The Crack Baby Incident

guess which one is the crack baby…

A funny thing happened when I started telling people about the crack baby myth: they didn’t believe me. “Myth?” they said, “but the crack baby is real!” My facebook page was consumed in a 25-comment debate before I could convince some of my intelligent, educated friends that, indeed, the crack baby is a fiction. An off-hand comment to a doctor likewise met with amazed surprise – no such thing as a crack baby? Over coffee, friends struggled to let go of the idea of the crack baby because, as one person confessed, it feels so viscerally true. How could something as awful as crack not cause permanent damage to babies? Maybe we don’t yet know how, their resistance implied, but it must be true.

…not this one!

Saying there is no such thing as a crack baby might be a slight exaggeration, but it pales in comparison to the things people were saying in the late 1980s and early 1990s. Despite the fact that infants born to crack-using mothers were not old enough to attend school, moral entrepreneurs (to borrow Becker’s term) were already warning about a “bio-underclass” flooding our communities and schools, unable to suckle or learn or feel human emotions. Even though early studies suffered from methodological shortcomings (small sample sizes, unreliable identification techniques, selection bias, inconsistent measures, high-attrition rates, racial and class bias) and confounding variables (alcohol, tobacco, and other drug exposure, overlap between cocaine exposure and poverty, poor home environment, lack of parental care, poor maternal health, poor nutrition, social disadvantage, maternal depression), politicians used the specter of the crack baby as part of a larger swing towards conservative, victim-blaming, anti-woman, racist, and classist social and legal policies, with terrible consequences for mothers and children.

“Our job is never easy because drug criminals are ingenious. They work everyday to plot a new and better way to steal our children’s lives” – R. Reagan

… but pregnant women often couldn’t access treatment, Mr. President, so who are you calling the criminal now?

Forgive me, then, if I sound glib when I say that there is no such thing as a crack baby. It just seems that if we have to continue to prove this very basic point, then we can’t go on to think about lessons we might learn from the whole crack baby scare.

Indeed, it’s been about twenty years since liberal scholars pointed out the race, class, and gender bias inherent to the legal crackdown on women who use cocaine while pregnant. Likewise, researchers like Diane Barone, who conducted a six-year study of children exposed to cocaine in utero, have consistently challenged the claim that so-called crack babies will not be able to acclimate to school, much less society. Indeed, it has been over a decade since the scientific community essentially put the crack baby to bed and cultural-studies oriented drug researchers did a post mortem on the effects of a media-hyped non-scandal. There are plenty of blog posts (both frustrated and outraged) about the fact that crack babies were just media hype. So how is it that most people outside our little community of drug researchers are surprised to hear that the crack baby must go the way of Santa Claus and the Easter Bunny? – Or maybe, more accurately, the boogey man lurking just around the corner.

actual stock image of a “crack baby,” possibly a child actor impersonating a crack baby, possibly just a baby.

Obviously, the correction is never as interesting as the claim, particularly when we’re talking about mothers who deliver drugs through umbilical cords – not to mention a generation of dangerous, sociopathic children running amok in our very midst. The nature of scientific research also makes it harder to correct the initial claim, since evidence against the crack baby came out in a series of studies rather than as a single, definitive data point. I wonder, though, if there is also something about the nature of the crack baby that contributes to its persistence in our imagination, despite ample evidence to the contrary.

it has the ring of truth(iness)

and if you have an explanation for that white smoke, I’m sure I can think of something else

As I read through highlights of what I might call The Crack Baby Incident, I noticed a problematic pattern, one I have also recognized in conversations with conspiracy theorists. As anyone who has had such a conversation knows, the most maddening thing about a conspiracy theory is its structure. It begins with a conclusion and, when the data don’t support that conclusion, conspiracists don’t alter the conclusion; they alter the data.

Every objection can be explained away with further hypothetical scenarios, but the conclusion remains sacrosanct. The elegance, the neatness, the sublime terribleness of the conclusion is just too tantalizing to let go.  Crack injures babies; we just don’t know precisely how. But it must do something.

prune belly: syndrome causing underdevelopment of abdominal muscles, undescended testicles, and urinary tract problems

Any review of the literature will reveal an ever-expanding laundry list of symptoms, behavioral and physical, supposedly caused by cocaine-exposure in utero. As causative claims are disproven, new ones emerge.

These new problems become increasingly “subtle” until they recede into the margin of error. For example, the initial article about cocaine effects in utero lists spontaneous abortion, prune-belly syndrome, SIDS, “consistent patterns of depressed interactive disorder and significant impairment in organizational abilities.” Women who used later in their pregnancy reported feeling increased fetal activity, experienced separation of the placenta, or went into labor. Subsequent reports in the years following this initial study added that crack babies suffered from: stiff limbs, tremors, muscle-tone and control problems, and difficulty with visual engagement, language development, attention, and self-regulation. They did not coo and babble on time, were irritable, tremulous, and difficult to soothe. Later on in life, they suffered from hyperactive disorder, aggression and behavior problems, inattentiveness, anxiety, depression, learning disabilities, and low IQ.

In 1997, as the crack baby started to go up in smoke, a conference (“Cocaine: Effects on the Developing Brain”) resuscitated the baby with papers that argued for more “subtle” effects of cocaine on babies. Ira Chasnoff et. al. adjusted their initial claims to argue that cocaine had only “limited impact” on IQ, and added that the home environment was the “strongest predictor of IQ.” Yet, the team continued, cocaine did cause behavioral problems including aggression, attention problems, difficulty focusing, anxiety, and depression. It seems odd that any researcher could trace IQ to home environment, but still suggest that in the same cohort, all the other problems were caused by cocaine exposure in utero and not by the same sort of chaotic home environment and poverty that contribute to a lower IQ.

Research like this (and I intend no disrespect to Chasnoff or any of the other researchers, many of whom signed a letter asking the media not to use terms like “crack baby” or oversimplify their research) indicates a fundamental assumption that crack does something to babies and, in that way, their research has the structure of a conspiracy theory. I suspect that, as with most drug scares, part of the problems lies in a desire to invest the substance with more power than it actually has.

Just as opiates never really turned women into nymphomaniac sex slaves,

but apparently the perfume does?

and marijuana never made anyone an ax murderer,

as it turns out, the marijuana was a red herring

and cocaine never made African Americans expert marksmen or immune to bullets,

foreshadowing of Rodney King?

there is no simple relationship between substance cause and fetal effect. Of course, recognizing this makes it harder to draw a clear, umbilical-cord like line between abuser and abused, mother and child, drug and effect, but it would enable us to get beyond facile assumptions about a much more complex relationship than we might want to acknowledge.

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3 thoughts on “The Crack Baby Incident

  1. In doing some custody work with the courts I came across the belief among a judge that a woman abusing cocaine would damage her child. Showing the judge one of the articles refuting this was really important in how he viewed a female addict and her children. Thank you for writing about this in such a way that we can understand now only the claim and the fear, but also the dynamic, and historical context. Don LCSW

  2. Thanks for a very interesting post.

    ‘…and I fully anticipate that this habit will be found not less destructive than the vice of drinking spirits…I cannot bring myself to think that the habitual use of a drug which produces such permanent effects as opium…can be consistent in general with the enjoyment of health, and the prolongation of life.’
    So opined the great toxicologist Robert Christison, appearing as an expert witness in 1838. He had completed a short series of case studies which failed to demonstrate that the habitual and prolonged use of opium shortened life. The court case was occasioned when the Edinburgh Life Assurance company that had insured the Earl of Mar, a Scottish nobleman who used opium for several decades, declined to pay up. Upon his eventual death, the company argued that the Earl’s habit must have impacted upon his longevity. Despite Christison’s findings, he declared his belief that eventually the evidence would be forthcoming.
    ‘I cannot bring myself to think’- to contemplate the possibility that opium use may not hasten death, that ‘crack babies’ may belong more to the realm of the imaginary- this remains, and is itself a fascinating and complex reluctance.

  3. Great post, Alex! As a child welfare worker, this is recognized in our courts. The drug that causes the worst short term and long term effects is alcohol. Hands down. Over any other drug. I have seen many exteme premature births to mothers who had used meth… but doctors hesitate to say that meth actually causes premature contractions that can lead to premature births. I have seen the devastating effect of multiple drug exposure, eventually causing the death of several very young babies that never made it out of the hospital neo natal ward. But in my 18 years of child welfare practice, it has yet to be shown that cocaine use/crack use causes much more than hypertonic muscles, irritability, feeding problems, etc at birth (which might have more to do with drug withdrawal symptoms than with the actual drug itself).

    Thanks for your point, well made!

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