CASA of Arizona

Substance Exposure - pg. 7

Substance Exposed Newborns (SEN)



There is growing concern for the care and safety of substance-exposed newborns in Arizona. Early intervention services for both the newborn and the mother are critical in minimizing the effects of prenatal substance exposure.

Based on extensive medical literature review, review of other state guidelines, and input from hospital newborn programs, this committee drafted "Guidelines for Identifying Substance-Exposed Newborns".

The Relationship Between Substance Abuse and Child Abuse



In addition to the biological risk that prenatal alcohol or drug exposure poses to these children, they are at an increased risk of child abuse and neglect by parents whose need for drugs takes priority over the care of their infants and children. As a result of these factors, there has been a sharp increase in the number of drug exposed children in out-of-home placements.

The driving force behind new efforts to identify and protect substance exposed infants and children is the understanding that intervention services for the newborn and mother are critical in minimizing the acute and long-term effects of prenatal substance exposure. Even if a newborn exhibits no clinically significant difficulties in the neonatal period, identification of a substance-exposed newborn may improve the infant?s long-term development.

There is also increasing concern about the negative impact on children when parents or other members of the household engage in other illegal drug-related activity, such as the manufacture of methamphetamines in home-based laboratories. The state of Arizona has responded to the growing problem of the manufacturing and distributing illegal substances by parents and caregivers by expanding the civil definition of child abuse or neglect so that children living in dangerous home environments can be protected.

The Ways in Which Children Are Exposed



Substance exposed infants are not only classified as such due to prenatal exposure to drugs and alcohol. Approximately 50% to 80% of all child abuse and neglect cases substantiated by Child Protective Services involve some degree of substance abuse by the child's parents.1 This can be due to a variety of factors including:
  • The often chaotic lifestyles and social instability where the primary focus of a parent or caregiver is directed towards obtaining and using drugs, instead of attending to the basic needs of an infant.
  • Substance abusing parents lose touch with reality, making them emotionally unavailable to their infants for much of the time.
  • Substance abusing parents are repeatedly observed having trouble balancing the needs of their infants with their drug use.
Between the ages of one and four months, babies need regular routines including periods of deep sleep and quiet alertness. Mothers with substance issues and without other support find it extremely difficult to provide a regular routine for their baby or assist in helping the baby reach developmental milestones.


1 U.S. Department of Health and Human Services. National Center on Child Abuse and Neglect. Protecting Children in Substance Abusing Families. 1994


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