A new guide for area hospitals and doctors calls for more vigilance in looking for signs of substance abuse in pregnant women and newborns.
The number of Florida newborns with signs of substance abuse dropped from 4,500 in 1990 to 2,600 in 1997.
But officials believe more infants are not diagnosed.
"You know it hasn't declined that much," said Carol Brady, executive director of the Healthy Start Coalition of Northeast Florida. "It's just that less attention is being paid to it. It's just not the problem of the day."
Even fewer pregnant women are being diagnosed.
In Northeast Florida, only 221 pregnant women were reported to have a substance abuse problem from October 1997 to September 1998, though 659 exposed newborns were reported. Statewide, 1,996 pregnant drug abusers and 5,383 drug-exposed infants were reported.
Part of the drop in reported cases may be due to a decline in crack cocaine use.
At its peak in 1985, 10 to 15 percent of all pregnant U.S. women used the drug. Now, about 5 percent do, said Isaac Delke, a physician in charge of University Medical Center's obstetrics program for pregnant women with HIV and substance abuse problems.
But health officials fear that with the drop in crack cocaine use, there no longer is an emphasis on screening women and babies for drug problems.
A local task force report concluded the state's dismantling of its Department of Health and Rehabilitative Services into separate health and social service agencies resulted in some women not coming to the attention of health care providers.
Also, Medicaid moved some patients into health maintenance organizations and out of public clinics that routinely look for substance abuse.
Doctors don't have to test pregnant women for drugs, or report positive cases. Hospitals must test newborns only if the mother is suspected to have abused substances.
The regional task force, created by the Northeast Florida Healthy Start Coalition, just published a guide that calls for screening all pregnant women by asking them questions, assessing whether they meet risk factors for substance abuse, or by performing a urinalysis.
The guidelines also give doctors suggestions for when to test newborns. …