CRACK Comes to New York

Group Pays Addicts for Sterilization

At a rancorous press conference several weeks ago, a controversial nonprofit called CRACK (Children Requiring a Caring Kommunity), which offers drug addicts and alcoholics $200 to go on long-term birth control or get sterilized, announced the opening of its first New York chapter. Relying solely on private donations and a fierce publicity campaign, founder Barbara Harris has successfully opened chapters all over the country, from Dallas to Washington, D.C., earning both intense support and outraged criticism. With a building outreach program, CRACK receives referrals from jails, treatment centers, and AA groups, among other places, and has paid 796 people so far to get temporarily or permanently sterilized.

Harris of Anaheim, California, started CRACK (also known as Project Prevention, a less contentious name) about five years ago out of anger at pregnant addicts who exposed their babies to drugs or alcohol before birth. Her own four foster children had to be tended through drug withdrawal and later behavioral problems—complications she never experienced with her three birth children. The ex-IHOP waitress started a crusade.

At the conference, Lynetta Gaskins, a CRACK client, nervously rose to speak. She recalled her history, including years of turning tricks for cocaine and heroin, contracting HIV, and 12 pregnancies. She had seven babies born addicted to crack, two of them afflicted with gross deformities. "I don't want to see kids born like that anymore," sobbed Gaskins. "If there's any way, then Barbara's is the better way." The group's Web site—which uses the Project Prevention name—states that as of early September the program had paid 768 women to get their tubes tied or to go on long-term options like Norplant and Depo-Provera. Taken together, these women had conceived 3809 times, with 2435 live births resulting. But 1396 of those children still remain in foster care due to their parents' inability to care for them.

The National Institute on Drug Abuse (NIDA) estimates that since the mid 1980s up to a million children have suffered cocaine exposure while in the womb. Also, according to the U.S. General Accounting Office, 75 percent of the children currently languishing in child welfare custody are there for circumstances related to parental drug use. Though eligible for adoption, newborns whose toxicology screens come out positive for drugs are very difficult to place, says T. Chedgzsey Smith-McKeever, assistant professor of social work at the University of Illinois in Chicago. Jim Woodhill, a smart-talking, right-wing, wealthy venture capitalist, has contributed close to $175,000 to CRACK, alongside other donors such as Dr. Laura Schlessinger, the controversial radio talk-show host. According to Woodhill, "These kids are not going on to be the next generation of happy, successful Americans. Rather, neglect [and/or] abuse in childhood leads to neglecting [and/or] abusing parenthood and the cycle of despair repeats."

CRACK's critics don't deny there are problems nationwide resulting from drug use that sorely need to be addressed, but they are repulsed by Harris's methods. Many have condemned the organization as unethical, discriminatory, misinforming, and even eugenic. But more troubling, says Wendy Chavkin, a professor of clinical public health and OB-GYN at Columbia University, is that CRACK infringes on a woman's reproductive autonomy. "Whether or not to have a child is a profoundly important and private decision. CRACK is offering money [for addicts] to go out and get high in exchange for a fundamental human capacity." Even worse, says Chavkin, it does not offer services that can genuinely change an addict's life, like drug treatment, housing, or job training.

"But I can't solve all the problems in the world!" counters Harris, who largely dismisses her opponents as being "blinded by women's rights issues" at the expense of drug-exposed babies who suffer for no fault of their own. Ninety percent of them, claims Harris, never get rescued from state care by their parents. Truth, though, is that many drug addicts fight to get their kids back only to run up against an unsympathetic system, says Corinne Carey, director of New York's Harm Reduction Law Project, which represents drug addicts attempting to reclaim their children from foster care. "These women are cut off from public housing and welfare, don't get the treatment they need, and have to deal with trying to get their child back on top of it all—there are so many obstacles," says Carey, who adds that untrained case workers misdirect her clients on a routine basis. On top of this, nearly 20 percent of those referred by physicians for substance abuse treatment are denied treatment by insurance companies, according to the National Center on Addiction and Substance Abuse. Getting pregnant often motivates mothers to change their behavior for the better, says Machelle Allen, an obstetrician who runs a prenatal clinic at Bellevue Hospital for pregnant drug addicts. Allen sees CRACK's methods as coercive and neglectful of the underlying problem of addiction.

Letha Grayson, on the other hand, is a supporter of Harris's work. She is the foster mother of seven drug-exposed children, all by the same birth mother. She tells how the mother's drug use has affected her children: One 12-year-old has only recently been successfully toilet trained, and an eight-year-old has yet to walk or talk.

The other five kids, while doing well, she says, are battling more commonplace conditions like hyperactivity and dyslexia. This, then, touches at the core of the issue—the fact that it is impossible to predict how seriously a child is likely to be affected by a parent's drug use.

If science irrevocably concluded that drugs single-handedly create miserable complications in drug-exposed children, CRACK might have a more acceptable case. But the truth is that researchers now recognize addiction as a multi-layered malady with many factors, such as environment and nutrition, influencing it. Admittedly, one NIDA study released this April found that children exposed to cocaine before birth are twice as likely to have delayed mental development by the age of two. However, this study was the only one of 10 large-scale studies to show such a negative effect, researchers wrote in a critical response to the NIDA findings in the Journal of the American Medical Association. What's more, researchers at the Boston University School of Medicine reported this week that trained research assistants who are unaware of a child's history cannot tell the difference between a four-year-old who was exposed to cocaine before birth and one who was not exposed. Perpetuating the myth of "crack babyism" is plain "anti-public health," says Deborah Frank, a medical professor at Boston University and co-author of the new study.

The "propaganda" promoting CRACK's mission is what Lynn Paltrow is most worried about. Paltrow, the group's most outspoken opponent and the executive director of the National Advocates for Pregnant Women, feels that Harris's intentions may be noble, but the tremendous media attention she attracts necessitates a higher level of moral responsibility. "What scares me is that [CRACK] is presenting inaccurate arguments, misleading people to believe that we can easily solve complex sociopolitical problems. This feeds into so many pre-existing prejudices in America," says Paltrow. Also, the program seems like a campaign to stigmatize drug users, says Harry Levine, a sociology professor at Queens College and co-editor of Crack in America: Demon Drugs and Social Justice. "These are a bunch of right-wing warriors stigmatizing 'bad' women!" says Levine, and with a "crummy bribe" to boot. Given that CRACK's outreach is bringing a clientele that is largely people of color, there is of course another kind of associative stereotyping linking addicts and race.

Though Harris has raised thousands from right-wing donors, politics seem far from her mind—but so do ethics, a long history of racial prejudice, and what it means to promote inaccurate stereotypes. She feels she is protecting the rights of unborn children, but in her single-minded and rather simplistic war against pregnant drug addicts, Harris has forgotten that it is far too easy to blame individuals rather than the conditions that thwart them.

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