Trends in U.S. State Alcohol and Other Drug Use During Pregnancy Policies from 2016 to 2020: Policymaking in the Comprehensive Addiction and Recovery Act Era

Prior to the U.S. Comprehensive Addiction and Reovery Act of 2016 (CARA) , policymaking on alcohol and drug use during pregnancy was more concentrated on alcohol than drug use policy - although the overlap between the two types of policy was high. Further, the highest levels of legislative activity were requirements to report pregnant women who used alcohol or other drugs and child abuse/neglect policy. This research brief uses rigorous legal epidemiology methodology to explore state policy activity on alcohol and other drug use during pregnancy after the U.S. Comprehensive Addiction and Recovery Act of 2016 (CARA) amended the 2010 Child Abuse Prevention and Treatment Act Reauthorization (CAPTA). Since CARA, policymaking has been more concentrated on drug policy than alcohol policy, although the overlap between the two is still high. Further, since CARA, states have concentrated policy activity on priority treatment for drugs and reporting requirements. Even though CARA does not require reporting for the purposes of child welfare investigations, several states adopted such requirements during these years.