The Media's Meth Baby Mania
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When crack was the scariest drug of all, "crack babies" were the culmination of the terror. Columnist Charles Krauthammer wrote of them in 1989, "A cohort of babies is now being born whose future is closed to them from day one. Theirs will be a life of certain suffering, of probable deviance, of permanent inferiority."
As it turns out, none of that was true. In fact, being labeled a "crack baby" appears to have done more harm to these children than the cocaine itself did. And with news stories popping up about "meth babies" in our latest drug panic, we seem to be about to repeat this shameful pattern.
Children born to mothers addicted to crack cocaine did have serious problems--but most of these were related to the fact that their mothers lacked prenatal care, were extremely poor and drank alcohol, smoked cigarettes and took other drugs as well as crack cocaine.
Women who do not stop using drugs or drinking during pregnancy tend to be those with long, complicated histories of victimization and mental illness (Over two thirds have survived childhood sexual abuse and/or are current victims of domestic violence, for example). It's undoubtedly a bad idea to use cocaine (or any drug, for that matter) during pregnancy--but the damage associated with prenatal cocaine exposure is less severe than that caused by alcohol and comparable to the harm done by cigarette smoking.
But being exposed to domestic violence as a baby or young child, in fact, is a far better predictor of behavior problems and low IQ than cocaine exposure in utero is. And, one study found that kids labeled "crack babies" (though they were actually not) were treated far worse than those who had not been tagged that way. When medical professionals thought they were dealing with a "crack baby," they interpreted normal behavior as abnormal and ascribed bad intentions to it.
Which brings us to the current methamphetamine panic. In a story with a headline that could have been pulled from the 1980s crack scare, "A Drug Scourge Creates its Own Form of Orphan" (7/11/05), Kate Zernike of the New York Times reported that 40% of child welfare officials say that methamphetamine has caused a rise in the number of kids taken into foster care; but the national numbers for those in fostercare (which go uncited in the Times article) have declined from 570,000 in 1999 to 523,000 in 2003--a period during which methamphetamine use was supposedly rising.
Foster care numbers often show a lag of several years in relation to drug problems because it takes time for people to become addicted, have children and then come to the attention of child welfare authorities. But during the crack epidemic, the number of kids in foster care went from 243,000 in 1982 to 400,000 in 1990 and it continued rising until 1999, despite the far earlier decline in crack use. So it's clear that if meth is causing an increase, it's nowhere near that associated with crack.
But foster care trends tend to be fed more by perceptions and theories than by the number of kids who are actually abused. Heavily reported instances of kids abused by dangerous parents (the case of Elisa Izquierdo in New York, for example) lead to increases in foster care admissions. Curiously, however, highly publicized cases of abuse in foster care usually don't lead to increased emphasis on "family preservation." Foster care trends, unsurprisingly, are also connected to poverty; but even so, some states tend to take more children from their families than others, regardless of poverty and regardless of drug use trends.
Unfortunately, foster care itself can do harm. According to Richard Wexler, Executive Director of the National Coalition for Child Protection Reform, only 20% of kids leaving foster care do well by the standard measures of employment and education and mental health. A study by Casey Family Programs found that foster care kids have double the rate of post-traumatic stress disorder seen in Gulf War veterans.
Of course, some of these problems are undoubtedly due to the reasons that they were seen as needing foster care in the first place--but one third of kids in foster care in this study reported being abused by their new caretakers and the effects of moving from one home to another as foster kids often do are uniformly negative. The average number of placements for kids in foster care (how many transitions from one home to another they experienced) was seven in this study. As Wexler says, "The best evidence we have is that drug treatment for the parents is almost always a better option than foster care for the children."
Given that media coverage drives foster care trends, it behooves editors and reporters to consider explicitly in their coverage whether foster care could do more harm than methamphetamine. It's especially important in this context to stop promoting the idea that meth addiction is harder to treat than other drug problems. Amazingly, in Zernike's Times article, she claims, with no factual basis, that treatment for methamphetamine requires a longer stay in care than treatment for crack did (treatment stays for all drugs are universally shorter since the advent of managed care--and there's no evidence that this has reduced efficacy).
She says, also incorrectly, that because of a 1997 law, this means that parental rights are likely to be terminated faster. The law makes an exception for people who are doing well in treatment. Zernike goes on to quote an Iowa child welfare advocate who says that because of meth's longer recovery time, "We know pretty early that these families are not going to get back together." But since this is based on a myth about treatment failure--and unfortunately child advocates who have a say in whether families get back together believe it--the Times is helping create a self-fulfilling prophecy by reporting it.
There is also a financial battle underlying child welfare agencies' relationship to methamphetamine, according to Wexler, that should have been covered in reporting on it. Federal budget efforts are underway to make foster care funding more flexible--to allow some of it, for example, to be used to treat addicted parents rather than to place kids in care. This, of course, would shift funds away from these agencies and towards drug treatment providers. Flexible funding wouldn't gain much support, of course, if "meth monsters" are untreatable.
Coverage of this issue should not present foster care agencies simply as disinterested child advocates, consequently.
It is certainly true that active stimulant addicts can be highly abusive and neglectful towards their children--and there are absolutely some cases where this should lead to custody termination. But because interventions like foster care can sometimes do harm, the media needs to be especially cautious when demonizing a drug to advocate them -- or else reporters risk hurting the innocent victims they are supposedly trying to help. Wexler has written to the Times' ombudsman to complain about the Zernike story and a group of key researchers on addiction and children have written an open letter to the media, but as this NBC news story demonstrates, the hype appears to be unstoppable.
Why doesn't the media ever ask "Cui bono?" when it comes to drug scares? Could it be because "we do" is one of the only truthful answers?