Pubdate: Sun, 10 Jun 2001 Source: Chicago Tribune (IL) Copyright: 2001 Chicago Tribune Company Contact: http://www.chicagotribune.com/ Details: http://www.mapinc.org/media/82 Author: Karen Brandon METHAMPHETAMINE RISE SPARKS WORRY FOR BABIES Research Limited On How The Drug Can Affect A Fetus OCEANSIDE, Calif. -- In the moments just after her daughter was born five weeks ago, Cassandra Farrell cradled the baby in her arms and apologized for having used methamphetamines during her pregnancy. "You feel the baby kick when you put the needle in," said Farrell, 29, a waitress who injected the illegal drugs up to five times a day through the seventh month of her pregnancy. "You're aware you are doing something harmful, but you don't care." The effects of methamphetamine abuse on Farrell's life are as painfully obvious as the burgundy scars lining her arms. Her addiction cost her a job, a home and custody of another daughter, now 8. But there is no way of knowing what the toll will be on her daughter, a bright-eyed, apparently healthy infant with a thick crown of dark hair born here in San Diego County, which has the highest rate of methamphetamine use in the country, according to the Maryland-based National Institute on Drug Abuse. Fifteen years after widespread cocaine abuse raised fears that a generation of so-called crack babies had suffered profound and possibly irreparable damage because they had been exposed to drugs in their mothers' wombs, the nation's changing drug abuse patterns are leading to similar concerns about methamphetamine. Methamphetamine is especially attractive to women of child-bearing age because it helps them lose weight by suppressing appetite. Those who care for young children while holding down jobs also are attracted to the drug because it reduces fatigue and boosts energy. Long-term users show some of the same brain damage seen in stroke victims and Alzheimer's disease sufferers. They also can suffer from paranoia and hallucinations. Though crack remains the largest drug problem among urban blacks, its use has waned among other groups. But the use of methamphetamine, cheaper than cocaine and relatively easy to make, is on the rise. Because methamphetamine popularity is relatively new, there is little data on its effects on fetuses. The National Institute on Drug Abuse put out a call last spring for research. "We have to be very careful and understand the complexity of this," said Alan Leshner, the institute's director. Otherwise, he said, a generation of children with potential could be written off, or children who genuinely need help could be ignored. Rizwan Shah, medical director of the Drug Affected Babies Clinic at Blank Children's Hospital in Des Moines, is one of the few U.S. pediatricians to study children exposed to methamphetamine in the womb. Once, 80 percent of her patients were exposed to cocaine. Now 80 percent of the infants are exposed to methamphetamine. Her project, started in 1993, has tracked 360 children, finding that they tend to be born prematurely. Full-term babies act more like premature infants, often showing difficulty in sucking and swallowing. They are very sensitive to touch and often shake, she said. "Even changing their clothing or getting them a bath can get them stressed out," she said. "We're talking about a child who gets purple and blue from crying so hard." Some babies suffer strokes or brain hemorrhages before birth because the mother used such a high dose it caused a rapid blood pressure rise in the brain. Older children seem to have more limits on their expressive language. "Fortunately, they show an excellent chance of recovery," she said, adding that none of the children she has studied is mentally disabled. There has been more research on the effects of alcohol, heroin and cocaine on the developing fetus than on methamphetamine, and no reliable estimate exists for the number of infants prenatally exposed to the drug. The only national survey aimed at measuring drug use among pregnant women was done by the drug abuse institute in 1992. It found that about 5 percent of the 4 million women who are pregnant each year used some illicit drug. Only a tiny fraction reported using methamphetamine, but the survey was done before the surge in the drug's popularity. Leshner said methamphetamine use is spreading throughout the West, Midwest and rural America. Worldwide, it is second only to marijuana as the most widely used illicit drug, with more users than heroin and cocaine combined, according to the World Health Organization. The federal drug abuse agenda, historically dominated by drugs that plague Eastern urban areas, was slow to address the emergence of methamphetamine, said Richard Rawson, associate director of the Integrated Substance Abuse Program at the University of California-Los Angeles School of Medicine. "Methamphetamine, being a West Coast, rural problem, just didn't draw the same attention that the crack epidemic in the big Eastern urban centers did 15 years ago," he said. For these reasons, Rawson said, the drug's popularity is unlikely to be a passing fad. "As long as people need to work long hours in tedious, physically demanding jobs, and as long as people want to lose weight, the attraction of methamphetamine is likely to remain." The drug has the potential to be more damaging than cocaine because its effects last longer. In adults its high may last for 12 hours, compared to the half-hour high of cocaine. "It's staying in the baby's system longer, and certainly has the potential to be more damaging to the baby's central nervous system," said Barry Lester, a psychiatry and pediatrics professor at Brown University and the main investigator in a long-term federal research project on fetal cocaine exposure. Still, his experiences with research on babies exposed to cocaine suggest that caution is in order when projecting the effects of drugs on infants. The children he is studying, now 8 years old, once were written off as "hopelessly damaged." They have since been found to have small but significant deficits in IQ, specifically in language abilities. They will need more expensive services and they will add to the number of children who fail in school, but the prediction of a lost generation was greatly exaggerated, Lester said. Children in families where methamphetamine addictions are present often are neglected or abused. Because the drug diminishes appetite, addicted parents often neglect to feed children, and the eventual paranoid and erratic behavior that follows long-term use affects their children. Terri Burnett of Vista, Calif., recently gained custody of her 4-month-old daughter, who tested positive for methamphetamine in a urine test just after birth. Burnett, 27, grew up in an upper-middle-class family, earned an associate's degree and never expected to have drugs ruin her life. Until pursuit of drugs became her full-time mission, she found methamphetamine gave her the energy to clean her house, to take care of her children and to work at her job managing an auto repair shop. When she was pregnant, she repeatedly tried to stop using, but she found it eased morning sickness. Her friends offered her drugs routinely, though never food, she observed. She enrolled in a residential treatment program the day before her daughter's birth at the end of January. Now she is trying to regain custody of her two other children, a 7-year-old son and 2-year-old daughter. Her newborn daughter, she said, needs physical therapy to help deal with some stiffness in her limbs, and she is being treated for asthma. "I couldn't stop doing it," Burnett said, "even though I knew it was wrong." - --- MAP posted-by: Beth