Newsgroups: talk.politics.drugs
Subject: Re: What about Crack Babies? REFERENCES !!!
Date: 8 Jan 1994 06:37:30 -0600
Here's a new article on "crack babies" from _Science_News_, Nov 9,
1991. Clip and save!
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"Smoking out cocaine's _in_utero_ impact"
Despite many reports of cocaine's ill effects on the developing
fetus, scientists lack definitive evidence specifically linking
cocaine to adverse reproductive effects (SN: 9/7/91, p.152).
Using a powerful statistical technique, a Canadian research
team has found that cocaine by itself causes very few problems
during pregnancy.
Gideon Koren of the University of Toronto and his colleagues
identified 20 previously published cocaine studies that in-
volved pregnant women and yielded mixed results. Those
studies often relied on small samples of cocaine users -- a
problem that limited each study's statistical power.
To home in on cocaine's reproductive risks, his team turned
to a method called meta-analysis, which statisticians use to
assess data by pooling a number of similar studies. Koren and
his colleagues identified women in the 20 studies who used
cocaine during pregnancy but did not use other illicit drugs or
alcohol, and compared them with those who reported no drug
or alcohol use during pregnancy. They found no statistical link
between prenatal cocaine use and premature delivery, low
birthweight or congenital heart defects in babies -- problems
often thought to result from cocaine.
The meta-analysis suggests that confounding factors -- such
as other drugs, alcohol and smoking -- may account for the fetal
growth retardation or prematurity commonly ascribed to
cocaine, the researchers assert in the October _TERATOLOGY_.
Koren says women who use cocaine tend to smoke more
cigarettes than women who use other illicit drugs and are more
likely to drink alcohol and take additional drugs.
The meta-analysis did reveal a chance that a pregnant
woman's cocaine use by itself might cause malformations of the
genito-urinary tract in a small number of infants. Koren says
this effect may trace to cocaine-induced constriction of the
placental blood vessels.
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(From _The Boston Sunday Globe_ * January 12, 1992, pg 69)
THE MYTH OF THE `CRACK BABIES'
By Ellen Goodman
They are called "a biological underclass" and "a lost generation."
Those are just two of the milder name tags attached to the children we
have come to believe were permanently damaged by their mothers' use
of cocaine.
The poster in maternity clinics conjure up the same image of the
prenatally doomed: "Some people who smoke crack never get over it."
The schools too have been put on emergency alert: "The crack babies are
coming, the crack babies are coming."
Indeed, the phrases "crack babies" and "crack kids" are shorthand for
monster-children who are born addicted. These are the kids destined to
grow up without the ability to pay attention or to learn or to love.
But just when the name has stuck, it turns out that "crack baby" may be
a creature of the imagination as much as medicine, a syndrome seen in
the media more often than medicine.
Three years after the epidemic of stories about these children began,
six years after hospitals began to see newborns in deep trouble,
researchers are casting doubt on the popular demon of the war on drugs.
The very phrase "crack baby" is, in any literal sense, a misnomer.
Cocaine is rarely taken by itself. It's part of a stew of substances
taken in a variety of doses and circumstances. No direct line has been
drawn from the mother's use of cocaine to fetal damage.
Alcohol and tobacco may do as much harm to the fetus as cocaine. So
may poor nutrition, sexually transmitted diseases, and the lack of
medical care. Most important, it appears that the children born to
cocaine-using mothers are not hopeless cases, permanently assigned to
the monster track. Dr. Ira Chasnoff, who did some of the original work
identifying the problem babies of mothers who took cocaine in
combination with other drugs, has done a two-year follow-up study about
to be published. It says, in his words, "Their average developmental
functioning level is normal. They are no different from other children
growing up. They are not the retarded imbeciles people talk about.
This is not, he cautions, a green light for taking drugs during
pregnancy. Drugs remain a serious health problem, and cocaine
specifically contributes to premature birth and small head size. While
the children in his study - children who have been offered some help -
now function normally as a group, they are at risk individually.
But, says Dr. Chasnoff, "As I study the problem more and more, I think
the placenta does a better job of protecting the child than we do as a
society." The need now is to widen the lens from nature to nurture, and
from the environment of the unborn to that of the born.
Another researcher who has taken a responsible second look at the
"crack baby" syndrome is Claire Coles of Emory University. She
believes these children, labeled by their drug of origin, are in fact
"often victims of gross neglect, not brain damage."
The worst damage that drugs may do is to the world a child inhabits
after birth. Coles has a collection of horror stories about children
growing up neglected, especially by cocaine addicts. One "crack kid"
who couldn't concentrate in class was in fact hungry. Another poorly
developed "crack baby" was being "raised" by a 5-year-old sister.
The myth of the "crack baby" became a media hit, Coles believes,
because "crack is exotic and happening mostly in `marginal' populations
among `bad people' who are not like `us.'" It is easier to think about
crack than alcohol or tobacco. There is more than a touch of racism in
the attention.
But perhaps the worst effect of this distortion is the sense of
hopelessness dispensed with the title "crack kid." Hopelessness on the
part of mothers, teachers, and even the children themselves. As Coles
warns, "If a child comes to kindergarten with that label, they're dead.
They are very likely to fulfill the worst prophecies."
So, no more convenient and empty names. The children whose mothers
used cocaine are neither universally nor permanently nor uniquely
damaged. The so-called "crack kids" are just a portion of our growing
population of children in deep trouble. They are only children, like
so many others, growing up with a treacherous mix of nature's and
nurture's woes.
If you need a label, call them kids who need help.
- Ellen Goodman is a Globe columnist.