Crack Baby Theory Debunked  

Infants and toddlers whose mothers used cocaine during pregnancy don't seem to have brain abnormalities or developmental problems attributable to the drug, according to a new analysis of research done over the last decade.

The study disputes the stereotype of the "crack baby" -- a pathetic, permanently damaged person unlikely to live a normal life. It does not, however, absolve cocaine of any damaging effect during pregnancy, or declare the drug safe for expectant mothers.

"There is no need to assume that [cocaine-exposed babies] are a doomed generation or a biologic underclass, which is what was said about them initially," said Deborah A. Frank, a pediatrician at the Boston University School of Public Health. "The idea that these children are uniquely 'unteachable' or somehow out of control is simply not supported by the data."

Writing in today's Journal of the American Medical Association, the researchers concluded that many developmental abnormalities attributed to cocaine exposure "can be explained in whole or in part by other factors, including prenatal exposure to tobacco, marijuana, or alcohol, and the quality of the child's environment."

The conclusions are valid only for children up to age 6 because longer-range evaluations are not finished. The National Institute on Drug Abuse, a branch of the National Institutes of Health, is following 14 groups of cocaine-exposed children.

"There are some subtle developmental outcomes that many laboratories are beginning to see as children get close to adolescence," said Alan I. Leshner, director of NIDA. "We need to be careful not to fall prey to a false sense of security."

Frank and her colleagues looked at 36 studies in which drug tests were given to women during pregnancy, or to their babies at birth. The children's development was then followed over time.

Many of the women used numerous drugs, including legal ones such as tobacco and alcohol, and many had other risk factors for delivering unhealthy babies, including poor diet, lack of prenatal care and poverty.

With so many variables at work, discerning cocaine's contribution to bad outcomes has been difficult. Most of the 36 studies -- all published previously -- tried to do that. What the researchers did was look at them together to determine a trend.

As a generality, the studies found that when a woman used alcohol and tobacco, or alcohol and marijuana, cocaine use had little or no "incremental impact" on her child's risk of problems after birth.

Specifically, cocaine had no lasting effect on physical growth; it generally did not affect the cognitive ability of infants or young children; it did not affect language skills (although few studies looked at this question); and a deleterious effect on motor skills that some researchers had found seemed not to extend beyond the first six months of life.

The most difficult area to assess was cocaine's possible effects on social behavior, mood and attention. Several studies found that cocaine-exposed children showed less joy, sadness or interest in learning tasks. Overall, though, children of cocaine-using mothers have no clear-cut behavioral problems.

Only some of the studies compared women who used cocaine (and other drugs) with women who used no drugs. Consequently, it's not possible to conclude that cocaine confers no risk -- only that its effects are similar, and not more severe, than other known risks to infants.

Previous research has shown that cocaine use raises the chances that a baby will be born prematurely, or will have a low birthweight, twofold to fourfold. Preterm birth and low birthweight also are risks for developmental problems.

In recent years, prosecutors in many states have tried to detain, forcibly treat or punish pregnant women found to be taking illegal drugs. In most cases, the women were compulsive users of crack cocaine.

In 22 states where the charges were challenged, courts have ruled in favor of the women. Last week the Supreme Court ruled that a South Carolina hospital overstepped its bounds in 1989 when it tested the urine of pregnant women for drugs and forwarded the results to police. Thirty women were arrested under that program, which was abandoned in 1994.

David S. Cohen, a lawyer with the Women's Law Project in Philadelphia, said most attempts to treat drug use during pregnancy as a crime occurred in the early 1990s "in direct response to the original hype of the so-called 'crack baby.' "

While such actions are rare today, "we still occasionally hear of prosecutions of pregnant women around the country," he said.

To view the entire article, go to http://www.washingtonpost.com/wp-dyn/articles/A1700-2001Mar27.html

 Ecstasy Panic Looms: 1985 All Over Again?
  from the DRCN  

In signs of an impending moral panic, in the last three weeks, media outlets across the U.S. and Canada have published a spate of Ecstasy (MDMA) scare stories, with a major Time magazine article hitting the newsstands this coming week.  The stories, clustered in the San Francisco Bay area, Western Canada, the U.S. Midwest, Toronto and Florida, tend to follow a similar pattern: young person dies after ingesting Ecstasy (or often another drug sold as Ecstasy); drug fighters raise hue and cry; reporter describes exotic rave scenes; police issue ominous warnings of impending doom.  

This flurry of interest bears a remarkable resemblance to previous drug panics, including the Ecstasy panic of 1985, when the drug emerged in Texas nightclubs and was being touted in press reports as the "yuppie drug."  Headlines like "Madness, Not Ecstasy" and "The Agony of Ecstasy" (which has lamentably been reached for again by more than one uninspired headline writer) prodded the DEA to undertake an emergency reclassification of the drug to the prohibitive Schedule I, severely increasing criminal penalties for its use and distribution.  

Now, fifteen years later, the Ecstasy menace again threatens the nation.  Or does it?  In the University of Michigan's annual surveys, high school seniors report a slight upward trend in experimental use, from 5.8% in 1997 to 8% in 1998. Still, the number using Ecstasy on a monthly basis is so low -- less than one percent -- that the drug doesn't even register on the federal drug use survey.  

Still, based on a handful of reported deaths and an increase in the amount of the drug seized by Customs authorities, federal officials began hyping the threat.  Last November, NIDA began a web site, , as part of its public relations campaign against Ecstasy, and Customs officials show up as sources for many of the stories.  In a May 19 San Francisco Chronicle story on Ecstasy, Mike Fleming, Customs spokesman in Los Angeles, tells the reporter, "It's out there in great quantities.  American teenagers have fallen in love with it... it's a serious drug with serious side effects.  We call it 'lobotomy in a pill.'"  

In Florida, the state's new drug czar (an alumnus of the National Office on Drug Control Policy) has been caught exaggerating the threat from Ecstasy and other "club drugs." After last summer's Operation Heat Rave, a statewide raid on the clubs, Florida state drug experts decided they needed proof of the deadly epidemic.  They claimed to have found a total of 254 club drug deaths, but the Orlando Sentinel ripped those findings to shreds (previous WOL coverage at http://www.drcnet.org/wol/138.html#floridacount).  

The Florida paper found that the drug fighters had included every death that tested positive for a list of some 20 drugs, some widely used in the rave scene, some occasionally used, and some not even linked to that scene.  Even worse, the numbers included such hard-partying teens as the 58-year-old man who died after a heart bypass, an infant crib death, middle-aged methamphetamine users and terminal cancer patients.  

Now, with more than half of the "club drug" deaths being rightfully attributed to other causes, the Florida drug czar's credibility is severely damaged, and even NIDA is concerned.  "Questionable data on the nature of the problem will tend to put all data in question... There's a tendency not to believe any of that government drug data," a NIDA researcher told the Sentinel.  

Observers less excitable than those Florida officials recognize that MDMA is a relatively safe drug with a low death rate, although its use does carry with it serious health concerns.  In the short term, the greatest danger (and the cause of most Ecstasy-related deaths) is "overheating," caused by the drug's effects on the body's ability to regulate body temperature.  According to Rick Doblin of the Multidisciplinary Association for Psychedelic Studies (http://www.maps.org), overheating deaths represent a tiny minority of Ecstasy users, and the best available numbers back him up.  The national medical emergency room survey, DAWN, reports a total of 27 deaths from 1994 through 1998. And, Doblin notes, simple harm reduction measures (drink lots of fluids, move to cool or air conditioned areas) can virtually eliminate that threat.  

The primary long-term health concern with MDMA remains its impact on serotonin production and changes in brain structures.  The research in this area is not conclusive, but some scientists warn of possible memory loss or premature aging as a result of repeated use.  Again, Doblin demurs, pointing out that these possible effects are "clinically insignificant," meaning that no research done thus far has found statistically conclusive evidence of quantifiable behavioral change.  

Some of the recent deaths that have fueled press attention are in fact not from Ecstasy but from substitutes sold to unsuspecting consumers as Ecstasy.  Two Chicago area youths who thought they were taking Ecstasy died when the pills they ingested turned out to be PMA (paramethoxyamphetamine), a more dangerous substance.  Still, this fact did not stop the Chicago area press from parroting alarmist information from local police and prosecutors.  As area police went on the alert for Ecstasy, however, other area papers were forced to admit "Ecstasy Drug Not Yet an Epidemic in the Region," (Munster Times).  One suburban Chicago policeman was quoted as saying "no arrests" had been made in his district; another worried, "I don't know how bad it is now.  I want to focus on how bad it is."  

It is worth noting that much of the risk associated with Ecstasy derives from adulterants or substitutes, as was the case in Chicago.  DanceSafe (http://www.dancesafe.org), an Oakland-based Ecstasy harm reduction organization, has reported that 20% of the tablets tested at local raves were not Ecstasy, with that figure rising to 40% for samples sent to its offices from elsewhere in the country.  In the forthcoming Time article, the writers describe an Oakland rave where nine people required hospitalization; DanceSafe confirmed that all but one had actually taken something other than Ecstasy.  

None of this has prevented law enforcement and elected officials at all levels from pursuing efforts to heighten penalties for MDMA use and possession.  Senators Charles Grassley (R-IA) and Bob Graham (D-FL) recently introduced the Ecstasy Antiproliferation Bill, which would dramatically decrease the amount of the drug sold needed to trigger serious trafficking charges.  In Illinois, the Chicago Tribune reports, a move is afoot to elevate Ecstasy sales from a Class 3 to a Class X felony, which imposes a mandatory minimum sentence of at least six years.  Class 3 felony sentences, on the other hand, range from probation to a maximum of two years.  

And the drug itself is not the only target.  Officials in Chicago, Toronto and Vancouver, among other places, are using the Ecstasy scare to attack raves, the popular all-night dance parties around which a young counterculture is centered.  In Chicago, the City Council quietly passed an ordinance to inhibit raves.  After the death of a 20-year-old at a Toronto rave last October, authorities there are considering a variety of measures to restrict or ban the parties.  

The combination of a vibrant youth counterculture -- the rave scene -- and a pleasure-enhancing drug such as Ecstasy is a fertile breeding ground for a full-blown moral panic.  The forthcoming article in Time is reasonably balanced (although visit http://www.maps.org/research/mdma/time.html for some criticisms), but other media, law enforcement and elected officials have their own motivations for exaggerating or sensationalizing the issue.  If the past is any indication, we may well be in for the Summer of Ecstasy, and such frenzies usually result in a new round of harsh criminal penalties for the substance in question.  And why not?  After all, Ecstasy is "no different from crack, heroin," according to an Orlando detective quoted on 60 Minutes II in April.  

Commentary on the MDMA panic

Yup, looks like Ecstasy is going to be the Great Satan of the Month Again. The article is pretty factual. Main physical dangers from E., like most psychedelics, are overheating or heart irregularities, but occur only if too much is taken or if the person is in an overheated, poorly ventilated space, or has a pre-existing heart condition. Overdoses are mainly an artifact of prohibition - - you can never be sure of the dose from the stuff you score on the street. Even being in an overheated area probably isn't risky to one's health unless you combine a heavy dose with something like alcohol. A good remedy in cases like that is just a wet cloth on the forehead. Actually, I know of a "certain person" who has used psychedelics under 100+ degree temperatures with no problems.

If one does have a heart condition, one can overcome the problem of rapid heartbeat by taking a beta-blocker such as propanolol (this works with cocaine and amphetamine, also).

The "problem" of changes in neural structure is also controversial - - they only seem to show up with heavy use, and there hasn't been any demonstration that they are actually damaging. It may even be that moderate use of E. or psychedelics promotes neuronal interbranching and increased blood flow to the brain, which may mean that use actually may enhance intelligence - - see the research done by Dr. Charles Grob at Harbor-UCLA Hospital.

The Straight Dope on Rohypnol
by Robert G. Weber, Jr.

Well, it looks like the evil geniusses at Hofmann-La Roche who try to unleash drug menaces on the American People have been foiled again. Igor and company working down in the dungeon laboratory came up with a horrifying drug called Rohypnol which was a threat to the well being of every American and the virtue of the female side of the population. Fortunately, our wise shepherd-guardians in the government were on the ball and exposed and crushed the evil plot (or so the public has been led to believe.). Congress hurried through a bill to criminalize the possession of Rohypnol and to outlaw its use to knock somebody out in the commission of a felony with only one dissenting vote. (More on that later.) President Clinton rushed to sign it. Truly, Rohypnol is the latest Great Satan of the War on Drugs.

Actually, Rohypnol TM is quite a useful drug. Known more technically as flunitrazepam, it is a close cousin to diazepam, or Valium TM, also a Hofmann-La Roche product. It is sold in over 65 countries and is used for much the same purposes as Valium TM: as a minor tranquilizer, a muscle relaxant and antispasmodic, as a pretreatment for surgery (it lowers blood pressure, thus reducing bleeding during surgery), and as a sleep aid. It is several times as potent as diazepam (potency is always a bad thing in Drug War Theology, witness the scares over high potency marijuana and manipulated nicotine levels in cigarettes.) Since its toxicity is not proportionately increased, this means that its index of safety, or the toxic dose divided by the therapeutic dose is much greater than diazepam, which is in turn much greater than drugs like the barbiturates.

One of the unfortunate effects of the hypnotics, which include Rohypnol, Valium, the barbiturates, chloral hydrate, and others, is that they combine synergistically with alcohol to multiply their effects, which can catch a naive user unaware. The Mickey Finn, a stock item of detective fiction for the last hundred years, was chloral hydrate slipped into a persons alcoholic drink. Some individuals have deliberately combined hypnotics and alcohol as part of their drug use, notably the poet/painter Dante Gabriel Rossetti, who combined chloral hydrate and alcohol, and the actor Bela Lugosi, who combined alcohol and paraldehyde (NOT formaldehyde, it and paraldehyde are two completely different chemicals.) The combined effects of hypnotics and alcohol produce enhanced intoxication in small doses and with larger doses can cause loss of consciousness with a degree of amnesia. (Lugosi and Rossetti probably used the amnesiac effects to hide the pain of their personal lives.) In even larger doses it can depress the central nervous system enough to cause death. Actresses Mary Ure and Billie Carleton inadvertently killed themselves in this way. The famous case of Karen Ann Quinlan was a similar happenstance.

So Rohypnol is a safer form of Valium which is safer than barbiturates--so why was it outlawed? Unavailable in this country because of the usual FDA footdragging with approving new drugs, it was used in a few sensational cases of date rape. (As I mentioned, any of the other hypnotics could have been used as well.) The Rohypnol scare has the classic pathology of a drug scare: The triangle of several lurid and hysterical stories in the press, alarmist warnings from law enforcement, and grandstanding by politicians to show they are tough on drugs. Politicians as diverse as Tom Hayden, Orrin Hatch, Dianne Feinstein, and my favorite nutzo drug warrior, New York Republican Congressman Gerald Solomon, all jumped on the Rohypnol bandwagon. Solomon, fresh from trashing the Tenth Amendment with his bill mandating 48 hour insurance coverage for maternity, delivered an uppercut to the Tenth with another bill outlawing the use of a drug in the commitment of a felony. For the first time, and with no constitutional authority, slipping someone a Mickey Finn is now a federal offense, along with such other newly created federal offenses as scrawling graffiti on the side of a church. ("Make a federal offense out of it," meaning to react all out of proportion to a situation, is a phrase you never hear anymore: today, everything is a federal offense. Come to think of it, you never hear the phrase "it's a free country," anymore, either.) There is now a three year federal sentence for mere possession of Rohypnol and a twenty year sentence for its use in a felony. The extreme punishment for its use has the interesting effect of proportionately lowering the penalty for use of a firearm or other deadly weapon in a felony instead.

The swift passage of the anti-Rohypnol bill is another illustration that the problem with government is not, as the populists would have it, that government is unresponsive. It is hyper-responsive. The problem with government is not that it lacks reflexes, it lacks brains. Where were the expert witnesses? Where was the cool deliberation? Where was the Constitution? Nowhere to be seen. To the extent that this safer drug is for all intents and purposes condemned in perpetuity, and to the extent that more hazardous drugs will be used instead, with a certain number of inevitable deaths, Congress, Clinton, and the FDA will be indirectly responsible for several hundred deaths each year, at least.

As I mentioned, one and only one Representative voted against the Rohypnol bill, and for this I present her, with a certain sense of irony, the Defender of the Constitution Award. That Representative is L.A. Democrat Maxine Waters, who denounced the bill as a cynical election year ploy. Of two major attacks on the Tenth Amendment this year, namely the Medical Insurance Reform bill and the Rohypnol bill, the only person in either party to vote against either one was none other than Ms. Waters. Not that I claim that Ms. Waters is a principled constitutionalist, any more than anyone else of either party in Washington, but these days one has to take respect for the Constitution anywhere one can find it.

JUST SAY YES!

"The breakfast table may someday feature not only orange juice and vitamins but also a more exotic health booster - - a compound extracted from marijuana."

"Cannabis contains a chemical that can protect cells by acting as an antioxidant, a new study shows. More effective than vitamins C or E, it offers an appealing option for the treatment and perhaps prevention of stroke, neurodegenerative diseases, and heart attacks, the researchers suggest."

--Science News, Vol. 154 (July 11, 1998)

The report in Science News is a digest of a report in July 7 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES. The researchers found that cannabadiol (CBD), a component of marijuana, does a great job of quenching the free radical toxins typically released in strokes; in fact, it's a great fat-soluble type antioxidant overall. The researchers hasten to add that CBD isn't the stuff in cannabis that makes you feel good (actually, it has something of a reputation as being the stuff in ditch weed that gives you that yecchy feeling, though I know of no studies that actually confirm this.) Interestingly, tetrahydrocannabinol (THC, the stuff in grass that makes you feel good) is just as effective as CBD, according to the researchers. (But God forbid anything good for you should actually make you feel good!) CBD and THC are actually chemical isomers - - they have the same number and type of atoms but differ slightly in their structure - - like lactose (milk sugar) and sucrose (cane sugar).

What this suggests is that habitual users of cannabis should suffer fewer strokes, Alzheimer's and Parkinson's cases, and heart disease than non-users. Sounds like we need some long term studies on the manner.