During the mid-1980s, so-called crack babies became an icon of the havoc wreaked by cocaine and a catalyst for new laws targeting pregnant women.
Hospitals began testing pregnant women for the drug and states started jailing addicted mothers and taking custody of their children. The media warned of the creation of an underclass of exposed infants born with devastating birth defects and permanent brain damage.
Twenty years of medical research have shown the prenatal effects of cocaine to be far less severe than the "crack baby" legend suggests. But the myth has resurfaced with the spread of methamphetamine and led to new labels: "meth babies" and "ice babies."
"As a country, we're on the verge of making the same mistakes with meth as we made with cocaine," said Brown University researcher Barry Lester. Lester is among 90 doctors and psychologists who recently signed an open letter urging the media to avoid such labels, which they say lack scientific validity and stigmatize children.
"Drug use needs to be treated as an illness and not a criminal activity," said Lester, director of Brown Medical School's Infant Development Center in Providence, RI. "The labels demonize women, but it's the kids who really suffer. If we expect a child to fail, he'll fail, and it won't have anything to do with the drug."
This is not to say that crystal methamphetamine is harmless.
Sharon P. McCully, a 3rd District juvenile judge in Salt Lake City, estimates that about 90 percent of the mothers she sees in child welfare cases are addicted to the powerful stimulant.
"We do know if mom is using meth, the kids are neglected," said McCully. "These parents become consumed with the next high and can sleep for hours when they finally crash. They may not abuse their kids, but they often neglect them."
No state agency collects data on the number of babies born in Utah testing positive for methamphetamine.
According to the state Division of Child and Family Services (DCFS), alcohol or drugs were a contributing factor in roughly 80 percent of the 1,100 child custody cases in 2004. But how many of those cases are meth-related is unknown.
Mothers and their newborns are not routinely tested for illegal drugs, which is left to the discretion of individual doctors and hospitals. If a baby or mother test positive, the physician is required by law to notify DCFS.
"Most doctors will test, because they don't want the liability of losing a baby," said Wendy Anderson, a spokeswoman for the National Advocates for Pregnant Women in New York City. "Lack of prenatal care can make doctors suspicious, or if the mother isn't gaining weight or has marks on her arm."
Anderson said the U.S. Supreme Court has ruled that a mother needs to be notified she is being tested, which is akin to a criminal search of her body.
"Where it gets sketchy is when pregnant women check into hospitals to deliver, they are signing consent forms left and right without reading them," said Anderson.
To date, there is no conclusive research on the long-term effects of meth in the womb.
But Lester is among a group of researchers hoping to change that. Granted $6 million by the National Institute on Drug Abuse, he and others have been studying the development of meth-exposed children from five cities. The study is still young. But Lester said so far, "the effects we're seeing at birth are very similar to effects we saw with cocaine."
Infants exposed to cocaine or its crystallized cousin, crack, tend to weigh less than non-exposed babies. Their IQ scores are 3 to 4 points lower on average and they exhibit a slight increase in behavior and attention problems - similar to the effects caused by cigarette smoking.
"There are subtle differences. Nurses will sometimes describe meth-exposed babies as being in an insulated sleep state. They're hard to arouse and when they do wake, hard to soothe," said Lester. "But you're not looking at a baby who will wind up institutionalized. You're looking at a baby who is very treatable."
More than the chemical effects of a drug, children born to substance-abusing parents face other risks.
"Whether the biologic risk manifests itself often has a lot to do with the postnatal environment," said Karen Buchi, a pediatrician at the University of Utah. "It's not just the drug, it's the lifestyle you lead when you're an addicted person. Addicts tend to engage in risky behavior."
But Lester says, contrary to reports of meth being instantly addicting and impossible to kick, treatment works.
The federal government's most recent National Survey on Drug Use and Health found that 4.9 percent of Americans have used methamphetamine at some point in their lives, but 0.6 percent used it within the past year.
Luciano Colonna, executive director of the Harm Reduction Project of Utah, said studies show women succeed better in treatment when they are allowed to continue rearing their children.
Children allowed to stay with their moms also fare much better than those swept into foster care, said Colonna. "These aren't pregnant women who become substance abusers, they're substance abusers who get pregnant. You can be a bad parent and a drug user, but being a drug user doesn't necessarily make you a bad parent."
Advocates are pressing policymakers to abandon proposals to punish addicts.
Speaking earlier this year to a congressional committee exploring solutions to stop the spread of methamphetamine, Lester urged states to enact legislation protecting mothers who voluntarily seek drug treatment from having their children taken away.
Utah Babies At Risk
One juvenile judge in Salt Lake City estimates 90 percent of the mothers she sees in child welfare cases are addicted to methamphetamine. Infants taken from mothers using drugs, including meth, made news in several Salt Lake County cases this year:
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