ADDICTS CASH IN ON BIRTH CONTROL PROGRAM

They Are Paid To Be Sterilized Or Use Long-Term Medication

PHOENIX - Sabrina Yanez, a teenage mother and former methamphetamine user,
got paid $200 for being fitted with an IUD at a Yuma, Ariz., clinic.

The check came from Barbara Harris, founder of CRACK, or Children Requiring
A Caring Kommunity, a nonprofit group that gives cash to addicts who agree
to be sterilized or use long-term birth control.

Ms. Harris, who has adopted four children born to a Los Angeles crack
addict, doesn't want more babies born to addicts.

Now in its fourth year, CRACK has paid 686 addicts, including 15 men, in 22
cities nationwide. That includes seven women and one man in Arizona.

The program is controversial. Those who work with addicts say these men and
women are desperate and incapable of making an important decision. They say
the money feeds drug habits.

"They may use the money for drugs, but that's their choice," said Ms.
Harris, who lives in California. "The babies don't have that choice."

AP Children Requiring A Caring Kommunity (CRACK) paid $200 to Sabrina
Yanez, 18, for being fitted with an IUD. The nonprofit, which doesn't want
addicts to have babies, has its critics: Some say participants will use the
money to buy drugs. Ms. Yanez, 18, who says she is clean, is a high school
student again. She spent the $200 on things for her 1-year-old son, Joseph:
summer clothes, shoes and a float for the pool. She's sure she doesn't want
more babies right now.

About 80 percent of the 33,000 neglect and abuse cases investigated
annually by Arizona Child Protective Services involve drugs, said Flora
Sotomayor, program administrator.

Children of addicts are often neglected. Some are abused by parents, some
by the company their parents keep. Women often turn to prostitution to pay
for their habits.

Dr. Eugenie Anderson delivered the baby of a cocaine addict in Phoenix.
There was a blood clot in the baby's leg. The leg, white and cold, had to
be amputated.

Sometimes the babies die. And sometimes, Dr. Anderson said, that's for the
best.

Dr. Anderson read about CRACK in a newsmagazine and offered to help. The
article was critical of Ms. Harris for targeting minorities.

Dr. Anderson is black.

"Drugs and poverty target certain minority groups, so that's where you find
the problem," she said.

The Other Side

But some worry that drug-dependent men and women are in no shape to consent
to sterilization, especially when enticed by cash. That $200 may influence
them to make choices they might not otherwise make, says Becka Perry,
program manager at Amity Inc., a Tucson rehabilitation center where mothers
can live with their children while they get off drugs.

There are other ways, such as education and treatment, to prevent women
from having drug-addicted babies, she said.

Ms. Harris and her husband became foster parents for the first time in 1989
to a baby girl born to a Los Angeles woman addicted to crack cocaine. She
was the woman's fifth child.

Every year for the next three years, the Harrises got a call from social
workers asking them to take the woman's sixth, seventh and eighth child.

One boy suffered the worst of his mother's addiction, sleeping only a few
minutes at a time and waking screaming.

In 1997, a tired Ms. Harris plastered the impoverished MacArthur Park area
of Los Angeles with fliers offering money to addicts who would voluntarily
be sterilized or use long-term contraception.

CRACK started with $400 from an attorney who handled child abuse cases. In
2001, the group collected almost $300,000, mostly from conservative donors.

Ms. Harris has stacks of letters on her desk from grateful women, many of
whom sell sex for money to buy drugs.

"You have to understand that these women don't want to have babies taken
away from them every year," Ms. Harris said.

One day recently, applications came in from Detroit, Minnesota, Florida and
from Ms. Yanez, the 18-year-old from Yuma.

"I love it when we get them young. When we get them at 40, the damage has
already been done," Ms. Harris said.

One woman had had 14 children by the time she was sterilized. Younger women
often choose birth control that is not permanent, Ms. Harris said.

Because the addicts often are poor, programs such as Medicaid pay for most
procedures. To be paid, they must have a doctor certify that the services
were done.

Ms. Harris said the people making this decision need to be thoughtful. To
get their tubes tied, for example, women must visit a doctor, fill out
paperwork and wait 30 days for surgery.

'Responsible Decisions'

"If they were zombies, they couldn't do that," Ms. Harris said. "These
women are making responsible decisions, whatever their motivation." Dr.
Anderson said she would not perform a procedure on someone who was
impaired. Women who show up stoned or drunk are turned down.

Ms. Yanez was 16 when she got pregnant. She used methamphetamine, just for fun.

"It was never like I needed it," she said. "I could go without it."

Ms. Yanez hasn't touched it since she found out she was pregnant. She moved
to Yuma from California to start a new life with her little boy, just the
two of them.

"Honestly, since the pregnancy with my son, I quit," Ms. Yanez said. "It
had everything to do with it. Just the idea of him being on his way into
this world, it changed everything."

She saw a flier for Ms. Harris' CRACK program in her doctor's office. She
was fitted with an IUD on April 1 and received a check for $200 two weeks
later, just in time for her son's first birthday.

Distributed by Associated Press