Why New Mexico’s newborn state custody directive is a harmful misstep

After the tragic death of two infants, New Mexico Gov. Michelle Lujan Grisham announced a policy intended to protect newborns—mandating 72-hour state custody for  infants who test positive for prenatal exposure to fentanyl, methamphetamine, or alcohol. But even something as harmless as a poppy seed muffin can trigger a false positive, meaning healthy babies could be taken from their mothers unnecessarily. Beyond these testing flaws, the policy drives pregnant women away from care, disrupts early bonding, and undermines long-term family stability. A better path would stabilize families by offering accessible, consistent addiction treatment alongside parenting support, ensuring children can remain safely with their parents whenever possible.

Protecting children is essential, but reducing their future to a single toxicology report ignores the complexity of what’s truly at stake. One test cannot distinguish between untreated substance use disorder, medication-assisted recovery, or prescribed pain management. Each of these scenarios presents distinct risks, whether related to infant health, the impact of unnecessary family separation, or the consequences of inadequate treatment access, and should be addressed through appropriate, individualized responses.

While many state laws require hospitals to detain infants after a positive toxicology screen, there is often no requirement to conduct follow-up testing to verify the results. This is despite the fact that toxicology screens produce false positive results up to 50% of the time, lack context, and often reflect past use—not current use. Yet, they are often treated as the sole basis for governments to seize a mother’s newborn child.

A study done by Health Economics, a peer-reviewed journal focusing on the economic aspects of health and healthcare, shows that punitive policies, like those that define prenatal substance exposure as child maltreatment in child welfare statutes or as grounds for the termination of parental rights, were associated with a 10-18% increase in infants born with opioid withdrawal syndrome. When healthcare providers serve as part of a punitive system, it undermines trust for both the providers and patients and discourages families from seeking the support they need to remain stable, healthy, and safe.

In a 2019 University of Arizona survey, 35% of people who use drugs said they avoided needed healthcare over fears of being mistreated by medical providers because of their drug use, something nearly all of them said they’d experienced before.e.  When pregnant mothers avoid this care, both maternal and infant health outcomes suffer.

Decades of public health evidence show New Mexico’s new mandate is a superficial fix that undermines effective, long-term solutions. Other states are seeking more effective answers. Nine states have adopted the Sobriety Treatment and Recovery Teams (START) model, which serves families in the child welfare system where a parent has been diagnosed with a substance use disorder. Families are enrolled within two weeks of a child welfare report and paired with a child welfare caseworker and a family peer mentor to guide long-term recovery. These professionals work as a team to coordinate care.

START Services include rapid connection to treatment, intensive recovery support, parenting and life-skills coaching, targeted case management, and counseling for parents, children, and other family members—all while keeping the family involved in decision-making. Evidence shows that START not only reduces child maltreatment and foster care placements but also strengthens parenting capacity. In Ohio, parents in START reported significant improvements in appropriate expectations for their children, healthier family role boundaries, and greater support for children’s independence. In interviews, parents described being more present, engaging in daily activities with their children, maintaining steady employment, and managing stress more effectively.

Nationally, more than 75 percent of children in START remain safely with their parents or reunify by program completion, mothers are nearly twice as likely to achieve sobriety compared to those in traditional services, and the model has roughly halved taxpayer expense overall by reducing foster care costs.

Similarly, the Native American Connections’ Patina Wellness Center in Phoenix, Arizona, is a culturally grounded residential treatment facility for pregnant and parenting women with substance use disorders. It incorporates core principles of the START model, with Indigenous healing practices, placing strong emphasis on the parent–child relationship throughout recovery. Their model achieves remarkable engagement, with 92 percent of participants completing treatment. Crucially, the model fosters lasting recovery, with 67 percent of pregnant and parenting women remaining substance-free six months post-treatment, rising to 75 percent at the 12-month mark.

Lasting progress will come from legislation that embeds family-centered recovery initiatives into state law. Such a framework would protect maternal autonomy by requiring informed consent for drug testing, prohibiting automatic removal of newborns based solely on toxicology results, and ensuring access to services like medication-assisted treatment, peer mentoring, and parenting support. When tied to proven models—such as START, which prioritizes family preservation, or residential programs like the Patina Wellness Center—these protections translate into higher treatment engagement, fewer foster care placements, and long-term cost savings while upholding individuals’ fundamental rights and dignity. This should be the way forward for New Mexico.

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