Vice Squad
Sunday, May 30, 2004
Crack Babies

One of the more emotionally-charged arrows in the drug prohibitionists' quiver is crack babies. If drug legalization were to lead to a substantial (or perhaps any) increase in the number of stunted, cocaine-addicted infants brought into this world, well, that would provide good reason even for committed drug policy reformers to reconsider.

And yet, the media reports of crack babies from the late 1980s and early 1990s probably created an impression that is much worse than reality, bad as reality is. (Or at least, the nature of the problem was misdiagnosed.) Infants born to crack-addicted mothers face a very tough row to hoe in life -- but not, apparently, because of the maternal crack use per se. From "When Pregnant Women Use Crack," by Harold Pollack:
All else equal, healthy pregnant women who consume moderate amounts of cocaine usually deliver healthy infants (Inciardi, Surratt, and Saum, 1997; Finnegan & Kendall, 1997). But all is not equal. Heavy users often drink to manage side-effects of cocaine use (Kleiman, 1993). Many are malnourished, in part because they squander scarce resources to finance their habit and perhaps because cocaine suppresses appetite. Some users frequent crack houses where they are vulnerable to violence and sexually-transmitted disease (Edlin, 1994).
The May 26, 2004 issue of the Journal of the American Medical Association provides a new study that looks at cocaine-exposed infants when they reach four years old. Here are the study's conclusions:
Prenatal cocaine exposure was not associated with lower full-scale, verbal, or performance IQ scores but was associated with an increased risk for specific cognitive impairments and lower likelihood of IQ above the normative mean at 4 years. A better home environment was associated with IQ scores for cocaine-exposed children that are similar to scores in nonexposed children.
For the conclusion of this post, let me borrow the end of the Pollack article:
In any event, the most important task is not to resolve basic moral questions, but to improve the capacity of beleaguered bureaucracies to accomplish what obviously must be done under any reasonable view. The reproductive rights debate would be less divisive and less necessary if we had systems to track severe substance abusers regardless of pregnancy, if effective drug treatment, family planning, and medical care were carefully linked with correctional and social service systems, if child protective services offered continuing and competent supervision of known offenders. Can we create such systems given the poor starting-point of essential institutions? After 15 years, public discourse that disparages or excuses drug-using women will not help us answer that question.
[UPDATE, June 1: Pete Guither at Drug WarRant looks at some of the legacy of the crack baby panic.]


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