FREQUENTLY ASKED QUESTIONS ABOUT COCAINE IN PREGNANCY

1. What is cocaine?

Cocaine is an alkaloid which is derived from coca leaves, most of which are grown in South America . It is a stimulant drug affecting the central nervous system. It makes people feel "high" and full of energy. It is similar in its effect to methamphetamines.

2. What is "crack"?

Crack is a processed form of cocaine which has been treated so that it can be absorbed into the bloodstream more rapidly.

3. What is a "crack baby"?

There is no such thing as a "crack baby". This is a term invented by the media to describe a baby whose mother used cocaine or crack during her pregnancy. Reputable professionals do not describe children this way. Since both the prenatal exposure and the parents' life style are important, such children are usually called, "children of substance abusing parents." It's not as catchy as "crack baby" but it's a lot more accurate.

4. How many women use cocaine in pregnancy?

This is hard to say. Probably between 1% and 5% in most studies. In some areas, like Washington D.C. and Miami , it's probably higher, in some rural areas, lower.

5. What about other drugs?

Most cocaine users are "polydrug" users. That is, they don't just use cocaine. Almost all of them smoke cigarettes, smoke marijuana occasionally, and use alcohol. Some use other drugs like heroin and methamphetamine. Alcohol and cigarettes are much more serious problems than cocaine in this country.

6. How many babies in Georgia are born with evidence of cocaine exposure?

A study carried out by the March of Dimes and the Centers for Disease Control and Prevention found that 0.5% of newborn babies had cocaine in their blood. That is one baby in every 200.

7. Is the rate the same all over the state or is this more of a problem in one area?

Cocaine use by pregnant women was identified all over the state but it was higher in urban areas and among certain disadvantaged groups of women.

8. Does maternal cocaine use cause prematurity in babies?

Maybe. There are some studies that have found a higher rate of prematurity among drug users than in the general population. Other studies have not found this relationship.

9. Does prenatal exposure to cocaine cause SIDS (sudden infant death syndrome)?

There is evidence that women who are addicted to any kind of drugs in pregnancy have children who are at higher risk for SIDS. The risk for babies exposed to cigarettes, heroin and methadone, and/or cocaine is about 5 times greater than unexposed infants.

10. Does cocaine exposure cause birth defects?

There isn't much evidence for a pattern of birth defects in cocaine. Some studies have identified a higher rate of birth defects but the research is really contradictory.

11. How long does the withdrawal from cocaine last in babies?

There is no withdrawal from cocaine. Like other stimulants including methamphetamines, cocaine is not physically addicting in the same way that narcotics are. For this reason, babies do not experience Neonatal Withdrawal Syndrome unless they have also been exposed to heroin, methadone, alcohol or some other depressant drug.

12. But everyone saw pictures of babies on TV who were tremoring and crying. What was that about?

They were probably withdrawing from narcotics which are frequently taken in conjunction with cocaine. You can't believe everything you see on TV!

13. What are the long-term effects on children of being exposed to cocaine during pregnancy?

A few years ago, the media reported that there were very serious problems in exposed children. Now, we understand that most of those problems were caused by neglect and abuse by drug-using parents after the children were born. The only effect that has been found regularly involves arousal regulation and attention. Sometimes more “externalizing” behavior problems are found.

14. Does cocaine exposure cause ADHD?

Probably not. ADHD is the most over-diagnosed disorder among children. Many non-professionals mistake other kinds of problems for ADHD. Since the media started the rumor that cocaine caused ADHD many people, even some medical professionals and teachers, have started believing this story.  We are not yet sure what this relationship is. However, because there may be more difficulty with self-regulation, this continues to be a concern.

15. What's the biggest risk for cocaine-exposed children?

Two things probably. First, neglect and abuse by addicted parents who are not able to care for them properly and, second, labeling by public and professionals who confuse the effects of poor caregiving with the effects of prenatal exposure.

Composed by Claire D. Coles, Ph.D., April, 1996, edition, 2001, 2005