It's bad enough
what crack does to adults. But what it does to kids can be a
real crime. Consider:
A baby girl is born in Boston,
three months early. She weighs less than three pounds, and clings
to life through a tangle of tubes and wires that provide what
her mother cannot-intensive care.
A five-year-old in Los Angeles bounces from foster home to foster
home, wearing down would-be caregivers with his outbursts. When
things don't go his way, he kicks, screams, rips at his hair,
and bangs his head on walls.
A girl is found dead in a New York apartment. Her neck is broken,
but she also has a broken arm, cuts and bruises on her face,
and welts on her buttocks. She was five years old.
brother was luckier, but only a little. Police found him in a
closet, with both legs -- and eight other bones -- broken. Covered
with bruises, he was hiding from the monsters who hurt him --
his crack-addicted parents.
In some ways. But drugs don't get any more extreme than crack.
And people don't get any more strung out on any other substance.
we put together this pamphlet. Because even though we're used
to seeing drug problems trickle down -- in the form of poverty
and disease and neglect -- to the children of addicts, there's
something new and terrible this time around.
is the sheer volume of problems associated with crack and the
viciousness of its impact on the children of users.
is the number of innocent young bystanders who've gotten hurt
already in crack's deadly crossfire.
..How are kids affected by a parent's use
They can be
affected in more ways than one, because the risk that crack poses
to children is really two-tiered.
Some kids get
hurt at the very outset of their lives, in the form of defects
caused by prenatal exposure to the drug.
can take the form of addiction, lowered birth weight, and other
physical changes. Problems can also tick away in the background,
waiting to explode later in life.
get hurt differently, when their moms and dads disappear into
crack houses and alleyways and forget who they are -- or used
to be, before they turned into crack addicts.
can take the form of abandonment, neglect, or outright physical
abuse, since the emotional lives of crack users can become so
turbulent, violent, and unpredictable -- and so centered on the
use of crack.
..How many kids are affected?
to say, but one thing is clear: The number is already too high
-- and it's getting higher. One big reason why is that crack
is used by so many women.
show that cocaine is used each year by hundreds of thousands
of women of childbearing age in the United States. And while
they're not all using crack, the hazards are the same.
The true extent
of fetal exposure to crack is harder to guess. Probably the best
estimate is that between 30,000 and 50,000 babies are born each
year to mothers who use crack at some stage in their pregnancies.
..How does crack affect a developing fetus?
When a pregnant
woman smokes crack, the drug quickly enters her bloodstream and
rushes to all parts of her body -- and to her developing baby.
with the drug's stimulant effects on the mother. Since the drug
blocks hunger and fatigue, a pregnant user can place severe nutritional
and stress demands on herself-and her baby.
for problems is increased even further when the drug's other
effects get figured in, particularly its ability to raise blood
pressure and constrict blood vessels throughout the body.
This can pose
two different types of risk to the fetus, since it increases
the pressure on developing blood vessels (particularly in the
brain) and blocks the flow of oxygen and nutrients to fetal tissue.
Fetal stroke and other serious problems can result.
..Can crack cause fetal death?
Yes. In fact,
stillbirth and spontaneous abortions are common complications
of cocaine use during pregnancy.
causes of fetal death include preterm labor, premature rupture
of the membranes, and early dislodging of the placenta.
No one really
knows why cocaine causes so many fetal deaths; we only know that
it does. In fact, one study showed fetal death to be 10 times
more likely among cocaine users than non-users.
..Are there any other risks?
are. One of the most common-and potentially risky-is in lowered
Low birth weight
derives in part from cocaine's ability to block appetite and
in part from its ability to speed users up. But the problem is
that cocaine does more than speed mom and baby up-it also speeds
up pregnancy itself, resulting in deliveries that average up
to two weeks ahead of schedule.
stem from the damage that cocaine can do to developing fetal
about 30 percent of the cocaine in the mother's bloodstream crosses
the placenta, the developing fetal liver isn't able to metabolize
it quickly. This means that a dose can stay on -- and stay active
-- in the fetus for hours longer than in its mother.
are less understood, but researchers worry most about the drug's
possible effects on the fetal brain and central nervous system.
include reduced fetal length and head circumference and a variety
of physical complications, including deformations in the heart,
lungs, and genitals.
..What happens to crack babies as they
Some crack babies seem to fare pretty well and show little long-term
harm. Others aren't as lucky and require a lot of help to simply
have a chance at life.
cause the most concern. Crack babies are more likely to exhibit
behaviors that could limit their ability to learn and develop
socially. Problems include irritability and hyperactivity, low
tolerance to frustration, impulsiveness, and impaired concentration.
neurological damage may show up in the form of impaired balance
and coordination and other motor control problems.
And these problems
don't automatically go away as crack kids age, either.
..Is there hope for crack kids?
There is if
they get help. And the most important first step in helping crack
kids is to get their mothers off crack.
Sooner is always
better when it comes to quitting crack. But later is better than
fact is that crack-related problems can snowball -- minor problems
get worse if they're ignored or compounded by poverty, disease,
or neglect -- and they're a lot more likely to be ignored or
compounded by mothers on crack.
Among the most
promising approaches to the problem thus far involve "one-stop"
services for both mother and child-drug treatment, employment
counseling, and child care training for mom, rehabilitative and
educational services for baby-in a single program.
are educational services for older crack kids that focus on highly
structured environments (to reduce the risk of overstimulation),
small classes (to provide greater one-on-one learning opportunities),
and class activities to make learning more concrete and less
The new approaches
seem to be working, too. In one study of 90 three-year-olds exposed
to cocaine during pregnancy who received intensive follow-up
services, 90 percent demonstrated normal intelligence and 70
percent showed no sign of behavior problems.
..Saving the Children
So what's the
There are a
lot of them. Potential solutions tried thus far have spanned
the gamut from increased addiction treatment services for pregnant
users to prosecuting addicted mothers for neglect or endangerment
and taking kids away from impaired parents.
It's a tough
choice, but it's a choice that sometimes has to be made.
really do represent our future. And they need care and protection
usually by their parents, but increasingly (and sadly)
in today's world, from their parents.
The most important
thing any of us can do to end the problem is to get a simple
message out, once and for all, that using crack or other drugs
during pregnancy isn't only a bad idea -- it's wrong. Period.
If you use crack or other drugs, stop. If you don't think you
can stop, get help. If you don't know where to get help, find
tough enough under the best of circumstances.
But for crack
kids, it can be a real disaster.
..Sidebar | Undoing
the Damage: Caring for A Crack Baby
We've known for a long time ago
that crack is a nightmare drug that creates nightmare people.
Still, we didn't realize just how nightmarish it can be until
we began to see it in the faces and the broken bodies and spirits
of babies exposed to the drug before birth.
birth defects are relatively rare, behavioral and neurological
problems are much more common. But they're not impossible to
overcome, particularly if a crack baby receives early love and
and support can be tricky, though. Many crack-addicted mothers
simply aren't capable of providing much, if any. And crack babies
can be difficult to care for. Still, it's important that they
get the care they need -- no matter where it comes from. Experts
recommend that caregivers focus on three main areas:
- Avoid overstimulation. Crack babies are often fussy and irritable,
particularly when overstimulated. Dimming bright lights and reducing
loud noises and other distractions can help.
- Be gentle. Crack babies may dislike being picked
up and held, but it's important that they feel human contact.
Experts advise a light touch when changing diapers or at meal
- Be patient. If a baby is born addicted to crack,
withdrawal symptoms can persist for up to four months. Other
problems can last even longer. Patience is a particular virtue
in caring for a crack baby, no matter how cranky the baby may