OPINION: New Mexico's drug testing policy prioritizes removal over evidence 

New Mexico officials announced in November that more than 100 newborns were taken into state custody after testing positive for drugs at birth. This practice is due to a recent directive from Gov. Michelle Lujan Grisham, and officials framed removals as successful protection of infants. Yet, separating newborns from their families is not a positive outcome; decades of evidence suggest it undermines the goal the policy aims to achieve.

In 2025, state lawmakers passed Senate Bill 42 to strengthen the implementation of Plans of Safe Care (POSC) by shifting oversight from the Children, Youth and Families Department to the Department of Health with the intention to improve consistency and follow-through. Rather than building on that framework, Lujan Grisham instead issued a directive that treats positive toxicology screens as sufficient grounds for the state to assume custody of a newborn at birth. That shift replaced individualized assessment and support with automatic intervention, potentially placing infants at greater risk.

The developmental consequences of early separation have long been documented. In a 1998 University of Florida study of cocaine-exposed infants, those placed in foster or kinship care were more likely to demonstrate developmental delays than infants who remained with their biological mothers. Researchers from this group and subsequent studies concluded that early separation may harm infants. Interrupting early skin-to-skin contact and the maternal-infant attachment that supports autonomic regulation, emotional development and long-term wellbeing introduces developmental instability.

Modern child welfare data reinforce this pattern. Delaware’s statewide POSC system followed 1,436 substance-exposed infants. Of these, 93.9% were provided a POSC, and 88.2% remained safely with their parents rather than entering foster care. Families received structured support: 43.5% of mothers were referred for community-based services, including substance use treatment and mental health care, and 57.8% of infants received developmental or pediatric follow-up. Out of the 1,347 infants who remained at home, only 11 babies experienced a serious injury or fatality — far below previous years and under national averages, illustrating that risk declines when states address concrete needs rather than reacting to the presence of substance exposure itself.

Colorado illustrates how changing the response to substance-exposed newborns can build trust, improve engagement and reduce unnecessary child welfare involvement. In 2020, the state ended the requirement that hospitals automatically report drug-exposed newborns as child abuse victims. Instead, hospitals partnered with families to build a plan of care and coordinate treatment. Within four years, referrals to child protective services fell by 25%, and hospitals reported greater trust and earlier engagement from pregnant people.

The potential consequences of New Mexico’s punitive approach are predictable and dangerous. Pregnant people who fear losing custody often avoid prenatal care, disengage from treatment or hide substance use. A 2019 survey of people who use drugs found that 35% avoided needed health care due to fear of mistreatment by providers. These behaviors increase risk for both parent and infant. For babies experiencing withdrawal, feeding difficulties or respiratory complications, delayed medical care can be life threatening. For parents attempting to stabilize in recovery, losing access to services can worsen symptoms and increase relapse risk. Some even forgo using medication for opioid use disorder because they fear it will cost them custody, a pattern documented in cases where methadone or buprenorphine use was treated as evidence of ongoing addiction.

The tragedies that motivated New Mexico’s new approach to drug-exposed infants require serious, evidence-based policy making. Decades of research point to what works: supportive interventions that strengthen families by expanding treatment access, securing stable housing and providing sustained postpartum care. New Mexico should follow the evidence.

Layal Bou Harfouch is a drug policy analyst at Reason Foundation, specializing in harm reduction.