New Jersey families now have a protection that did not exist a year ago, and it changes the calculus for anyone weighing addiction treatment in New Jersey during pregnancy.
Hospitals must confirm a positive drug test with a second, more precise test before reporting a new parent to child welfare, making New Jersey one of the first states in the country to require it.
The Marshall Project reported the new regulations on July 16, following its investigation with Reveal News into how hospitals handle drug testing during childbirth.
Why False Positives Became a Problem
The tests hospitals typically use at the bedside are fast and inexpensive. They are also easy to misinterpret, and reporting by The Marshall Project and Reveal News found false positive rates running as high as 50 percent.
Child welfare agencies have separated parents from newborns based on positive results traced to poppy seeds, to legally prescribed medications, and to drugs given by hospital staff during labor and delivery.
Patients have often been tested without being told and without consenting, and many describe lasting trauma from an investigation that began in their baby’s first days. As of 2024, not a single state required hospitals to confirm a preliminary result before reporting.
What Changed in New Jersey
New Jersey law already said a positive drug test by itself is not child abuse or neglect and does not have to be reported.
Hospitals reported anyway, triggering assessments and investigations of new mothers. Between mid-2018 and mid-2023, state child welfare officials received more than 2,300 reports of newborns allegedly exposed to drugs before birth.
The new regulations require a second, more precise test before results go to child welfare, and describe rapid results as preliminary. Providers can still report if a patient discloses drug or alcohol use during pregnancy.
The New Jersey Department of Children and Families also built an online portal that lets providers submit information about a family without identifying them, and it can generate a list of support services a parent might need, such as counseling or addiction treatment.
If a provider is worried about a newborn’s safety, the portal prompts a separate report. Molly Linhorst, a staff attorney with the ACLU of New Jersey, called the changes “a huge step forward for New Jersey.”
The group filed the first complaints in 2023 for two mothers drug tested during birth, and Linhorst said at least three dozen women have come forward since.
Understanding Medication for Opioid Addiction During Pregnancy
Buprenorphine and methadone are FDA-approved medications for opioid use disorder and the standard of care during pregnancy.
Stopping them abruptly carries real risk for both the parent and the fetus, which is why clinicians recommend continuing treatment.
That is what made the old reporting practice counterproductive. Jennifer Kirkman, an assistant director at the New Jersey Department of Children and Families, said providers find the new rules reassuring for patients taking prescriptions to treat opioid addiction, many of whom had considered going off those medications to avoid an investigation.
Signs someone may need help include taking more than intended, withdrawal between doses such as nausea, sweating, and muscle aches, pulling away from family and friends, and continuing to use despite wanting to stop. During pregnancy, the safest response is to talk to a prescriber, not to quit on your own.
Unequal Testing Has Been Part of the Picture
The New Jersey Department of Health issued guidance directing providers to obtain informed consent before drug testing, flagging concerns about disproportionate testing of patients who are non-White, immigrants, and low income.
Research has found Black women are more likely than White women to be drug tested at childbirth and reported to child welfare.
Ashley Sawyer of the advocacy group Pregnancy Justice said asking for consent often leads providers to realize the test is not needed to guide care.
Other States Are Moving Too
Virginia passed a law this year clarifying that prescribed addiction treatment medications during pregnancy should not be treated as child abuse or neglect, and Massachusetts removed its blanket newborn reporting requirement in 2024.
Bills in New York, Arizona, and Tennessee did not clear their sessions, though the New York measure passed the State Senate.
Finding Addiction Treatment in New Jersey
If you are pregnant or parenting in New Jersey and want help with substance use, a few steps make the process easier:
- Search addiction treatment centers in New Jersey with experience treating pregnant and postpartum patients
- Ask whether a program offers medication for opioid use disorder and can coordinate with your obstetric provider
- Ask whether the program accepts New Jersey Medicaid or offers sliding-scale fees
- Contact SAMHSA’s national helpline at 1-800-662-4357 for free, confidential referrals
Addictions.com lists verified treatment centers across New Jersey. Search the directory to compare local options and levels of care.