Parental Substance Use as Child Maltreatment - North Carolina

Substance-Exposed Newborns 
Citation: CPS Assessments Policy, Protocol, and Guidance

In policy: In North Carolina, health-care providers involved in the delivery and care of such infants must notify the county child welfare agency in the form of a report upon identification of the infant as 'substance affected.' A 'substance-affected infant' is an infant that meets one of the following definitions:

• The infant is affected by substance abuse, as indicated by either of the following:
  • The infant has a positive urine, meconium, or cord segment drug screen with confirmatory testing in the context of other clinical concerns, as identified by current evaluation and management standards.
  • The infant's mother has had a medical evaluation, including history and physical or behavioral health assessment indicative of an active substance use disorder, during the pregnancy or at the time of birth.
• The infant is affected by withdrawal symptoms as manifested by clinically relevant drug or alcohol withdrawal.
• The infant is diagnosed with one of the following:
  • Fetal alcohol syndrome (FAS)
  • Partial FAS
  • Neurobehavioral disorder associated with prenatal alcohol exposure  
  • Alcohol-related birth defects
  • Alcohol-related neurodevelopmental disorder
• The infant has known prenatal alcohol exposure when there are clinical concerns for the infant per current evaluation and management standards. 

As specified in the Child Abuse Prevention and Treatment Act, the notification is to ensure that services are provided to the infant and caregiver, but it does not establish a definition under Federal law of what constitutes child abuse or neglect. Furthermore, the requirement for notification should not be construed to mean that prenatal substance use is intrinsically considered child maltreatment. Therefore, while the notification is required, not every report about a substance-affected infant will result in a child protective services assessment.

Children Exposed to Parental Substance Use
Citation: Ann. Stat. § 15A-1340.16

When imposing a sentence upon conviction of a crime, the court shall consider evidence of aggravating or mitigating factors present in the offense that make an aggravated or mitigated sentence appropriate, but the decision to depart from the presumptive range is at the discretion of the court. The State bears the burden of proving beyond a reasonable doubt that an aggravating factor exists, and the offender bears the burden of proving by a preponderance of the evidence that a mitigating factor exists.

The court shall make findings of the aggravating and mitigating factors present in the offense only if, in its discretion, it departs from the presumptive range of sentences specified in § 15A-1340.17(c)(2). If the jury finds factors in aggravation, the court shall ensure that those findings are entered into the court's determination of sentencing. Findings shall be in writing. The requirement to make findings to depart from the presumptive range applies regardless of whether the sentence of imprisonment is activated or suspended.

Aggravating factors include the following:

• The offense involved the sale or delivery of a controlled substance to a minor.
• The offense is the manufacture of methamphetamine and was committed where a person under age 18 lived, was present, or was otherwise endangered by exposure to the drug, its ingredients, its by-products, or its waste.
• The offense is the manufacture of methamphetamine and was committed in a dwelling that is one of four or more contiguous dwellings.

Mitigating factors include the following:

• The defendant has entered and is currently involved in or has successfully completed a drug treatment program or an alcohol treatment program subsequent to arrest and prior to trial.
• The defendant has a good treatment prognosis, and a workable treatment plan is available.