Meth and Crack: Same Myth, Different Year

 

Here we go again. Back in the 1980s it was the “crack” mania, with all sorts of exaggerated hype about “crack babies” and similar stories. There is a pattern to how the media deal with public issues like this one.  In virtually all stories on this topic and related topics, the issue is framed in a similar fashion.  Typically, a specific and egregious example is described. A search is done for similar stories and soon the conclusion is reached that there is some sort of “trend” or, worse still, an “epidemic.” This is augmented by some juicy comments from representatives of law enforcement and in some cases celebrities and politicians are asked about their opinions (as if they have done some careful research on the issue). Rarely are researchers contacted.  In the case of both “crack” and “meth” medical researchers are ignored, at least at first. Much of the “evidence” cited is anecdotal and the focus is almost always on a few, isolated and exceptional cases (otherwise it would not be “news”) which are then followed by gross generalizations. My friend Jerry Kurelic has offered a unique way of explaining this phenomenon often used by the media and also by political pundits.  He uses the acronym W.I.S.E. which is as follows:  Withhold information that is contrary to their opinion; identify that which is consistent with their opinion; sensationalize that which is consistent with your opinion; expand it as if it is representative of the whole.

            In the stories below, there are two carefully crafted articles by Maia Szalavitz, written about a year and a half apart, plus one example of the exaggerated hype, which in turn is followed by an “open letter” to the public written by an expert on the subject.

 

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The Media's Meth Baby Mania

 

Maia Szalavitz
 
September 1, 2005

http://www.alternet.org/story/24739/
 
When crack was the scariest drug of all, "crack babies" were the culmination of the terror. Columnist Charles Krauthammer wrote of them in 1989, "A cohort of babies is now being born whose future is closed to them from day one. Theirs will be a life of certain suffering, of probable deviance, of permanent inferiority."

As it turns out, none of that was true. In fact, being labeled a "crack baby" appears to have done more harm to these children than the cocaine itself did. And with news stories popping up about "meth babies" in our latest drug panic, we seem to be about to repeat this shameful pattern.

Children born to mothers addicted to crack cocaine did have serious problems--but most of these were related to the fact that their mothers lacked prenatal care, were extremely poor and drank alcohol, smoked cigarettes and took other drugs as well as crack cocaine.

Women who do not stop using drugs or drinking during pregnancy tend to be those with long, complicated histories of victimization and mental illness (Over two thirds have survived childhood sexual abuse and/or are current victims of domestic violence, for example). It's undoubtedly a bad idea to use cocaine (or any drug, for that matter) during pregnancy--but the damage associated with prenatal cocaine exposure is less severe than that caused by alcohol and comparable to the harm done by cigarette smoking.

But being exposed to domestic violence as a baby or young child, in fact, is a far better predictor of behavior problems and low IQ than cocaine exposure in utero is. And, one study found that kids labeled "crack babies" (though they were actually not) were treated far worse than those who had not been tagged that way. When medical professionals thought they were dealing with a "crack baby," they interpreted normal behavior as abnormal and ascribed bad intentions to it.

Which brings us to the current methamphetamine panic. In a story with a headline that could have been pulled from the 1980s crack scare, "A Drug Scourge Creates its Own Form of Orphan" (7/11/05), Kate Zernike of the New York Times reported that 40% of child welfare officials say that methamphetamine has caused a rise in the number of kids taken into foster care; but the national numbers for those in foster care (which go un-cited in the Times article) have declined from 570,000 in 1999 to 523,000 in 2003--a period during which methamphetamine use was supposedly rising.

Foster care numbers often show a lag of several years in relation to drug problems because it takes time for people to become addicted, have children and then come to the attention of child welfare authorities. But during the crack epidemic, the number of kids in foster care went from 243,000 in 1982 to 400,000 in 1990 and it continued rising until 1999, despite the far earlier decline in crack use. So it's clear that if meth is causing an increase, it's nowhere near that associated with crack.

But foster care trends tend to be fed more by perceptions and theories than by the number of kids who are actually abused. Heavily reported instances of kids abused by dangerous parents (the case of Elisa Izquierdo in New York, for example) lead to increases in foster care admissions. Curiously, however, highly publicized cases of abuse in foster care usually don't lead to increased emphasis on "family preservation." Foster care trends, unsurprisingly, are also connected to poverty; but even so, some states tend to take more children from their families than others, regardless of poverty and regardless of drug use trends.

Unfortunately, foster care itself can do harm. According to Richard Wexler, Executive Director of the National Coalition for Child Protection Reform, only 20% of kids leaving foster care do well by the standard measures of employment and education and mental health. A study by Casey Family Programs found that foster care kids have double the rate of post-traumatic stress disorder seen in Gulf War veterans.

Of course, some of these problems are undoubtedly due to the reasons that they were seen as needing foster care in the first place--but one third of kids in foster care in this study reported being abused by their new caretakers and the effects of moving from one home to another as foster kids often do are uniformly negative. The average number of placements for kids in foster care (how many transitions from one home to another they experienced) was seven in this study. As Wexler says, "The best evidence we have is that drug treatment for the parents is almost always a better option than foster care for the children."

Given that media coverage drives foster care trends, it behooves editors and reporters to consider explicitly in their coverage whether foster care could do more harm than methamphetamine. It's especially important in this context to stop promoting the idea that meth addiction is harder to treat than other drug problems. Amazingly, in Zernike's Times article, she claims, with no factual basis, that treatment for methamphetamine requires a longer stay in care than treatment for crack did (treatment stays for all drugs are universally shorter since the advent of managed care--and there's no evidence that this has reduced efficacy).

She says, also incorrectly, that because of a 1997 law, this means that parental rights are likely to be terminated faster. The law makes an exception for people who are doing well in treatment. Zernike goes on to quote an Iowa child welfare advocate who says that because of meth's longer recovery time, "We know pretty early that these families are not going to get back together." But since this is based on a myth about treatment failure--and unfortunately child advocates who have a say in whether families get back together believe it--the Times is helping create a self-fulfilling prophecy by reporting it.

There is also a financial battle underlying child welfare agencies' relationship to methamphetamine, according to Wexler, that should have been covered in reporting on it. Federal budget efforts are underway to make foster care funding more flexible--to allow some of it, for example, to be used to treat addicted parents rather than to place kids in care. This, of course, would shift funds away from these agencies and towards drug treatment providers. Flexible funding wouldn't gain much support, of course, if "meth monsters" are untreatable.

Coverage of this issue should not present foster care agencies simply as disinterested child advocates, consequently.

It is certainly true that active stimulant addicts can be highly abusive and neglectful towards their children--and there are absolutely some cases where this should lead to custody termination. But because interventions like foster care can sometimes do harm, the media needs to be especially cautious when demonizing a drug to advocate them -- or else reporters risk hurting the innocent victims they are supposedly trying to help. Wexler has written to the Times' ombudsman to complain about the Zernike story and a group of key researchers on addiction and children have written an open letter to the media, but as this NBC news story demonstrates, the hype appears to be unstoppable.

Why doesn't the media ever ask "Cui bono?" when it comes to drug scares? Could it be because "we do" is one of the only truthful answers?

Maia Szalavitz is a senior fellow at the media watchdog group STATS.

© 2005 Independent Media Institute. All rights reserved.
View this story online at: http://www.alternet.org/story/24739/
Here’s the NBC new story she refers to:

 

Meth’s youngest victims
Children of meth lab homes are placed into foster care

By Kevin Corke

Correspondent

Updated: 7:57 p.m. ET Aug. 9, 2005

 

CLERMONT COUNTY, Ohio - Days like these leave Child Protective Services Agent Joy Swing feeling like a drug counselor.

“It seems every case we get is drug-related,” says Swing as she makes another visit with someone whose children have been taken away because police suspected meth use in the home.

Swing talks with a man in his living room. The exchange is quick.  She tells the man his son won’t be coming back as planned.

Over the past five years, the man’s child is one of 85 who have been pulled from what police say are meth lab homes and placed into foster care. 

The number is so overwhelming for this rural community they’ve even had trouble placing some newborn babies.

It’s also something Clermont County Sheriff Tim Rodenberg never imagined would happen here.

“It actually rips up the fabric of your community in many ways, says Rodenberg, “Children are often involved at sites where meth labs are operating.”

Once thought to be a rural and small-town problem, meth use is spreading so quickly it’s now proving a major challenge even for the nation’s top drug enforcement officer, National Drug Control Policy Director John Walters.

“The damage this has done to children is the worst thing I’ve seen with regard to the meth problem,” says Walters. “I think it gives us an enormously powerful reason to act quickly.”

The Drug Enforcement Agency calls them “meth orphans,” and last year, the DEA says some 3,000 children were pulled from homes during meth lab seizures. 

That’s troubling, not just for the families involved, but for an already overburdened foster care system.

According to a National Association of Counties survey, during the past five years, 71 percent of responding counties in California reported an increase in out-of-home placements because of meth.  The number is 70 percent in Colorado, and in Minnesota, there was a 69 percent increase just in the last year.

For the fortunate few, there are scheduled, monitored visitations between separated parents and children.

But Swing acknowledges, “Now we have so many in foster care ... we’re running out of homes.”

And time is running out to warn others of a coming storm that’s already leaving its mark on rural America. 

 

© 2005 MSNBC.com

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Here’s Szalavitz’ first article.

 

THE DEMON SEED THAT WASN'T

 

Debunking the "crack baby" myth

 

Maia Szalavitz

 

City Limits MONTHLY
Date: March 2004

 

Charles Krauthammer wrote, "A cohort of babies is now being born whose future is closed to them from day one. Theirs will be a life of certain suffering, of probable deviance, of permanent inferiority."

 

Many "crack babies" were actually withdrawing from heroin and other opiates that their mothers had used. Opiate withdrawal leads to behavior like jerking and shaking--but cocaine was blamed for these symptoms, even though it doesn't cause withdrawal illness.

 

When four starving boys aged 19, 14, 10 and 9, were taken from their New Jersey adoptive parents last October, all were severely emaciated. The oldest was so stunted--he weighed 45 pounds and measured four feet tall--that police thought he was a grade-schooler. He had been found by neighbors, rooting through their trash for food at 2:30 a.m. He was so weak, he couldn't even open the Tastykake they hastily offered.

The press was quick to blame New Jersey's child welfare agency. Although social workers had visited the family 38 times over two years, they had never sought help for the starving boys, who were said to have subsisted on a diet of uncooked pancake mix, cereal, peanut butter and wallboard. As soon as they were taken from their adoptive parents, Raymond and Vanessa Jackson, the boys rapidly started gaining weight.

After the Jacksons were arrested for child abuse, their pastor, Harry Thomas, began a public relations campaign to defend the couple. The media had noted that the Jacksons' six other children--three biological children, two adopted daughters and one foster daughter--were well fed and clothed. Thomas said this was because the adopted boys were tough cases. They had eating disorders. They were victims of fetal alcohol syndrome. Worst of all, they were "crack babies," and presumably as a result, the oldest was "a habitual liar."

The Jacksons apparently had managed to evade neighbors' and social workers' suspicions for years by attributing their adoptive sons' problems to the fact that their mothers smoked crack cocaine while pregnant. That this excuse still seemed reasonable--20 years after the 1980s crack 'crisis' and over a decade after the medical community dismissed the "crack baby" as a media myth--shows how resilient and pernicious the stereotype is.

In a century of drug scare stories, the "crack baby" was a crowning achievement. Throughout the late 1980s and early 1990s, images of horrifyingly tiny, herky-jerky infants with eerie, cat-like cries flooded television screens and prompted columns about a new "biological underclass" and a "lost generation." Media coverage of the crack "epidemic" began as a trickle in 1984, but by the following year had exploded into a tsunami. Crack, Nancy Reagan said, was "killing a whole generation."

President Reagan declared "war on drugs" in 1986, and in July of that year alone, the networks' evening news programs ran 74 crack stories; in the run-up to the election, over 1,000 articles about crack appeared in newspapers and magazines. Meanwhile, the media had gotten hold of Ira Chasnoff's 1985 New England Journal of Medicine report on the possible consequences of cocaine use by 28 pregnant women. The study cautioned that the data was preliminary and no conclusions about causality could be drawn from it. But the ground was already sown for panic, and the media had no compunction about predicting the worst imaginable consequences.

Within days, CBS News had found a social worker treating an 18-month-old "cocaine-exposed" baby, who claimed that the child would grow up to be "a 21-year old with an IQ of perhaps 50, barely able to dress herself." By 1989, a National Institute on Drug Abuse psychologist claimed that exposure to cocaine in utero "was interfering with the central core of what it is to be human." Columnist Charles Krauthammer alleged, "A cohort of babies is now being born whose future is closed to them from day one. Theirs will be a life of certain suffering, of probable deviance, of permanent inferiority. At best, a menial life of severe deprivation. And all of this is biologically determined from birth."

Evidence to support these claims was no stronger in 1989 than in 1985. In fact, as soon as more careful studies were done, with proper control groups and other measures to rule out other factors that could have led to developmental problems, the link between cocaine use during pregnancy and major difficulties in infants began to look far less certain. As early as 1992, the Journal of the American Medical Association decried "the rush to judgment" on the effects of prenatal cocaine exposure.

So what, exactly, does the medical research show about the effects of cocaine on infants exposed in utero? And what caused the so-called "crack babies" to seem so sickly?

As it turns out, those scrawny infants in the neonatal intensive care units who made for such dramatic video had mothers whose problems went far beyond crack cocaine. For one, most of their babies hadn't received prenatal care. Often as a result, they were born premature.

Premature birth can be caused by all sorts of medical problems that might well have been caught and treated if the mother had gotten health care during pregnancy. These problems can damage a child, even when they have no direct connection to drug use. In fact, prematurity is demonstrably much riskier for fetuses compared to a mother's use of cocaine.

When the media showed images of "crack babies," it was often depicting prematurity rather than signs of drug exposure. High-pitched cries and jerky movements, for instance, are common in preemies. (On the other hand, some babies born too early--and some cocaine-exposed infants as well--act abnormally calm, or "floppy." But these newborns weren't chosen by the media to illustrate the "crack baby" problem.)

In addition, many "crack babies" were actually withdrawing from heroin and other opiates that their mothers had used along with cocaine, alcohol and tobacco. Opiate withdrawal leads to jerking and shaking--but cocaine was blamed for these symptoms, even though it doesn't cause withdrawal illness. While withdrawal from opiates is unpleasant for the infant, being exposed to them before birth does no lasting harm. Alcohol and tobacco, on the other hand, can seriously damage fetuses. Not surprisingly, both of these legal substances were widely used by "crack mothers."

To make matters worse, these mothers also typically had long histories of poverty and victimization. More than two thirds had been sexually abused as children or were current victims of domestic violence. It was also quite common for them to have witnessed traumatic events, like seeing a relative murdered. Most were depressed.

All these stressors, particularly in combination, can seriously threaten a pregnancy. And they're probably a big reason "crack mothers" sought chemical escape in the first place. Profound stress is believed to be such an important factor in prematurity and other neonatal development problems that the March of Dimes' Campaign to Prevent Birth Defects recently targeted stress as a priority research area.

Amid all these problems, prenatal exposure to cocaine was just one part of a very complex and disturbing picture--and, it turned out, not a very significant part. Dr. Deborah Frank, Associate Professor of Pediatrics at Boston University School of Medicine, published a review of the research in the Journal of the American Medical Association in 2001. The next year, she testified that "there are small but identifiable effects of prenatal cocaine-crack exposure on certain newborn outcomes, very similar to those associated with prenatal tobacco exposure. There is less consistent evidence of long term effects up to age six years, which is the oldest age for which published information is available... Based on years of careful research, we conclude the crack baby is a grotesque media stereotype, not a scientific diagnosis."

Says Ira Chasnoff, the author of the first New England Journal report, "From the earliest studies, [researchers] showed that there was no effect on IQ." As for behavior, he adds, "It's very difficult to say. There do appear to be some effects. It's still up in the air--some research says yes, some says no. Right now there's no consensus."

But experts do agree that cocaine-exposed babies are in no way doomed to a life of degeneracy, illiteracy and crime. According to Chasnoff, the most consistently noted effect of mothers' cocaine use on children is subtle difficulties with what researchers call "executive function: the ability to plan, organize and complete tasks." Such problems can look like attention-deficit disorder (ADD) because the child has difficulty seeing things through to completion or remaining focused long enough to do schoolwork well.

Even if these problems do occur, they're not necessarily irreversible. Treatments similar to those for ADD can help. And raising a child in a nurturing, healthy environment makes a huge difference. Says Chasnoff, "By six years old, if you look at intellectual functioning, the single most important factor that predicts IQ is whether the mother continued to use [cocaine or its derivatives] after pregnancy, not during." Frank adds that a child's exposure to violence after birth predicts behavioral and IQ lags, much more than does prenatal exposure to cocaine.

Further, according to Frank, being labeled a "crack baby" may hurt a child far more than exposure to drugs does. "The stigma sometimes leads people to ignore real problems: 'Oh, that's just because he's a crack baby,'" she says, citing the Jackson kids. "Children like them are thought to be hopeless."

Frank has done chilling research on this phenomenon. In one study, she asked professionals to pick out the "crack babies" from a group of infants. "Even people of good will think they can tell who is a 'crack baby' and who isn't," she says. "In fact, they can't." Even more frighteningly, another study showed students videotapes of two healthy toddlers. If the children had been labeled crack babies, normal behavior was interpreted as pathological. Frank recalls giving a lecture and being approached afterwards by a woman who had adopted her cocaine-exposed nephew. "At two days old, the nurses told her the baby was a congenital liar!" Frank says. "One woman thought that her 18 month old still had crack in his system because he wouldn't stay quiet during a four-hour church service." Children who are labeled as crack babies may come to see themselves as destined for low achievement and bad behavior. That perception can become a self-fulfilling prophecy.

If the crack baby is a mere figment, why has it persisted in our collective imagination? Why, in the 21st century, can parents be allowed to starve their children and blame their failure to grow on a label that doesn't correspond to reality?

Craig Reinarman, Professor of Sociology at the University of California-Santa Cruz, says the answer lies in the social purposes served by the myth. "You have, in the crack baby and mother, both a perfect victim and a perfect villain. Who is more innocent than an unborn or a newly born child? It's the ultimate angelic victim. On the other hand, who could be a more demonic villain than a woman who would put this child at risk for something as awful and selfish as her own pleasure? Central casting couldn't do better."

The crack baby myth also helped assuage guilt about the massive cuts to social services that preceded the crack epidemic in the ghettos--and which may have exacerbated it, given that widespread crack addiction occurred almost invariably in poverty-stricken communities. The very word "ghetto" conjures up images of black and brown people, so while the crack baby was angelic, it was also a racialized, infant demon: a baby destined to grow up mentally deficient and criminal because of the damage done by its monstrous parent. "This image fit perfectly with conservative ideology, because if we had any residual guilty feelings about having cut back all the services that did even a little bit to help the poor, the idea of the vile crack mother absolved us of all responsibility," says Reinarman.

"We had the welfare queen," says Lynn Paltrow, an attorney and founder and executive director of National Advocates for Pregnant Women. "The only thing that could top the welfare queen was the crack mother welfare queen."

Paltrow represents Regina McKnight, who, like the Jackson boys, is a victim of crack baby hysteria. McKnight is serving out a 12-year sentence for murder in South Carolina because her stillborn baby tested positive for a derivative of cocaine. She was convicted in 2001. McKnight is the only woman in America serving time for this "crime" and had no prior criminal record.

The ironies of McKnight's case are profoundly disturbing. The mother of two had first been given crack by her aunt, who hoped to end McKnight's depression following the death of her mother. Her mom had been killed by a speeding truck driver who has since racked up several drunk-driving convictions. Following the fatal accident, he was never breath-tested, nor was he charged with a crime. The truck driver is white. McKnight and her family are African American.

McKnight, who has a tenth-grade education, got no prenatal care during any of her pregnancies. South Carolina has no detox facilities for addicted pregnant women and does no outreach to them. It is the state with the least per-capita spending on addiction treatment in America. Until it lost in the U.S. Supreme Court in March 2001, the state had a policy of secretly drug-testing pregnant women who sought prenatal care and arresting those who came up positive. (Virtually everyone arrested under the law was black.) Paltrow helped beat back that policy, successfully arguing to the Court that the practice not only violated the women's constitutional rights, but likely also deterred them from getting help.

Since lack of prenatal care is a bigger factor than crack use in harming fetuses, and since the state had a policy while McKnight was pregnant that effectively punished drug-using women for seeking care, South Carolina may be more responsible for McKnight's child's death than was McKnight herself.

Unfortunately, the Supreme Court declined to hear Paltrow's appeal in the McKnight case, and despite amicus briefs from every relevant U.S. medical association, the highest state court upheld her conviction. There is no medical evidence suggesting that cocaine use was the only--or even the most likely--cause of McKnight's baby's death. Paltrow is still working on appeals.

Years of research have debunked the notion of the crack baby among medical experts, but the myth lingers, due largely to inaccurate media items. Recently, the New York Times cited a report published by the state of New Jersey claiming that 13 percent of all infant deaths in the state are caused by maternal drug use. There is absolutely no way that such a statistic could be accurately compiled, given how much uncertainty there is about the link between drug use and infant deaths, and considering the many other problems that women usually suffer from when they give birth to drug-exposed babies. Nonetheless, the statistic was in the newspaper of record--which will, no doubt, be cited by others as an unassailable source.

The media has also been slow to pick up on the fact that dire predictions about crack babies growing up to be "super-predators" not only failed to materialize, but were completely contradicted as the kids grew up. The first "crack babies" hit their teens in the mid-1990s--when crime, youth violence, teen pregnancy and drug use began dropping dramatically.

More skeptical coverage is needed if the crack baby myth is ever going to die. When asked what he would have done differently in the early 1980s when his work was used to justify the scare, researcher Chasnoff said he wouldn't have spoken with the press. But with well-funded conservative activist groups still actively pushing the stereotype--one, a national group called CRACK, pays drug-addicted women $200 to be sterilized or use long-term birth control--the voice of science is needed more than ever.

Frank says that the very phrase "crack baby" is inflammatory and should be abandoned. "Nobody these days would refer to a child with trisomy 21"--Down's syndrome--"as a mongoloid idiot. 'Crack baby' is just as inappropriate. It should be no more acceptable in public discourse than the N word."


Maia Szalavitz is a New York-based writer who is working on a book about behavior-modification programs for teenagers, to be published by Riverhead in 2005.

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Finally, here is the “open letter” by David Lewis

 

Meth Science Not Stigma: Open Letter to the Media
7/25/2005

Contact: David C. Lewis, M.D.
Professor of Community Health and Medicine
Donald G. Millar Distinguished Professor of Alcohol & Addiction Studies
Brown University
Phone: 401-444-1818
E-Mail: David_Lewis@brown.edu

To Whom It May Concern:

As medical and psychological researchers, with many years of experience studying prenatal exposure to psychoactive substances, and as medical researchers, treatment providers and specialists with many years of experience studying addictions and addiction treatment, we are writing to request that policies addressing prenatal exposure to methamphetamines and media coverage of this issue be based on science, not presumption or prejudice.

The use of stigmatizing terms, such as "ice babies" and "meth babies," lack scientific validity and should not be used. Experience with similar labels applied to children exposed parentally to cocaine demonstrates that such labels harm the children to which they are applied, lowering expectations for their academic and life achievements, discouraging investigation into other causes for physical and social problems the child might encounter, and leading to policies that ignore factors, including poverty, that may play a much more significant role in their lives. The suggestion that treatment will not work for people dependant upon methamphetamines, particularly mothers, also lacks any scientific basis.

Despite the lack of a medical or scientific basis for the use of such terms as "ice" and "meth" babies, these pejorative and stigmatizing labels are increasingly being used in the popular media, in a wide variety of contexts across the country. Even when articles themselves acknowledge that the effects of prenatal exposure to methamphetamine are still unknown, headlines across the country are using alarmist and unjustified labels such as "meth babies."

Just a few examples come from both local and national media:

Other examples include an article about methamphetamine use in the MINNEAPOLIS STAR TRIBUNE that lists a litany of medical problems allegedly caused by methamphetamine use during pregnancy, using sensationalized language that appears intended to shock and appall rather than inform, "...babies can be born with missing and misplaced body parts. She heard of a meth baby born with an arm growing out of the neck and another who was missing a femur." Sarah McCann, "Meth ravages lives in northern counties" (Nov. 17, 2004 at N1). In May, one Fox News station warned that "meth babies" "could make the crack baby look like a walk in the nursery." Cited in "The Damage Done: Crack Babies Talk Back," Mariah Blake, COLUMBIA JOURNALISM REVIEW Oct/Nov 2004.

Although research on the medical and developmental effects of prenatal methamphetamine exposure is still in its early stages, our experience with almost 20 years of research on the chemically related drug, cocaine, has not identified a recognizable condition, syndrome or disorder that should be termed "crack baby" nor found the degree of harm reported in the media and then used to justify numerous punitive legislative proposals.

The term "meth addicted baby" is no less defensible. Addiction is a technical term that refers to compulsive behavior that continues in spite of adverse consequences. By definition, babies cannot be "addicted" to methamphetamines or anything else. The news media continues to ignore this fact.

In utero physiologic dependence on opiates (not addiction), known as Neonatal Narcotic Abstinence Syndrome, is readily diagnosable and treatable, but no such symptoms have been found to occur following prenatal cocaine or methamphetamine exposure.

Similarly, claims that methamphetamine users are virtually untreatable with small recovery rates lack foundation in medical research. Analysis of dropout, retention in treatment and re-incarceration rates and other measures of outcome, in several recent studies indicate that methamphetamine users respond in an equivalent manner as individuals admitted for other drug abuse problems. Research also suggests the need to improve and expand treatment offered to methamphetamine users.

Too often, media and policymakers rely on people who lack any scientific experience or expertise for their information about the effects of prenatal exposure to methamphetamine and about the efficacy of treatment. For example, a NEW YORK TIMES story about methamphetamine labs and children relies on a law enforcement official rather than a medical expert to describe the effects of methamphetamine exposure on children. A police captain is quoted stating: ''Meth makes crack look like child's play, both in terms of what it does to the body and how hard it is to get off." (Fox Butterfield, Home Drug-Making Laboratories Expose Children to Toxic Fallout, Feb 23, 2004 A1)

We are deeply disappointed that American and international media as well as some policy makers continue to use stigmatizing terms and unfounded assumptions that not only lack any scientific basis but also endanger and disenfranchise the children to whom these labels and claims are applied. Similarly, we are concerned that policies based on false assumptions will result in punitive civil and child welfare interventions that are harmful to women, children and families rather than in the ongoing research and improvement and provision of treatment services that are so clearly needed.

Please click here for a pdf version of the open letter with the complete list of signatures.

We would be happy to furnish additional information if requested or to send representatives to meet with policy advisors, staff or editorial boards to provide more detailed technical information. Please feel free to contact David C. Lewis, M.D., 401-444-1818, David_Lewis@brown.edu, Professor of Community Health and Medicine, Brown University, who has agreed to coordinate such requests on our behalf.