DRUG-EXPOSED BABIES NOT THE LOST CAUSES MANY THINK

Treatment Is Key: Some Doctors Say That Postnatal Neglect Is The Bigger Issue

During the mid-1980s, so-called crack babies became an icon of the
havoc wreaked by cocaine and a catalyst for new laws targeting pregnant women.

Hospitals began testing pregnant women for the drug and states
started jailing addicted mothers and taking custody of their
children. The media warned of the creation of an underclass of
exposed infants born with devastating birth defects and permanent
brain damage.

Twenty years of medical research have shown the prenatal effects of
cocaine to be far less severe than the "crack baby" legend suggests.
But the myth has resurfaced with the spread of methamphetamine and
led to new labels: "meth babies" and "ice babies."

"As a country, we're on the verge of making the same mistakes with
meth as we made with cocaine," said Brown University researcher
Barry Lester. Lester is among 90 doctors and psychologists who
recently signed an open letter urging the media to avoid such
labels, which they say lack scientific validity and stigmatize children.

"Drug use needs to be treated as an illness and not a criminal
activity," said Lester, director of Brown Medical School's Infant
Development Center in Providence, RI. "The labels demonize women,
but it's the kids who really suffer. If we expect a child to fail,
he'll fail, and it won't have anything to do with the drug."

This is not to say that crystal methamphetamine is harmless.

Sharon P. McCully, a 3rd District juvenile judge in Salt Lake City,
estimates that about 90 percent of the mothers she sees in child
welfare cases are addicted to the powerful stimulant.

"We do know if mom is using meth, the kids are neglected," said
McCully. "These parents become consumed with the next high and can
sleep for hours when they finally crash. They may not abuse their
kids, but they often neglect them."

No state agency collects data on the number of babies born in Utah
testing positive for methamphetamine.

According to the state Division of Child and Family Services (DCFS),
alcohol or drugs were a contributing factor in roughly 80 percent of
the 1,100 child custody cases in 2004. But how many of those cases
are meth-related is unknown.

Mothers and their newborns are not routinely tested for illegal
drugs, which is left to the discretion of individual doctors and
hospitals. If a baby or mother test positive, the physician is
required by law to notify DCFS.

"Most doctors will test, because they don't want the liability of
losing a baby," said Wendy Anderson, a spokeswoman for the National
Advocates for Pregnant Women in New York City. "Lack of prenatal
care can make doctors suspicious, or if the mother isn't
gaining weight or has marks on her arm."

Anderson said the U.S. Supreme Court has ruled that a mother needs
to be notified she is being tested, which is akin to a criminal
search of her body.

"Where it gets sketchy is when pregnant women check into hospitals
to deliver, they are signing consent forms left and right without
reading them," said Anderson.

To date, there is no conclusive research on the long-term effects of
meth in the womb.

But Lester is among a group of researchers hoping to change that.
Granted $6 million by the National Institute on Drug Abuse, he and
others have been studying the development of meth-exposed children
from five cities. The study is still young. But Lester said so far,
"the effects we're seeing at birth are very similar to effects we
saw with cocaine."

Infants exposed to cocaine or its crystallized cousin, crack, tend
to weigh less than non-exposed babies. Their IQ scores are 3 to 4
points lower on average and they exhibit a slight increase in
behavior and attention problems - similar to the effects caused
by cigarette smoking.

"There are subtle differences. Nurses will sometimes describe
meth-exposed babies as being in an insulated sleep state. They're
hard to arouse and when they do wake, hard to soothe," said Lester.
"But you're not looking at a baby who will wind up
institutionalized. You're looking at a baby who is very treatable."

More than the chemical effects of a drug, children born to
substance-abusing parents face other risks.

"Whether the biologic risk manifests itself often has a lot to do
with the postnatal environment," said Karen Buchi, a pediatrician at
the University of Utah. "It's not just the drug, it's the lifestyle
you lead when you're an addicted person. Addicts tend to engage in
risky behavior."

But Lester says, contrary to reports of meth being instantly
addicting and impossible to kick, treatment works.

The federal government's most recent National Survey on Drug Use and
Health found that 4.9 percent of Americans have used methamphetamine
at some point in their lives, but 0.6 percent used it within the past year.

Luciano Colonna, executive director of the Harm Reduction Project of
Utah, said studies show women succeed better in treatment when they
are allowed to continue rearing their children.

Children allowed to stay with their moms also fare much better than
those swept into foster care, said Colonna. "These aren't pregnant
women who become substance abusers, they're substance abusers who
get pregnant. You can be a bad parent and a drug user, but being
a drug user doesn't necessarily make you a bad parent."

Advocates are pressing policymakers to abandon proposals to punish addicts.

Speaking earlier this year to a congressional committee exploring
solutions to stop the spread of methamphetamine, Lester urged states
to enact legislation protecting mothers who voluntarily seek drug
treatment from having their children taken away.

Utah babies at risk

One juvenile judge in Salt Lake City estimates 90 percent of the
mothers she sees in child welfare cases are addicted to
methamphetamine. Infants taken from mothers using drugs, including
meth, made news in several Salt Lake County cases this year:

lAn infant girl was abandoned at a Salt Lake City homeless shelter
in March after testing positive for heroin at birth. Her mother,
Bobbie Joe Ramirez, has a history of drug abuse and four other
children had previously been taken by child welfare workers.

lChild welfare caseworkers took custody of a girl in August born two
months premature via Caesarean-section to a woman killed in a
gunbattle over drugs and money. The girl was born with cocaine,
opiates and barbiturates in her system. The mother, Darla Marie
Woundedhead, had lost custody of three other children.

lMethamphetamine user Tammaria Gehring, seven months pregnant, was
booked into the Salt Lake County jail in September at the request of
a state judge who feared for the baby's health. The jail made an
exception to its ban on booking pregnant women. In October, Gehring,
30, checked into a treatment program with her newborn daughter.

lChild welfare workers in October took a 2-day-old girl from mother
Mallissa Kooyman, who a year earlier pleaded guilty to a drug charge
after police discovered baggies of methamphetamine in her purse.
Kooyman, 24, had previously been found to have abused or neglected
her six other children, most of whom have been adopted.