METHAMPHETAMINE RISE SPARKS WORRY FOR BABIES

Research Limited On How The Drug Can Affect A Fetus

OCEANSIDE, Calif. -- In the moments just after her daughter was born five
weeks ago, Cassandra Farrell cradled the baby in her arms and apologized
for having used methamphetamines during her pregnancy.

"You feel the baby kick when you put the needle in," said Farrell, 29, a
waitress who injected the illegal drugs up to five times a day through the
seventh month of her pregnancy. "You're aware you are doing something
harmful, but you don't care."

The effects of methamphetamine abuse on Farrell's life are as painfully
obvious as the burgundy scars lining her arms. Her addiction cost her a
job, a home and custody of another daughter, now 8.

But there is no way of knowing what the toll will be on her daughter, a
bright-eyed, apparently healthy infant with a thick crown of dark hair born
here in San Diego County, which has the highest rate of methamphetamine use
in the country, according to the Maryland-based National Institute on Drug
Abuse.

Fifteen years after widespread cocaine abuse raised fears that a generation
of so-called crack babies had suffered profound and possibly irreparable
damage because they had been exposed to drugs in their mothers' wombs, the
nation's changing drug abuse patterns are leading to similar concerns about
methamphetamine.

Methamphetamine is especially attractive to women of child-bearing age
because it helps them lose weight by suppressing appetite. Those who care
for young children while holding down jobs also are attracted to the drug
because it reduces fatigue and boosts energy. Long-term users show some of
the same brain damage seen in stroke victims and Alzheimer's disease
sufferers. They also can suffer from paranoia and hallucinations.

Though crack remains the largest drug problem among urban blacks, its use
has waned among other groups. But the use of methamphetamine, cheaper than
cocaine and relatively easy to make, is on the rise.

Because methamphetamine popularity is relatively new, there is little data
on its effects on fetuses. The National Institute on Drug Abuse put out a
call last spring for research.

"We have to be very careful and understand the complexity of this," said
Alan Leshner, the institute's director. Otherwise, he said, a generation of
children with potential could be written off, or children who genuinely
need help could be ignored.

Rizwan Shah, medical director of the Drug Affected Babies Clinic at Blank
Children's Hospital in Des Moines, is one of the few U.S. pediatricians to
study children exposed to methamphetamine in the womb. Once, 80 percent of
her patients were exposed to cocaine. Now 80 percent of the infants are
exposed to methamphetamine.

Her project, started in 1993, has tracked 360 children, finding that they
tend to be born prematurely. Full-term babies act more like premature
infants, often showing difficulty in sucking and swallowing. They are very
sensitive to touch and often shake, she said.

"Even changing their clothing or getting them a bath can get them stressed
out," she said. "We're talking about a child who gets purple and blue from
crying so hard."

Some babies suffer strokes or brain hemorrhages before birth because the
mother used such a high dose it caused a rapid blood pressure rise in the
brain.

Older children seem to have more limits on their expressive language.
"Fortunately, they show an excellent chance of recovery," she said, adding
that none of the children she has studied is mentally disabled.

There has been more research on the effects of alcohol, heroin and cocaine
on the developing fetus than on methamphetamine, and no reliable estimate
exists for the number of infants prenatally exposed to the drug.

The only national survey aimed at measuring drug use among pregnant women
was done by the drug abuse institute in 1992. It found that about 5 percent
of the 4 million women who are pregnant each year used some illicit drug.

Only a tiny fraction reported using methamphetamine, but the survey was
done before the surge in the drug's popularity.

Leshner said methamphetamine use is spreading throughout the West, Midwest
and rural America. Worldwide, it is second only to marijuana as the most
widely used illicit drug, with more users than heroin and cocaine combined,
according to the World Health Organization.

The federal drug abuse agenda, historically dominated by drugs that plague
Eastern urban areas, was slow to address the emergence of methamphetamine,
said Richard Rawson, associate director of the Integrated Substance Abuse
Program at the University of California-Los Angeles School of Medicine.

"Methamphetamine, being a West Coast, rural problem, just didn't draw the
same attention that the crack epidemic in the big Eastern urban centers did
15 years ago," he said.

For these reasons, Rawson said, the drug's popularity is unlikely to be a
passing fad. "As long as people need to work long hours in tedious,
physically demanding jobs, and as long as people want to lose weight, the
attraction of methamphetamine is likely to remain."

The drug has the potential to be more damaging than cocaine because its
effects last longer. In adults its high may last for 12 hours, compared to
the half-hour high of cocaine.

"It's staying in the baby's system longer, and certainly has the potential
to be more damaging to the baby's central nervous system," said Barry
Lester, a psychiatry and pediatrics professor at Brown University and the
main investigator in a long-term federal research project on fetal cocaine
exposure.

Still, his experiences with research on babies exposed to cocaine suggest
that caution is in order when projecting the effects of drugs on infants.

The children he is studying, now 8 years old, once were written off as
"hopelessly damaged." They have since been found to have small but
significant deficits in IQ, specifically in language abilities.

They will need more expensive services and they will add to the number of
children who fail in school, but the prediction of a lost generation was
greatly exaggerated, Lester said.

Children in families where methamphetamine addictions are present often are
neglected or abused.

Because the drug diminishes appetite, addicted parents often neglect to
feed children, and the eventual paranoid and erratic behavior that follows
long-term use affects their children.

Terri Burnett of Vista, Calif., recently gained custody of her 4-month-old
daughter, who tested positive for methamphetamine in a urine test just
after birth.

Burnett, 27, grew up in an upper-middle-class family, earned an associate's
degree and never expected to have drugs ruin her life. Until pursuit of
drugs became her full-time mission, she found methamphetamine gave her the
energy to clean her house, to take care of her children and to work at her
job managing an auto repair shop.

When she was pregnant, she repeatedly tried to stop using, but she found it
eased morning sickness. Her friends offered her drugs routinely, though
never food, she observed.

She enrolled in a residential treatment program the day before her
daughter's birth at the end of January. Now she is trying to regain custody
of her two other children, a 7-year-old son and 2-year-old daughter.

Her newborn daughter, she said, needs physical therapy to help deal with
some stiffness in her limbs, and she is being treated for asthma.

"I couldn't stop doing it," Burnett said, "even though I knew it was wrong."