The Cocaine Kids

Everyone has heard of crack babies, one of the most compelling symbols to emerge from the war on drugs in recent years: Exposed to cocaine in the womb, they are born addicted and brain-damaged, with little hope for a normal life. They develop slowly, have difficulty forming emotional bonds, and fall behind in school because they can't pay attention.

This widely accepted image of crack babies has recently come under attack—not only by skeptical researchers but by one of the agencies involved in the federal campaign against illegal drugs. The January/February issue of NIDA Notes, the newsletter of the National Institute on Drug Abuse, reports that the media have greatly exaggerated the effects of prenatal exposure to cocaine. Under the headline, "'Crack Babies' Not a Lost Generation, Researchers Say," the newsletter quotes experts who argue that "such labeling not only overstates the impact of prenatal drug exposure, it is harmful in and of itself to drug-exposed children."

The article notes that expectations of parents and teachers that "crack kids" will be irritable, unloving, stupid, or hard to control can become self-fulfilling prophecies. Indeed, all reports of long-term damage from prenatal exposure to cocaine have been subject to this sort of bias.

Another difficulty in research on crack babies is separating out the effects of variables such as nutrition, drinking and smoking, prenatal care, and the home environment. Since women who smoke crack are more likely to be poor, to neglect their health, to use other drugs, and to be inattentive parents, their children (as a group) would be worse off than average, both at birth and later on, even if cocaine exposure had no impact on them at all.

Dr. Deborah Frank of Boston City Hospital is conducting a NIDA-funded study aimed at distinguishing the longterm effects of prenatal cocaine exposure (if any) from the effects of the postnatal environment. "The popular press is way out ahead of the data in prognosticating horrible outcomes for these kids, particularly on the basis of biological risk," she told NIDA Notes. "All that has been shown in well-controlled blind studies that have been replicated over many sites is an incremental risk for shorter length, lower weight, and smaller head circumference at birth." These characteristics are statistically associated with health problems, but they are not permanent disabilities.

Dr. Ira Chasnoff, whose research is frequently cited by drug warriors, recently completed a two-year study of crack babies. "Their average developmental functioning level is normal," he told Boston Globe columnist Ellen Goodman. "They are no different from other children growing up. They are not the retarded imbeciles people talk about….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."