Whitner Decision: A punitive response to substance use among women in South Carolina

Substance abuse among women is a public health issue of immense importance contributing to economic, social, physical, mental, family, and public health problems. South Carolina has chosen to respond to this problem through a punitive rather than treatment or harm reduction approach. In fact, SC has had the most punitive substance abuse laws for women in the nation since the Whitner v. State decision established substance use during pregnancy as a maternal act of child abuse (October, 1997). Although treatment providers and women's health specialists have advocated that women are avoiding care due to fear of imprisonment and/or losing custody of their children as a result of mandatory reporting, little empirical research has actually been done to truly examine the effect Whitner has had for women seeking treatment. The purpose of this health policy event study was to determine the impact Whitner may have had on women of reproductive age seeking substance abuse treatment at publicly funded centers in SC. Of particular interest was whether the law resulted in 1) criminalizing historically disadvantaged women, 2) deterring women from seeking treatment for fear of prosecution, and 3) decreasing the likelihood that women received more intensive residential care. Research was conducted using the Treatment Episode Data Set (n = 101,169 admissions). Using dummy variables, t-tests with regression coefficients were analyzed to test for differences before and after the Whitner decision. Results regarding the law's social justice impact will be shared with the goal of decreasing stigma and criminalization for substance using women.