GUEST COLUMN
OPINION: New Mexico is expanding family separation under the guise of child welfare
Since last year when Gov. Michelle Lujan Grisham directed that all exposed to drugs or alcohol be separated from their parents, over have been taken into state custody. In an attempt to move the state toward a more balanced, support-based system, the administration recently passed , the 鈥淐omprehensive Addiction and Recovery Program.鈥� Now the proposed rules for how to implement it could the very family separation policies the law sought to mitigate.
After legislation is passed, the New Mexico Administrative Code requires agencies to go through a public rule-making process to determine how that law will be implemented. Under the proposed , any pregnant patient who admits to substance use, including prescribed medications or legal substances such as alcohol, tobacco or marijuana, can be required to comply with a Plan of Safe Care (POSC), including mandatory substance use treatment, even in the absence of a clinical assessment or diagnosis. Families accessing medication-assisted treatment, like methadone or buprenorphine, would be subject to the same requirements as those using illicit substances. Families deemed 鈥渘oncompliant鈥� with these plans can be referred directly to the Children, Youth and Families Department for assessment, bypassing the multilevel response system outlined in SB 42.
These rules will fall most heavily on pregnant women and their children, who risk unnecessary system involvement and separation. The New Mexico Health Care Authority should revise the rules to ensure interventions are based on clinical assessment and aligned with SB 42鈥檚 intended, proportionate approach.
What these rules reflect is a more punitive approach to substance use during pregnancy. A punitive framework treats substance use not as a health issue, but as grounds for surveillance, intervention and potential separation. It lowers the threshold for state involvement, expands mandatory reporting and compliance requirements, and ties access to care to the risk of child welfare consequences. shows that punitive prenatal substance use policies have not been shown to reduce substance use during pregnancy. Instead, they are associated with reduced engagement in prenatal care and substance use treatment, as patients delay or avoid care out of fear of detection and potential loss of custody.
In the United States, there were 22 maternal per 100,000 live births in 2022, more than double 鈥� and in some cases triple 鈥� the rate seen in other high-income countries. Nearly two-thirds of pregnancy-related deaths occur during the postpartum period, a time when continuity of care and support is critical. Pushing expecting mothers away from the health care system in this context only makes those gaps worse.
Apart from the disastrous health consequences for expecting and postpartum mothers, family separation, even when it is temporary, carries its own set of risks. consistently finds that separating children from their parents is associated with increased anxiety, depression and behavioral problems, with lasting effects on development. These outcomes are reflected in broader system data. In the United States, roughly 80% of children in foster care have significant mental health needs, compared to about 20 of children in the general population. Attachment disruptions are also common, with showing that about 1 in 4 foster care placements break down, often abruptly, contributing to repeated instability that makes it harder for children to form and maintain secure relationships over time.
SB 42 was supposed to move New Mexico in a different direction. It recognized that substance use during pregnancy is complex and requires responses grounded in clinical judgment and individual circumstances. The draft rules counteract that push by lowering the bar for state involvement and treating admission of use as enough to trigger intervention, regardless of context.
That is not what the law prescribed.
There are models that take a more pro-family approach. Programs like Sobriety Treatment and Recovery Teams (START) connect families to treatment quickly, pair them with caseworkers and peer mentors, and provide ongoing support while keeping families involved in decisions. More than 75% of children in START remain safely with their parents or reunify, and mothers are nearly twice as likely to achieve sobriety. There is also a better way to accomplish POSC. Delaware鈥檚 POSC system shows that 93.9% of substance-exposed infants received a plan, 88.2% remained safely with their parents, and only 11 infants experienced serious harm among the 1,347 infants who stayed at home 鈥� well below prior years and national averages.
Continuing to expand these policies in the name of 鈥渟afety鈥� ignores what the evidence actually shows. What improves outcomes is early access to treatment, coordination across services and keeping families engaged in care. New Mexico should be building policy around those approaches, not expanding interventions that push people away from the very systems meant to support them.
Layal Bou Harfouch is a policy analyst at Reason Foundation focused on interdisciplinary harm reduction across drug policy, criminal justice, housing, child welfare and women鈥檚 health. She is also a doctoral researcher at the University of Oxford. Follow her on X @layalbouharfou.
