It Might Be Premature to Blame 'Meth Babies' for Imposing 'Tremendous Burdens on Society'


A new study of behavior problems in children prenatally exposed to methamphetamine has prompted predictably alarming headlines that recall the panic about "crack babies," who supposedly were handicapped for life by their mothers' drug use. Those concerns turned out to be wildly overblown, and for years scientists who regret that episode have been warning their colleagues not to make the same mistake with "meth babies." But such admonitions may be no match for researchers' natural tendency to exaggerate the importance of their findings, combined with journalists' constant thirst for a good scare story. 

In this case, researchers led by Brown University psychologist Linda LaGasse compared the Child Behavior Checklist (CBCL) scores of 166 children whose mothers had consumed meth during pregnancy to those of 164 children whose mothers had not. The two groups, drawn from four cities (Los Angeles, Honolulu, Des Moines, and Tulsa), were matched for "race, birth weight, public health insurance, and education," and the kids were assessed at ages 3 and 5 based on an oral questionnaire answered by their caregivers. "This first report of behavior problems in patients as young as 3 years associated with MA [methamphetamine] exposure identifies an important public health problem," LaGasse and her colleagues write in the April issue of Pediatrics. "These effects on behavior problems are quite robust and may have substantial public health implications because problems as noted on the CBCL tend to persist over time and predict later psychopathology and criminal behavior that place tremendous burdens on society."

Sounds serious. If you look at the overall CBCL scores, however, you will see that the exposed and nonexposed kids were virtually indistinguishable. At age 3, the "total problems" score was 52.2 for the exposed children and 51.1 for the comparison group; at 5, the scores were 52.9 and 50.2, respectively. In neither case was the difference statistically significant. The two groups' "internalizing" scores (which include four subscales) also were essentially the same. "There were no effects of MA on the internalizing or total behavior problems scales," LaGasse et al. report.

Instead of concluding that the two groups were basically the same, the researchers focus on a few subscales where there were statistically significant differences. "MA exposure was associated with increased emotional reactivity and anxious/depressed problems at both ages and externalizing and attention-deficit/hyperactivity disorder problems by age 5 years," they write. The differences range from slightly less than a point to slightly more than a point. "Because CBCL findings are based on caregiver report," the authors concede, "there could be reporting bias." In other words, the mothers or other caregivers who answered the questionnaires may have been more inclined to perceive and report problems precisely because they worried about the potential damage caused by meth exposure. There was a similar weakness in much of the research on children exposed to cocaine in the womb.

Assuming the score gaps reflect real differences, how do we know they are caused by prenatal exposure to methamphetamine? To their credit, LaGasse et al. take into account a bunch of other variables: "prenatal exposure to alcohol, tobacco, and marijuana; birth weight; gender; SES [socioeconomic status]; maternal age; single (no partner); caregiver change; domestic violence; postnatal use of MA; tobacco, alcohol, and marijuana exposure; caregiver psychological symptoms; the quality of the home; child abuse; and study site." But they concede that "our measure of child abuse through caregiver report of Child Protective Services likely underestimates abuse." Likewise, their measure of "caregiver psychological symptoms" (which were associated with children's behavior problems) may not have captured all of the relevant differences between women who smoke meth when they're pregnant and women who don't.

In short, it is not clear from these data that "meth babies" (as several headlines called them) are different from other children in practically significant ways, that they represent "an important public health problem," that they they will "place tremendous burdens on society," or even that meth itself is the cause of any differences that actually exist. Given the cautionary example of "crack babies"—who were stigmatized as dramatically and permanently damaged, while their mothers were singled out for special condemnation and punishment—researchers and the journalists who trumpet their findings should try to be a little more careful this time around.

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  1. …journalists’ constant thirst for a good scare story.

    That’s the thirstiest thirst of all.

  2. This is nonsense. There’s no way you can take reporting from people aware of the circumstances at face value, on top of the almost identical total scores. It’s the entire reason legitimate studies are double-blind.

  3. I am curious what threshold these researchers used for statistical significance. If they were testing a number of hypotheses in parallel, p<0.05 is widely — and wrongly — used.

  4. Oh, those poor poor meth babies, this is their future.

    1. My mother smoked meth when she was pregnant with me. I turned out to be a seditionist.

  5. I was under the impression that any baby was a burden on society.

    I blame their parents though.

  6. Meth baby or not, they’re all jerks.

  7. Oh why, oh why wont someone think of the meth children!?!?!

  8. I would assume most health problems with meth babies to occur during the pregnancy, not after?

    1. That’s what most would assume because that’s the pattern laid out by the crack-babies myth, but the researcehs in all fairness did test for other well-known influences, like socio-economic status, and those kids growing up with “meth parents” could be mistreated if the parent’s use is heavy. Both of these can lead to malnutrition for instance and cause health problems. But the scores doesn’t really seem to support those worries. Pretty amazing.

  9. Isn’t it good news that women who turn to meth to salve their emotional distress over loss of access to safe affordable contraception don’t have to worry about its effect on their unwanted newborns?

  10. “the two groups, drawn from four cities (Los Angeles, Honolulu, Des Moines, and Tulsa), were matched for “race, birth weight, public health insurance, and education,””

    But not the behavior of their parents. It’s quite possible that mothers who do drugs while pregnant might act differently in other ways than mothers who don’t.

    1. I was thinking the same thing, poor nutrition etc.

    2. “It’s quite possible that mothers who do drugs while pregnant might act differently in other ways than mothers who don’t.”

      Don’t screw-up the narrative!

    3. Or (maybe this is what you were getting at) mothers who smoke meth while pregnant have a distinctive neurological makeup. Their children inherit this, and at a young age it manifests itself in the ways found in the study.

      Of course, I would expect pregnant meth-smoking mothers and typical mothers to have statistically significant differences in the descriptions they gave of a brick wall. The fact that they describe their children’s behavior as different doesn’t tell us much about the children.

  11. Meth babies? What about “speed kids”? I have vague recollection of some study that showed children prescribed CNS stimulants such as Ritalin and amphetamines for ADD/ADHD have a much higher rate of “abuse” of CNS stimulants (coke, meth) as adults.

    1. look, if you know of a better way to deal with kids’ behavior than drugging them…

  12. I tried to say the same things to Lindsey Tanner when she called, but that didn’t make good news, so I wasn’t quoted. I guess I shouldn’t feel too bad to be booted out by someone at NIH, who stressed the preliminary nature of the study. Also, as Michael P. stated above, they tried to look at too many variables, so the fact that they found two measures “statistically significant” is not surprising.

  13. While regulations are anathema to libertarian values, I would be more than happy to see a requirement that news reporters that report on scientific research results be required to print the actual statistical measures used (types of statistical tests performed and the resulting test statistic values) and the resulting numbers so that people can think for themselves as to how much it really means. Another good example is the recent red meat blather running around the news sphere. If you look at the “increased risk” found in the red meat study, it is a scenario where if you are 40 years old today and you eat one serving of red meat a day compared to your buddy who is also 40 and identical to you in every other way but doesn’t eat the red meat, you would statistically die at about age 79 and he will die at age 80. And yet I couldn’t find a news story that had that kind of information

  14. Yes, the “meth babies” headline might be a way to sell stories and is misleading — but here’s one from Humboldt County today where a woman was sentenced to six years for her son’s death:

    The conviction — which was in doubt up until Maggie Jean Wortman agreed to leave her guilty plea in place on Monday — is the state’s first for voluntary manslaughter in a case where a woman stood accused of passing a lethal dose of methamphetamine to her child through breast milk while nursing.

    The mother claims that someone strangled the baby.

    Looks like that baby won’t be a burden on society anymore. But the mother sure is.

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