-syndicated columnist, educator and therapist. She resides in Scioto County, Ohio.

Melissa Martin, Ph.D., is an author, self-syndicated columnist, educator and therapist. She resides in Scioto County, Ohio.