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Crack: info on crack cocaine and cocaine freebase

I want first to express my personal opinion that freebasing is a very bad thing to do for your body and mind. I have seen a few people hooked on it, and it is not a nice thing to see. I strongly disrecommend doing it. It is easy to overdose and die of cardiac arrest. Some people doing freebase will exhibit the same kind of behavior as those rats whose pleasure centers are electrically stimulated: they will do it until either the supply runs out, or until they die.

The recipes are readily available. In fact, a few years ago, police officers would go to great lengths explaining how crack was made when given interviews (at least in Montreal)! There was also an article in Time a few years ago explaining the procedures.

I have never tried any of those procedures or smoked freebase, and will never do it. The information I post comes from a used booklet I bought a long time ago ("Cocaine Handbook", by Davis).

Crack is actually a impure form of freebase. Procedures for both substances are based on the fact that while cocaine hydrochloride is very soluble in water, base cocaine is almost insoluble.



Mix about 1 g of coke in 10 ml of water in a small vial. Slowly add drops of ammonia to the solution. A white milky precipitate will form. Stop adding ammonia when additional drops no longer result in precipitation. Add 5 ml of ethyl ether, close vial, and shake. The precipitate (freebase) will dissolve in the ether. Siphon off the ether with a pipette (ether and water don't mix), and slowly drip it on a plate. As the ether evaporates, white crystals will form. This is the evil freebase. Crush the crystals and put under a heat lamp for at least 24 hrs to let the solvent evaporate.


This is how Richard Pryor almost died. A lot of untrained people killed themselves doing that procedure, and this is why crack is now more popular.


Mix 2 parts ok coke HCL for 1 part baking soda in 20 ml of water. Heat solution gently until white precipitates form, and stop heating when precipitation stops. Filter and keep precipitate. wash precipitate once with water (this procedure usually omitted in street product). Dry 24 hours under heat lamp. Voila. The product is much less pure (there is lots of baking soda left) but the procedure is safer.

Date: Fri, 13 Nov 92 09:21:26 -0500
From: (anonymous)
Subject: Crack / Rock Cocaine

Let me first say that this is also freebase. Its not as pure as the other recipe and has a *much smaller return* than using ammonia (no one really does the ether part, just ammonia and heat it).


[previous crack "recipe" deleted -cak]

After gentle heating, it will float to the top, any excess soda will precipitate to the bottom. Given that, you'd never filter it, and the 24 hour heat lamp thing is unrealistic, too. Note that what you're trying to do is start and sustain a chemical reaction (bonding the hcl with the base-soda) so as long as the reaction is happening you don't have to continue heating.

In article <1993Mar4.215558.9171@midway.uchicago.edu> bagg@midway.uchicago.edu writes:

I suspect that freebase cocaine is probably not too bad for your lungs.

After writing this, I bopped onto Medline and yanked the following abstracts for the sake of thoroughness:

1. Khalsa ME; Tashkin DP; Perrochet B.
Smoked cocaine: patterns of use and pulmonary consequences.
Journal of Psychoactive Drugs, 1992 Jul-Sep, 24(3):265-72. (UI: 93058148)
Abstract: This article offers a perspective on the use of volatilized alkaloidal cocaine in its freebase and crack forms and on the pulmonary consequences of such use. The inhalational route of administration of freebase and crack cocaine exposes the lung to their combustion products, raising concern about possible adverse pulmonary effects. A brief historical review of cocaine and its methods of use precedes the presentation of data concerning current modes and patterns of use and some pulmonary complications of crack and freebase use. Results from a systematic study of a large sample of cocaine users document a high frequency of occurrence of acute respiratory symptoms in temporal association with cocaine smoking. No relationship was detected between the prevalence of acute pulmonary symptoms and identifiable aspects of techniques of cocaine administration. These results suggest that the respiratory consequences of alkaloidal cocaine are most likely attributable to the inhaled cocaine itself, rather than to variable characteristics of usage.

2. Oh PI; Balter MS.
Cocaine induced eosinophilic lung disease.
Thorax, 1992 Jun, 47(6):478-9.
(UI: 92358464)
Abstract: A patient developed fever, bronchoconstriction, hypoxaemia, pulmonary infiltrates, and serum and bronchoalveolar lavage fluid eosinophilia on two occasions after inhaling crack cocaine. Transbronchial biopsy specimens showed normal lung parenchyma but a dense eosinophilic infiltrate within the bronchial wall. Both episodes resolved promptly after treatment with corticosteroids. Eosinophilic lung disease may be a steroid responsive complication of crack cocaine abuse.

3. Perper JA; Van Thiel DH.
Respiratory complications of cocaine abuse.
Recent Developments in Alcoholism, 1992, 10:363-77.
(UI: 92270885)
Pub type: Journal Article; Review; Review, Tutorial.
Abstract: Upper respiratory and pulmonary complications of cocaine addiction have been increasingly reported in recent years, with most of the patients being intravenous addicts, users of freebase, or smokers of "crack." The toxicity of cocaine is complex and is exerted via multiple central and peripheral pathways. Recurrent snorting of cocaine may result in ischemia, necrosis, and infections of the nasal mucosa, sinuses, and adjacent structures. Pulmonary complications of cocaine toxicity include pulmonary edema, pulmonary hemorrhages, pulmonary barotrauma, foreign body granulomas, cocaine related pulmonary infection, obliterative bronchiolitis, asthma, and persistent gas-exchange abnormalities. Respiratory manifestations are nonspecific and include shortness of breath, cough, wheezing, hemoptysis, and chest pains. Severe respiratory difficulties have been reported in neonates of abusing mothers. In the absence of a cocaine-abuse history, it may be difficult to recognize the etiological role of cocaine, especially in the absence of needle tracks pointing to previous intravenous drug abuse and/or negative toxicology.

4. Ferre C; Sirvent JM; Vidaller A.
[Hemoptysis and pulmonary infiltrates following crack poisoning (letter)].
Medicina Clinica, 1992 Mar 7, 98(9):358.
Language: Spanish.
(UI: 92261122)
Pub type: Letter.

5. Tashkin DP; Khalsa ME; Gorelick D; Chang P; Simmons MS; Coulson AH; Gong H Jr.
Pulmonary status of habitual cocaine smokers.
American Review of Respiratory Disease, 1992 Jan, 145(1):92-100.
(UI: 92117426)
Abstract: We determined the prevalence of respiratory symptoms and lung dysfunction in a large sample of habitual smokers of freebase cocaine ("crack") alone and in combination with tobacco and/or marijuana. In addition, we compared these findings with those in an age- and race-matched sample of nonusers of crack who did or did not smoke tobacco and/or marijuana. A detailed respiratory and drug use questionnaire and a battery of lung function tests were administered to (1) a convenience sample of 202 habitual smokers of cocaine (cases) who denied intravenous drug abuse and (2) a reference sample of 99 nonusers of cocaine (control subjects). The cocaine smokers (85% black) included the following: 68 never-smokers of marijuana, of whom 43 currently smoked tobacco and 25 did not, and 134 ever-smokers of marijuana (42 current and 92 former), of whom 92 currently smoked tobacco and 42 did not. The control subjects (96% black) included the following: 69 never-smokers of marijuana, of whom 26 currently smoked tobacco and 43 did not, and 30 ever-smokers of marijuana (18 current and 12 former), of whom 21 currently smoked tobacco and 9 did not. Cases smoked an average of 6.5 g cocaine per week for a mean of 53 months. The median time of the most recent use of crack prior to study was 19 days (range less than 1 to 180 days). After controlling for the use of other smoked substances, frequent crack use was associated with: (1) a high prevalence of at least occasional occurrences of acute cardiorespiratory symptoms within 1 to 12 h after smoking cocaine (cough productive of black sputum [43.7%], hemoptysis [5.7%], chest pain [38.5%], usually worse with deep breathing, and cardiac palpitations [52.6%]) and (2) a mild but significant impairment in the diffusing capacity of the lung.(ABSTRACT TRUNCATED AT 250 WORDS)

6. O'Donnell AE; Mappin FG; Sebo TJ; Tazelaar H.
Interstitial pneumonitis associated with "crack" cocaine abuse.
Chest, 1991 Oct, 100(4):1155-7.
(UI: 92006753)
Abstract: A 33-year-old woman developed acute bilateral pulmonary infiltrates after the intense use of rock cocaine (crack). She subsequently had progressive deterioration of pulmonary function to the point of being ventilator-dependent. Open lung biopsy showed a chronic interstitial pneumonia with extensive accumulation of free silica within histiocytes associated with mild pulmonary fibrosis. This pattern of interstitial pneumonia has not been previously reported in crack users.

7. Susskind H; Weber DA; Volkow ND; Hitzemann R.
Increased lung permeability following long-term use of free-base cocaine (crack).
Chest, 1991 Oct, 100(4):903-9.
(UI: 92006781)
Abstract: The clearance of inhaled 99mTc DTPA aerosol from the lungs is used as an index of lung epithelial permeability. Using the radioaerosol method, we investigated the effects of long-term "crack" (free-base cocaine) inhalation on lung permeability in 23 subjects. Eighteen control subjects (12 nonsmokers and 6 cigarette smokers) with no history of drug use were also studied. Subjects inhaled approximately 150 muCi (approximately 5.6 MBq) of 99mTc DTPA aerosol and quantitative gamma camera images of the lungs were acquired at 1-min increments for 25 minutes. Regions of interest (ROIs) were selected to include the following: (1) both lungs; (2) each individual lung; and (3) the upper, middle, and lower thirds of each lung. 99mTc DTPA lung clearance was determined from the slopes of the respective time-activity plots for the different RIOs. Radioaerosol clearance half-times (T1/2) for the seven nonsmoking crack users (61.5 +/- 18.3 minutes) were longer than for the seven cigarette-smoking crack users (27.9 +/- 16.9 minutes) and nine cigarette-smoking crack plus marijuana users (33.5 +/- 21.6 minutes). T1/2 for the nonsmoking crack users was significantly shorter (p less than 0.001) than for the nonsmoking control group (123.8 +/- 28.7 minutes). T1/2 for the cigarette-smoking drug users was similar to that of the cigarette-smoking control group (33.1 +/- 17.8 minutes), suggesting a similar mechanism of damage from the smoke of crack and tobacco. From these groups, one nonsmoker and 11 cigarette smokers displayed biexponential 99mTc DTPA clearances, indicative of greater lung injury than found in the usual cases of monoexponential clearance. The upper lungs of all crack users groups cleared faster than the lower lungs. The faster and biexponential clearance properties of inhaled 99mTc DTPA aerosol were the principal functional abnormalities found in all the drug users. In contrast, 19 of 23 crack users had normal spirometry and gas exchange. These results indicate that 99mTc DTPA may provide a sensitive and useful assay to evaluate the physiologic effects of cocaine inhalation in the lung.

8. McCarroll KA; Roszler MH.
Lung disorders due to drug abuse.
Journal of Thoracic Imaging, 1991 Jan, 6(1):30-5.
(UI: 91116637)
Pub type: Journal Article; Review; Review, Academic.
Abstract: Drug-related diseases of the lungs have been noted with increasing frequency in urban patients. These entities are also being seen in smaller urban and suburban settings, however. The spectrum of pathology is also changing coincident with the marked increase in crack cocaine use. The incidence of abnormal chest radiographs in cocaine users admitted with pulmonary complaints has ranged from 12% to 55%. Findings have included focal air space disease, atelectasis, pneumothorax, pneumomediastinum, and pulmonary edema. Pulmonary complications related to injections of illicit drugs have included pulmonary infection, pulmonary edema, particulate embolism, and talcosis. The "pocket shot" places the patient at risk for a unique set of complications. Radiologists should be aware of this wide spectrum of pulmonary disease that may be related to this increasingly frequent social problem.

9. Smart RG.
Crack cocaine use: a review of prevalence and adverse effects.
American Journal of Drug and Alcohol Abuse, 1991, 17(1):13-26. (UI: 91247446)
Pub type: Journal Article; Review; Review, Tutorial.
Abstract: Crack is a potent form of cocaine which results in rapid and striking stimulant effects when smoked. This paper reviews epidemiological research on the extent of use as well as reports of adverse effects. Crack is used by a small minority of adult and student populations but by a large proportion of cocaine users and heavy drug-using groups. Use does not appear to be increasing in general populations, but there are no trend studies for high-risk groups. Crack users tend to be young, heavy polydrug users, many of whom have serious drug abuse problems. The adverse reactions to crack are similar to those of cocaine and include effects on offspring, neurological and psychiatric problems, as well as pulmonary and cardiac abnormalities. However, two adverse reactions unique to crack have been reported. One relates to lung infiltrates and bronchospasm. The other involves neurological symptoms among children living in crack smoke-filled rooms. There is a need for improved treatment and preventive programs for crack use.

10. Forrester JM; Steele AW; Waldron JA; Parsons PE.
Crack lung: an acute pulmonary syndrome with a spectrum of clinical and histopathologic findings.
American Review of Respiratory Disease, 1990 Aug, 142(2):462-7.
(UI: 90343162)
Abstract: In this report, we review the hospital course of four patients who presented with an acute pulmonary syndrome after inhaling freebase cocaine and compare them with previously described case reports. Two patients had prolonged inflammatory pulmonary injury associated with fever, hypoxemia, hemoptysis, respiratory failure, and diffuse alveolar infiltrates. Lung tissue specimens from both patients revealed diffuse alveolar damage, alveolar hemorrhage, and interstitial and intraalveolar inflammatory cell infiltration notable for the prominence of eosinophils. Immunofluorescent staining performed on one of the biopsy specimens showed a striking deposition of IgE in both lymphocytes and alveolar macrophages. Both patients were treated with systemic corticosteroids and rapidly improved. In contrast, two patients presented acutely with diffuse pulmonary alveolar infiltrates associated with dyspnea and hypoxemia, but without fever, and within 36 h of discontinuing cocaine their pulmonary infiltrates and symptoms had spontaneously resolved. Our report further supports the finding that an acute pulmonary syndrome can occur after inhalation of freebase cocaine. Furthermore, the lung injury may respond to systemic corticosteroid therapy when it is associated with a prominent inflammatory cell infiltration.

11. Hannan DJ; Adler AG.
Crack abuse. Do you known enough about it?
Postgraduate Medicine, 1990 Jul, 88(1):141-3, 146-7.
(UI: 90310821)
Pub type: Journal Article; Review; Review, Tutorial.
Abstract: Crack use has increased dramatically because the drug is cheap, highly addictive, and easy to use. As a result, an increased frequency of cocaine-related medical problems has been noted. The effects of crack abuse on fetal outcome and neurobehavioral development are becoming more apparent. In addition, the role of crack use in furthering transmission of sexually transmitted diseases has been documented, and the implications for AIDS transmission have been speculated on. Crack use enhances social disorganization, particularly in poor urban areas, where increased child abuse, neglect, and prostitution are common. Ever present are the financial incentives to increase the number of crack users. Cocaine was once considered a drug for the elite, rich, and famous. Crack clearly has changed that notion.

12. Tashkin DP.
Pulmonary complications of smoked substance abuse.
Western Journal of Medicine, 1990 May, 152(5):525-30.
(UI: 90273700)
Pub type: Journal Article; Review; Review, Tutorial.
Abstract: After tobacco, marijuana is the most widely smoked substance in our society. Studies conducted within the past 15 years in animals, isolated tissues, and humans indicate that marijuana smoke can injure the lungs. Habitual smoking of marijuana has been shown to be associated with chronic respiratory tract symptoms, an increased frequency of acute bronchitic episodes, extensive tracheobronchial epithelial disease, and abnormalities in the structure and function of alveolar macrophages, key cells in the lungs' immune defense system. In addition, the available evidence strongly suggests that regularly smoking marijuana may predispose to the development of cancer of the respiratory tract. "Crack" smoking has become increasingly prevalent in our society, especially among habitual smokers of marijuana. New evidence is emerging implicating smoked cocaine as a cause of acute respiratory tract symptoms, lung dysfunction, and, in some cases, serious, life-threatening acute lung injury. A strong physician message to users of marijuana, cocaine, or both concerning the harmful effects of these smoked substances on the lungs and other organs may persuade some of them, especially those with drug-related respiratory complications, to quit smoking.

13. Brody SL; Slovis CM; Wrenn KD.
Cocaine-related medical problems: consecutive series of 233 patients [see comments].
American Journal of Medicine, 1990 Apr, 88(4):325-31.
(UI: 90224989)
Abstract: PURPOSE: Little information describing common cocaine-related medical problems is available. This study examined the nature, frequency, treatment, incidence of complications, and emergency department deaths of patients seeking medical care for acute and chronic cocaine-associated medical problems. PATIENTS AND METHODS: A consecutive series of 233 hospital visits by 216 cocaine-using patients over a 6-month period during 1986 and 1987 was studied. Medical records were retrospectively reviewed to determine patient characteristics, nature of complications, treatment, and outcome. RESULTS: Patients most commonly used cocaine intravenously (49%), but freebase or crack use was also common (23.3%). Concomitant abuse of other intoxicants, especially alcohol, was frequently seen (48.5%). The vast majority of complaints were cardiopulmonary (56.2%), neurologic (39.1%), and psychiatric (35.8%); multiple symptoms were often present (57.5%). The most common complaint was chest pain though rarely was it believed to represent ischemia. Altered mental status was common (27.4%) and ranged from psychosis to coma. Short-term pharmacologic intervention was necessary in only 24% of patients, and only 9.9% of patients were admitted. Acute mortality was less than 1%. CONCLUSION: Most medical complications of cocaine are short-lived and appear to be related to cocaine's hyperadrenergic effects. Patients usually do not require short-term therapy or hospital admission. Acute morbidity and mortality rates from cocaine use in patients presenting to the hospital are very low, suggesting that a major focus in the treatment of cocaine-related emergencies should be referral for drug abuse detoxification and treatment.

14. Wallach SJ.
Medical complications of the use of cocaine.
Hawaii Medical Journal, 1989 Nov, 48(11):461-2.
(UI: 90077816)
Abstract: There are many serious medical problems that are associated with the use of cocaine and "crack" cocaine.

15. Eurman DW; Potash HI; Eyler WR; Paganussi PJ; Beute GH.
Chest pain and dyspnea related to "crack" cocaine smoking: value of chest radiography.
Radiology, 1989 Aug, 172(2):459-62.
(UI: 89316319)
Abstract: The chest radiographs of 71 patients who had chest pain or shortness of breath following the smoking of highly potent "crack" cocaine were retrospectively evaluated. Nine patients had abnormal findings on radiographs as follows: atelectasis or localized parenchymal opacification in four, pneumomediastinum in two, pneumothorax in one, hemopneumothorax in one, and pulmonary edema in one. Radiographic detection of these abnormalities was important in the clinical management of these patients. This spectrum of findings is presented with a discussion of the pathophysiologic mechanisms responsible.

16. Cherukuri R; Minkoff H; Feldman J; Parekh A; Glass L.
A cohort study of alkaloidal cocaine ("crack") in pregnancy.
Obstetrics and Gynecology, 1988 Aug, 72(2):147-51.
(UI: 88276400)
Abstract: The recent dramatic increase in the use of alkaloidal cocaine ("crack") has led to concern about possible deleterious fetal effects associated with its use during pregnancy. Crack, which is not destroyed by heating, can be smoked, and delivers a large quantity of cocaine to the vascular bed of the lung, producing an effect similar to that from intravenous injection. To describe the association of crack use with pregnancy outcome, we conducted a retrospective matched cohort study of 55 women who admitted to the use of crack during pregnancy and 55 non-drug-using women who delivered during the same period. The groups were matched for age, parity, socioeconomic status, alcohol use, and presence or absence of prenatal care. A significantly larger number of women using crack delivered at 37 weeks or earlier (50.9 versus 16.4%; P = .001). Crack-exposed infants were 3.6 times more likely to have intrauterine growth retardation (P less than .006) and 2.8 times more likely to have a head circumference less than the tenth percentile for gestational age (P less than .007). Premature rupture of the membranes was 1.8 times more common in the crack group (P less than .03). Sixty percent of crack-using mothers received no prenatal care. Abnormal neurobehavioral symptoms were present in a minority of infants and were usually mild.

17. Snyder CA; Wood RW; Graefe JF; Bowers A; Magar K.
"Crack smoke" is a respirable aerosol of cocaine base [published erratum appears in Pharmacol Biochem Behav 1988 Apr;29(4):835].
Pharmacology, Biochemistry and Behavior, 1988 Jan, 29(1):93-5.
(UI: 88177036)
Abstract: The smoking of cocaine base [corrected] ("crack") has emerged as a significant substance abuse problem. A detailed characterization of cocaine smoke is a prerequisite for studies of its pharmacokinetics, abuse potential and toxicity. Model pipes were used to generate cocaine smoke analogous to that inhaled by human "crack" abusers. Using procedures to minimize pyrolysis, cocaine base smoke was determined to be 93.5% cocaine particles with the remainder being cocaine vapor. The average particle size generated from all model pipes was 2.3 mu which is small enough to ensure deposition into the alveolar region of the human lung. Although this particle size is eminently respirable [corrected] by primates, a much smaller fraction will reach the alveolar region of rodents. Special generating procedures would therefore be required to expose rodents to meaningful doses of airborne cocaine that mimic the rapid absorption achieved by "crack" smokers.

The following article appeared in the Santa Cruz Sentinel, 12/6/92. It is an Associated Press article, so it probably appeared in other papers as well.

'Crack Babies' catch up

By: Dana Kennend, The Associated Press
Comments by: Bela Lubkin
NEW YORK - When they spoted the playground, looming like a leafy oasis amid the graffiti-scarred tenements of central Harlem, the 10 toddlers and pre-schoolers erupted in excitement. As they entered Morningside Park, the older kids raced to the swings and slides. The younger ones clapped their hands and cheered them on.
Within seconds, the children were indistinguishable from the other youngsters in the park, swooping down slides and climbing monkey bars.Three-year-old Johnny scrambled up the slide so fast that kids from a nearby school watching in awe. Two-year-old Tanika jumped onto the jungle gym like a tiny mountain goat.
This wasn't supposed to happen. These children, on their daily outing from Hale House, were born exposed to crack. In recent years, the term "crack babies" has become a national buzzword, a riveting soundbite that conjures images of mutant, monster children.
Punchy headlines such as "Crack Babies: Genetic Inferiors" and "Crack in the Cradle" have helped shape the stereotype.
But the children themselves may have the last word. Doctors, social workers and teachers involved with crack-exposed kids indicate that many are rising above the dire predictions made for them.
"When people find out what I do, they say 'Ok, those poor crack babies,'" said Hale House nurse Anne Marie Nedd as she chased active, giggling 18-month-old Daren around the park. "I get so mad. I tell them, "There's nothing really wrong with these kids!'"
Since crack swept the country in 1985, children born to crack addicts were thought to be physically and mentally damaged, doomed to a marginal life and an ongoing burden for taxpayers. The first wave of crack-exposed children entered first and second grades in New York City this fall, a year after one state report estimated the cost of special care for them could total $2 billion over the next 15 years. Harlem Hospital researchers estimated that the cost of caring for crack babies costs the country $500 million a year.
Such statistics have fed the kind of fear that led Ross Perot to invoke the dread specter of "crack babies" during the first presidential debate. "Again and again and again, the mother disappears in three days and the child becomes a ward of the state because he's permanently and genetically damaged," Perot said.
Permanently and genetically damaged. That's the kind of description that angers Hale House program director Jackie Edmond as she feeds beaming, 6-month-old Quashia some apple sauce. Hale House cares for children 3 and under born addicted to drugs. Like Quashia, almost all the kids there now were born addicted to crack.
"Tell me, what does a crack baby look like?" Edmond says angrily as she recounts the stories she's read about crack babies and the comments she hears from strangers. "Nobody who talks about them ever comes in to see them. They'll come in here and look at our kids any the look normal. So they says, 'Where are the drug babies?' I tell them, 'They're right here.'"
Across town on Wards Island, watching a group of animated 3- and 4-year-olds reading aloud from workbooks in a sunny room at Odyssey House, Cheryl Nazario had the same reaction. "These kids were labeled a lost cause," said Nazario, who directs a residential program helping former crack addicts and their children. "It was like everyone expected them to walk into schools like little androids. But they catch up. They really do catch up."
While crack-exposed babies may develop more slowly than others, many experts say they often appear to grow out of early problems if they receive proper care as infants and toddlers. Many believe their prognosis is as good as children born drug-free if they get early intervention.
Such children have to overcome a lot. The gripping image of the jittery, irritable baby who doesn't want to be touched and cries all the time is a reality, experts say. But kids born to mothers addicted to other drugs share the same symptoms, the result of a disorganized nervous system.
Programs all over the country, including Hale House and Odyssey House in New York and the Charles R. Drew Head Start in South-Central Los Angeles, have developed strategies to lessen the symptoms, help kids adapt to their surroundings and teach parents how to better care for them.
Many experts who have researched or worked with kids exposed to cocaine decry what some call the myth of "crack babies."
"It's nonsense," said Claire Coles, a clinical psychologist at Emory University in Atlanta who has studied crack kids. "There's no evidence of genetic damage, nothing like what was originally supposed. It's astonishing that so much fuss has been raised about cocaine when kids born with fetal alcohol syndrome are so much worse off."
The problems suffered by children exposed to cocaine stem from many factors, Coles said. Many were born prematurely to mothers who had little or no prenatal care and a returned to a neglectful environment. But cocaine itself has not been proven to be any more damaging than any other drug used by pregnant woment, Coles said.
Those familar with crack-exposed children also echoed Coles' assertion that children with fetal alcohol syndrome are much more likely to suffer from mental retardation.
Researchers at the National Association for Perinatal Addiction Research and Education in Chicago have tracked a group of 300 children born exposed to crack for almost seven years, while helping the kids and their mothers.
The association's president, Ira Chasnoff, said kids born exposed to crack, or other drugs, often suffer from a decreased attention span, more impulsive behavior and have difficulty concentrating. But environment may play a more key role than drug exposure in the womb, he said.
In NAPARE's study, researchers found that the IQ scores of children born exposed to crack were the same as children who were not crack-exposed but who lived in a similar environment.
Chasnoff painted a dark picture behind society's morbid embrace of "crack babies."
"The image of the crack baby really moved out there," he said. "Politicians really picked it up. It worked into the trend of writing about the underclass. It's sexy, it's interesting, it sells newspapers and it perpetuates the us-versus-them idea." In fact, said Chasnoff, "Poverty is the worst thing that can happen to a child."
(Bela) My comments: I find it interesting and encouraging that now that the Reagan/Bush/Quayle years are officially doomed, the mainstream media feel they can start to debunk the myths generated by PFDA and others.
Unfortunately, the article failed to debunk the other half of this myth - it never said anything direct about the number of "crack babies". Without that information an uninformed but intelligent person must still be concerned about the costs of giving this "head start" to so many thousands, millions. I forget what PFDA says of addicted kids. In fact, as we know, the numbers are low and now we see that the consequences are low.
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The following article appeared in the Calgary Herald in Canada on Saturday, June 11, 1994.

Placenta barrier to cocaine, study finds

By: Mark Lowey

TORONTO - Developmental problems in children exposed to cocaine prior to birth may be due more to neglect at home than the drug's longterm effects, a study suggests. "Cocaine babies," a term used by the popular media to label children with problems, is a misnomer, said Dr. Carmine Simone, researcher at the Hospital for Sick Children in Toronto. He co-authored the study to be published in the American Journal of Obstetrics and Gynecology, with Dr. Gideon Koren, head of clinical pharmocology at the hospital.

Prenatal exposure to cocaine may be a merker of other problems at home, such as child abuse, neglect and substance abuse by parents, Simone said.

In fact, researchers found that the placenta in the womb may actually help protect the fetus from cocaine abuse by the mother.Using placenta recovered from full term births, researchers devised apparatus that simulates conditions in the womb when the mother takes cocaine. "We can mimick the way women take drugs," Simone said. "It's a model for what's happening."

The placenta is usually discarded after birth, he noted, adding the study was conducted according to strict ethical guidelines and no fetuses were involved.

Results showed the placenta appears to act as a barrier to cocaine. It is able to absord about one-third of the administered dose, with about one-third getting through that would affect the fetus. The rest is eliminated. Simone said this situation may be due to the way cocaine is taken, in staggered "hits" as the high wears off. The placenta appears to metabolize and eliminate the drug between the hits. Children of cocaine abusers show no proven lasting physiological or developmental effects due to their experiences in the womb, said study co-author Koren. A study involving three Toronto hospitals found about six per cent of new borns, or one in 16, showed exposure to cocaine in the final three months before birth. But if the placenta buffers exposure, this would help explain why only 10 of 120 of the babies needed resuscitation or other intensive care. Other research shows cocaine-exposed newborns are smaller than average and much less healthy.
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Crack babies for real - Pasko Rakic

By: Dave Blake
Date: 3 Mar 1995

I just got back from a talk given by Pasko Rakic, the emminent neuroscientist from Yale. He showed evidence from someone else's lab that crack babies are real. I do not want to misrepresent what was done, so I'll give you the blow by blow.

First, he showed that when radioactive thymidine is given to a pregnant primate on a certain day, all the radioactive label will go to one cortical cell layer in the baby. This fits in well with Rakic's radial migration hypothesis, in that cells proliferating on the day when the thymidine is given will take up the label, and all cell's proliferating on the same day migrate to the same cortical layer.

Then he showed that when the exact same experiment is done, except that the mother is given coke from the day the thymidine is given until the birth of the child, the cell migration is somewhat random. The cells that migrate the furthest end up in their normal position. Most cells end up somewhere between the cortical plate and their predestined layer.

So there is hard evidence that cocaine will affect brain development in a primate fetus, if the mother is given coke.

As for dosage - he didn't say and I do not know. As for whether this translates to humans - I think that you need to think very carefully as to whether you would want to take that chance. He seemed to think that it did translate to humans, but it does highlight his hypothesis.
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1996 Dan Baum - Little, Brown and Co.

Pregnant women would pay the highest price "for transgressing the rights of others" in Bennett's War on Drugs. No other group of drug users was treated as harshly by the media, the legislatures, or the courts. No other group took as much blame for the failure of the nation at large to act with reason and compassion. Having turned its wrath variously on Negro junkies, teenage potheads, yuppie coke dabblers, and black crack dealers, the Drug War now would elevate pregnant drug users - often poor, uneducated, and unable to get treatment - to Public Enemy Number One.

The proximate roots of the "crack baby crisis" were in 1981, when federal cuts in Medicaid stripped more than a million poor mothers and their kids of access to medical care. Within a few years, half of all African-American women had access to poor pre-natal care or none at all, and the effects showed up at once. By 1984, their infant mortality rate had noticeably worsened for the first time in twenty years - and this was a full year before crack appeared. The number of uninsured child-bearing women in California exploded by almost half between 1982 and 1986. And even those who qualified for public assistance weren't guaranteed access to care. Twelve of the state's fifty-eight counties had no doctors at all willing to accept Medicaid patients. Flu, infections, and pneumonia killed impoverished American babies in ever-greater numbers.

And then crack arrived on the scene.

Crack is bad news for pregnant women and their babies. Like men, women on crack binges neglect everything else - sleep, nutrition, safety, and their health in general. They tend to smoke cigarettes, drink alcohol, and use other drugs to moderate the intense highs and lows of crack.

Their babies show the effects . They are frequently premature, and on average smaller and lighter, with smaller heads. When suddenly deprived of cocaine they alternately howl and drop into deep sleep. At one Washington, D.C., hospital where the average neonatal stay was three days in 1989, babies born to crack-using mothers stayed an average forty-two days.

By 1989 scientists had had four years to study the phenomenon of "crack babies" and some were backing off from their initially alarming reports. Ira Chasnoff, the Chicago doctor whose 1985 article in the New England Journal of Medicine started the crack-baby panic, now cautioned that crack was only a small part of the problem for small, undernourished, and sickly babies. Pregnant women are sixteen times more likely to use alcohol than crack, he wrote, and unlike cocaine, alcohol has proven fetus-damaging effects. Chasnoff and other re searchers cautioned that the lives of poor, crack-using women were bad for babies in so many ways that there was no way to isolate crack as the primary cause of their infants' health problems. Poor women have always birthed smaller and sicker babies, and the sharp increase in the number of poor, uninsured women was certain to boost the number of ailing newborns. Prenatal care - and the insurance to pay for it---was and is a better predictor of a newborn's health than whether the mother smokes crack. "In the end," Florida health officials concluded in 1985, "it is safer for a baby to be born to a drug-abusing, anaemic, or a diabetic mother who visits the doctor throughout her pregnancy than to be born to a normal woman who does not." The Yerkes Primate Research Center in Atlanta tried to isolate cocaine's effects, administering a pure cocaine intravenous drip to rhesus monkeys for the entire duration of their pregnancies. Their babies were unaffected. Researchers of human "crack babies" furthermore found that the effects of cocaine wore off within a few months and that such babies who were well fed, loved, and properly stimulated could recover completely.

These were not, however, messages even the medical community wanted to hear. Research papers trumpeting the foetal dangers of cocaine were eleven times more likely to be published in professional journals than those claiming few or no harms, according to the British medical journal The Lancet, which analyzed all the "crack baby" studies submitted to the Society of Paediatric Research during the eighties. Moreover, the "negative" studies were better, controlling more effectively for other foetus-damaging factors and taking more care to verify cocaine use, The Lancet found.

Yet the myth of the "crack baby" grew ever larger. Syndicated columnist Charles Krauthammer dismissed "crack babies" in 1988 as a "biologic underclass whose biological inferiority is stamped at birth." Boston University president John Silber criticized "spending immense amounts on crack babies who won't ever achieve the intellectual development to have consciousness of God." The New York Times declared "crack babies" unable to "make friends, know right from wrong, control their impulses, gain insight, concentrate on tasks, and feel and return love. " Even Rolling Stone condemned "crack babies" as "like no others, brain damaged in ways yet unknown, oblivious to any affection."

Reporters sent out to write "crack baby" stories sometimes got their facts right without knowing it. After forty-odd inches of horror stories of low-income women giving birth to "crack babies," the Wall Street Journal, in a typical July 1989 front-page article, let drop that "their mothers aren't all low income. Linda, an impeccably dressed 34-year- old, now looks more like the accountant she once was than a recovering addict who once had a $2,000-a-week crack habit." Turns out, the Journal reported, "her son was born healthy." No explanation was offered as to why a woman smoking $2,000 worth of crack a week can give birth to a healthy baby. And no connection was made to the fact that, unlike every other mother in the article, Linda is an impeccably dressed accountant who likely had health insurance and proper care.

Getting poor women to stop using drugs during pregnancy wouldn't have guaranteed healthy babies, but it certainly would have helped. Even if the effects of drug exposure in utero are relatively short-lived, the home of a crack addict is no place for a baby to grow up. Infants of crack users frequently show up in the hospital again, dehydrated, underfed, filthy, and sometimes injured. If only for the sake of babies after they are born, getting pregnant women off drugs would have been not only humane, but a genuine bargain. The cost of caring for babies neglected and abandoned by crack-using parents was estimated in 1989 in the hundreds of millions of dollars a year.

Yet the federal government refused to pay for residential drug treatment for the poor because it classified drug abuse as a mental illness, and under Medicaid rules that was a state responsibility. The states were similarly unwilling or unable to provide care. Of the various drug- treatment programs in New York City in 1989, 54 percent refused pregnant women, 67 percent refused pregnant women on Medicaid, and 87 percent specifically denied treatment to Medicaid women dependent on crack. Only one hospital in the entire Chicago metropolitan area had a residential treatment program for pregnant addicts, and the program had only two beds. The state of Indiana had only sixteen beds for the treatment of pregnant addicts. Nearly a third of the women living in California had no prenatal care at all, let alone treatment for prenatal drug abuse. "We seem more willing to place the kid in a neonatal intensive care unit for $1,500 or $2,000 a day, rather than put $1,500 into better prenatal care," one psychiatrist complained to Time.

Jennifer Johnson, a black twenty-three-year-old mother of three living in Seminole County, Florida, tried several times during her fourth pregnancy to get treated for her cocaine addiction. "I thought that . . . if I tell them I use drugs they would send me to a drug place or something," she later testified. Alas, there was no "drug place" for her in Seminole County. What there was instead was jail, and the confiscation of her newborn.

When she delivered her baby on January 23, 1989, the attending doctor recorded that the baby "looked and acted as we would expect a baby to look and act." But Johnson told the doctor she had used cocaine during the pregnancy, and urine tests on mother and child bore that out. The hospital reported the birth of a "crack baby" to a state childprotection agency, which in turn called the local sheriff, who ordered Johnson's arrest.

Assistant state's attorney Jeff Deen had been waiting for just such a case to test a new prosecution tactic. Deen was fed up with seeing pregnant women get away with abusing their unborn children by using drugs. When Deen heard about Jennifer Johnson, he decided to charge her with delivering cocaine to a minor. Courts throughout the country had held to the legal doctrine - which lies at the heart of abortion rights - that a fetus is not a person in the eyes of the law. But Deen had a new argument: In the sixty seconds between the baby's birth and the cutting of her umbilical cord, Johnson had "delivered" cocaine to her baby through the cord.

Judge 0. H. Eaton Jr. of the Seminole County Circuit Court declared himself "convinced" and convicted Johnson, sentencing her to a year of house arrest and fourteen years probation. Jennifer Johnson thus became the first woman to be convicted of the special crime of using drugs while pregnant. The Court of Appeals for the Fifth District affirmed her conviction.

Given Johnson's repeated attempts to find treatment for her drug abuse, Eaton's decision seems particularly cruel. "Pregnant addicts . . . have a responsibility to seek treatment," he ruled. The same judicial reasoning applied in the 1988 prosecution of a heroin addict in Butte County, California, who was convicted of birthing a drug-tainted baby after making Herculean efforts to get treatment. For months, she travelled 130 miles round-trip to a private methadone clinic that charged $200 a month. When her car broke down, she hitchhiked. When her money ran out, the clinic stopped treating her, even knowing she was seven months gone. Visibly pregnant, she asked several doctors and clinics in her area to help her, but none would do so. Twenty-four hours after giving birth, the district attorney confiscated her baby and charged her. "I don't see people making a choice unless you force them," he explained.

As has often been the case in the War on Drugs, the drug warriors wanted it both ways. Drugs are immoral, Bennett's drug office was saying at the time, because they "enslave" people and "take away their ability to function as free citizens." Yet when people fall into the "slavery" of drug use, they are prosecuted for making a bad "choice."

It is no accident that the first woman prosecuted for prenatal drug abuse was black. During a single month in 1989, Ira Chasnoff and his colleagues collected urine samples from every pregnant woman who visited a public health clinic or private obstetrician in Pinellas County, which contains St. Petersburg and is the fourth most populous county in Florida. They found that equal percentages of both black and white women - about 15 percent - used drugs during pregnancy. But the black women were ten times more likely than the whites to be reported to authorities for drug use. And the poorest women - with incomes of less than $12,000 - were seven times more likely to be reported than those earning more than $25,000. Private hospitals and obstetricians weren't about to intrude on their paying customers' privacy with a drug test, but public hospitals often were required to do so. Typical was South Carolina, where one characteristic used by public hospitals to identify "probable drug users" for testing was "no prenatal care or late prenatal care (24 weeks)." In South Carolina, Medicaid doesn't cover prenatal care before nineteen weeks.

"If these mothers were walking away from treatment, I might feel differently," said the director of Family and Children's Services in San Francisco. "But they are not walking away from treatment. They are walking away from waiting lists."

With drugs at the top of every pollster's list, the country walked away from treating pregnant users. In one national poll, almost half thought prenatal drug abuse should be a criminal offence. Which perhaps isn't surprising, given such headlines as (in the Washington Post) CRACK BABIES: THE WORST THREAT IS MOM HERSELF and SHE SMOKED CRACK, THEN KILLED HER CHILDREN. Senator Pete Wilson of California in Iggo asked Congress to give treatment funding only to states that make it a crime to give birth to a drug-tainted baby, a classic Catch22: few pregnant women would seek drug treatment in a state where doing so invited jail and loss of the baby. In Florida, where such a law was already on the books, doctors complained to the St. Petersburg Times that pregnant women withheld important information about their drug use "because word had gotten around that the police will have to be notified." San Francisco deputy city attorney Lori Giorgi began noticing an increase in "toilet-bowl babies"- born at home or in secret. "They're afraid their babies will be taken away," she concluded.

If they birth them at all. In one Washington, D.C., case, a woman "miscarried" days before appearing before a judge who'd threatened to jail her because he thought she was using drugs while pregnant. Researchers reported being told often about such abortions. This is particularly ironic, since the movement to prosecute drug- using mothers gets much of its steam from the anti-abortion movement. Such prosecutions create a legal division between mother and fetus that doesn't exist elsewhere in the law. If a woman can be prosecuted for drugging her unborn baby, why not for killing it?



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