"Doctor, you wouldn't believe what I see every week" remarked one of my patients. She was a social worker deploring that irresponsible young mothers on welfare abuse both the system and their unborn children. She, of all people, trained in the sympathetic care of society, wondered at the folly of it all.
Patient X has a caseload of 200 women ranging from 16 to 29 years of age. In her Toronto office there are 16 other social workers with the same caseload. Add it up across the country it represents a huge number of women.
My patient claims many of her cases involve young women glassy-eyed from taking crack cocaine. They are given $550.00 and they go on their way, intending not to buy food, but drugs. Many are pregnant and every time they bring into the world another drug-injured infant they get more money. She wonders how long we can tolerate such a situation, and so do I.
Dr. Gideon Koren, Professor of pediatrics at the University of Toronto, is dedicated to the well being of women and their unborn babies. He's the author of the book "The Children of Neverland", about a silent human disaster.
Dr. Koren remarks, "Neverland is the place where many children will reside permanently, not being able to reach their full potential. When millions of children world wide are afflicted by drugs, illness or poverty this stops being a scientific issue and turns into a global disaster."
Cocaine is produced from the leaves of the cocoa plant. For thousands of years Indian tribes were aware of the potential pharmacological effects of the leaves when chewing them.
The active ingredient, cocaine, has potent effect, inducing mood elevation, optimism, anti-fatigue and initially better sexual performance.
These "adrenaline-like" properties made cocaine popular among young professionals in the 70s. Sniffing it gave them longer hours of effective work, more positive and optimistic attitudes and uninhibited sexual drive.
But eventually the bad news about severe adverse effects hit the media. Several well publicized incidents hit the news of famous athletes who died from heart attacks and bleeding in their brains, the effect of cocaine on heart rate and blood pressure. This scared many middle and upper class users. And the ill effects of cocaine on unborn babies forced many yuppies to stop using it.
During the 80s and 90s cocaine and its free base form (crack) has been used more and more by low-middle and low class adolescents and young adults.
Studies in American inner cities show that up to 40 percent of sexually active young women have used cocaine. Consequently many unborn babies have been exposed to this drug. This has raised concern about the long-term effects of cocaine on millions of children.
For a few years the medical community harboured a major misconception, that the placenta acted as a barrier preventing dangerous chemicals from reaching the fetus. Then the thalidomide disaster destroyed this theory. Now we know that cocaine can be found in the urine and blood of newborn infants whose mothers have used cocaine.
Some people argue that testing for cocaine infringes on women's rights. But is cocaine abuse any different from other types of abuse? As Dr.Koren says "Few would argue that it's ethically wrong to X-ray the bones of a child suspected of being physically abused."
Now all studies show overwhelmingly that cocaine exposure in pregnancy is associated with serious health hazards to the fetus.
For instance, cocaine-exposed children are more likely to suffer growth restriction, stillbirth and premature separation of the placenta. And the effects of cocaine on fetal brain development is a major concern. A Chicago study of cocaine-exposed children at three years of age has worrying implications. Researchers discovered that these children had smaller head circumferences, an objective measure of brain development.
Crack cocaine babies unfortunately face more than one risk. All too often their mothers smoke, drink excessively, take other drugs and develop sexually transmitted diseases. A recent study from an American inner city showed that 15 percent of crack users were infected with the AIDS virus.
So what will society do about these Neverland children? Who is going to stop this social and economic disaster? The answer is no one.
My social worker patient has no power to stop it. And can you believe current politicians will end it? One who would publicly stand up and say these brain-damaged children also have rights. That irresponsible women who have one brain-damaged child after another should be sterilized. Hell will freeze over before this will happen.
If this column doesn't worry you, read Dr. Koren's book. It can be obtained by sending $25.00 to "Dr. Gideon Koren, 555 University Avenue, Toronto, Ontario, M5G 1X8.
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