BIRTH CONTROL FOR DRUG ADDICTS

After monitoring the status of hundreds of neglected and abused children
for 15 years as a Superior Court judge, I have come to some inescapable
conclusions:

(1) The number of such children in our community is substantial and
increasing alarmingly.

(2) A disproportionately high percentage of these children are born to a
relatively small group of mothers, who abandon their children at birth, are
addicted to drugs and have six or more children in foster care.

(3) Resources available to address the needs of neglected children are not
limitless; thus the effect of a burgeoning system falls most directly upon
the children themselves.

These children desperately need a pragmatic, long-term community effort
implemented with the willingness to spend whatever is necessary--but with
efficiency and foresight. The CRACK program (Children Requiring a Caring
Community), reported on in the June 26 Metro story, will not resolve this
crisis, but it may help. If a drug-addicted mother who has abandoned her
children decides to prevent future pregnancies, would not such a decision
be beneficial to the community? Is the benefit diminished if the decision
is monetarily motivated?

If we summarily reject such programs, it is the community and, most
directly, the children who will suffer the consequences.

Robert S. Tignor, Washington

The writer is a senior judge on the Superior Court of the District of Columbia.

The group that offers $200 to addicts to stop having children bases its
program on myths.

A core myth is that drug-using mothers are beyond help. In fact,
comprehensive drug-treatment programs that don't separate mothers from
their children are highly successful and cost-effective.

Another myth is that drug-using women give birth to a large number of
children. On the contrary, studies have found that women who have
substance-abuse problems have on average no more children than other women.
Research also demonstrates that when they do become pregnant they are
especially motivated to get help--but often find it unavailable.

The CRACK program presumes that even if treatment were available, many
drug-using women wouldn't bother to get it. But to get the $200, an
addicted woman must go to an interview, fill out a questionnaire, get a
physical exam, wait 30 days, undergo a surgical procedure (most are
sterilized) and submit a letter confirming that she's been sterilized. If
$200 and a little moral support can persuade a woman to give up the right
to have children, what would a little support accomplish if it were instead
used to advocate for decent treatment?

The program also stigmatizes drug-exposed children as damaged or liable to
die prematurely. Many children who are exposed to a range of substances,
even cocaine and nicotine, are not "damaged."

Rather than giving up on drug-using mothers and their families, efforts
should focus on ensuring that help for overcoming drug dependence--and the
range of reproductive health services--is within these women's reach.

Robert Newman, President and CEO, Continuum Health Partners Inc.

Lynn M. Paltrow, Program Director, National Advocates For Pregnant Women,
New York