C.R.A.C.K.: Unethical? What About Misogynist, Racist, and Classist? Suzanne Shatila, Samuel A. MacMaster, Jenny Jones, and Katherine Chaffin Children Requiring a Caring Kommunity (C.R.A.C.K.) aims to reduce the number of children bom drug affected by offering money to substance using women to terminate reproductive rights. While the goal of improving the lives of children bom to mothers who use substances may be noble, ensuring that they are not bom is not. It could be suggested that this program is the product of simplistic assumptions by well-meaning individuals who have a misunderstanding of the issues, but a genuine concem for the children of substance users. This article argues that the program is much more insidious; that the very assumption on which it is based denigrates female substance users and harbors a base sentiment that is anti-poor, anti-woman, and anti-minority. If the outcome is the prevention of the birth of individuals who are deemed less valuable than others, then this program is simply a retum to the policies of eugenics.
The rights of marginalized populations have long been the center of debate. In America, in particular, those in power have long tried to place blame at the feet of the poor and disenfranchised for many of America's woes. When someone is an ethnic or racial minority or a woman in addition to being poor, he or she is often a scapegoat for all of society's ills. From the break down of the family to public aid, poor women, more than poor men, often find themselves being targeted by members of higher socioeconomic classes as the root of these social issues. Some organizations, often operating under the guise of helping disenfranchised populations, seek to limit people's rights and the very programs touted as fixing social problems only serve to further alienate these populations. C.R.A.C.K, (Children Requiring a Caring Kommunity) or Project Prevention as it is now known, is a prime example of an organization and program purported to address the needs of a marginalized population, (i.e., poor parents who abuse sub-
Suzanne Shatila, Samuel A. MacMaster, Jenny Jones, and Katherine Chaffin teach at the University of Tennessee, Nashville in the College of Social Work. Journal of African American Studies, Summer 2005, Vol. 9, No. 1, pp. 32-42.
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stances) when in reality it only serves to curtail the rights and liberties of poor women, many of whom are African American and Latina. C.R. A.C.K. was started in 1997 by Barbara Harris in Stanton, California (Scully, 2000) and boasts an organizational objective "to offer effective preventive measures to reduce the tragedy of numerous drug affected pregnancies" (Project Prevention, 2003). Preventive measures include long-term birth control or sterilization in exchange for $200 and a $50 incentive if you refer a friend (Scully, 2000). Since its conception in 1997, C.R.A.C.K. has had 1126 paid clients: 1102 women and 24 men (Project Prevention, 2004). The program works by offering cash incentives in exchange for sterilization. Women are gathered through the use of billboards in African-American and Latino communities stating, "If You Are Addicted to Drugs, Get Birth Control—Get $200 Cash," and "Don't Let a Pregnancy Ruin Your Drug Habit" (Scully, 2000). Project Prevention (2003) also reports that they receive referrals through social workers, probation officers, jails, drug treatment programs, methadone clinics, and police officers. The very nature of the assumptions on which Project Prevention is based reflects racist, classist, and sexist attitudes. While Project Prevention's supporters dismiss the claims of any wrong doing, many of their efforts and the assumptions that are made about the targeted populations, no matter how well meaning they may be, are in actuality anti-poor, anti-women, and anti-minority. Assumptions Related to Poverty Thomas (1998, p. 419) stated, "to be a woman, poor, and fertile in the United states.. .is to be blamed by politicians and social reformers for an increase in poverty and alleged immortality in society." This has been true for over a century now, when the idea of eugenics, including involuntary sterilization of women and men who were thought to be unfit of reproducing, became popular policy. Originally intended to stop the growth of certain populations deemed undesirable to reproduce by middle class, white America in the late 1880s (Carlson, 2003), eugenics forcibly and involuntarily sterilized "criminals, the insane, and feebleminded persons" (Reilly, 1987, p. 153), as well as individuals suffering from epilepsy, alcoholics, and "paupers" (Reilly, 1987, p. 154). Additionally, individuals who had been diagnosed with mental retardation and chronic diseases often faced statesanctioned obstacles when it came to having children (Reilly, 1987). The eugenics movement embodied certain classist and racist attitudes, as the movement gained momentum by blaming unemployment and poverty on certain groups of people, including African Americans and foreign-born citizens (Carlson, 2003; Reilly, 1987). These groups were often blamed for draining American's resources, and it was thought their poverty was genetically programmed. The only way to preserve America's resources and America's way of life was to prevent undesirable groups from reproducing, since their children would only drain America's resources as well, including putting a strain on state foster care systems when their own parents were unable to care for them (Reilly, 1987). Though the official eugenics movement is technically in the past, there has been a resurgence of many of the movement's tenets in recent years. Most famous were family cap initiatives included by different states during the 1990s as part of wel-
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fare reform. By the mid-1990s, several states denied aid to additional children bom to mothers who received Aid to Families with Dependent Children (AFDC). Additionally, many of these states sought to either provide bonuses for women who obtained long-term birth control, such as Norpiant, or introduced bills that would deny women aid if they did not obtain long-term birth control (Thomas, 1998). The message being sent by policy makers at this time was that the sexuality and fertility of low-income women needed to be controlled in order to ensure the well being of society as a whole. Using scare tactics and misinformation, politicians, such as Newt Gingrich and others behind the Contract With America in the 1990s, were able to muster support for their initiatives, thereby inflicting further damage on lower-income communities and marginalized populations by promoting stereotypes while simultaneously denying aid to groups in dire need. Sadly, these methods are similar to those employed by Project Prevention. The idea is clear—the women and men being targeted by Project Prevention are not suitable to reproduce and their children unfairly burden the state foster care system. By promoting the idea of damaged children bom to damaged men and women. Project Prevention has been able to garner support for their program, one that harkens back to the days of eugenics and forced sterilization. Though the "paid clients," (Project Prevention, 2003) as they are called, who utilize these services appear to be undergoing sterilization voluntarily, there is nothing voluntary about asking a man or woman to give up the ability to reproduce for money when under the influence of highly addictive substances. Women who would be willing to trade their reproductive rights for a mere $200 can be assumed to be either of lower socioeconomic status or at the least so deep into the world of addiction that they are desperately seeking money to subsidize their addiction. And because they are poor, or at least in need of money, it is easy for middle class Americans, like Barbara Harris, to use misinformation to target them. Though very few could argue that providing family planning options to substance users is not a positive step in the right direction, the way in which Project Prevention goes about this raises some concerns as well as some serious ethical questions. Assumptions Related to Gender According to Project Prevention's own statistics, as of December 12,2003,1,126 individuals had "made the responsible and logical choice," as its website states, to either become sterilized or obtain long-term birth control, such as DepoProvera or Norpiant (Project Prevention, 2003). Of the 1,126 "paid clients," 1,102 (97.86%) were women and 24 (2.13%) were men. Though Project Prevention's website claims to serve both men and women, it is clear from its own statistics that the number of women being paid to be sterilized or to obtain long-term birth control far outnumber men. Of the 1,126 total clients, 461 choose DepoProvera, 451 choose tubal ligations, 152 choose IUDs, 37 choose Norpiant, and 24 choose vasectomies. A total of 475, or 42.18%, of their clients opted for sterilization over long-term birth control. Of the 475 individuals who were sterilized either through tubal ligations or vasectomies (Project Prevention, 2003), only a fraction, 5.05%, were men while 94.94% were women. Though men and women share an equal responsibility when it comes to concep-
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tion, women often unfairly bear the burden when it comes to blame associated with unplanned pregnancies. This is no less the situation with Project Prevention and is evidenced by the number of men they have served compared to the number of women. Project Prevention's website makes numerous references to children who are being raised in the foster care system due to mothers who were unable to care for them because of their addictions. Therefore, conception and pregnancy are no longer human issues, instead they are presented as uniquely female issues, even though biologically women are not capable of conceiving on their own; poor women who use substances are to blame for the number of children in foster care and for draining America's resources, not poor men who do the same. Included in Project Prevention's website is a section entitled "How We Help the Children," which details aspects of the program. While the information starts out by stating that both men and women are paid to be sterilized, by the end of the section the inclusion of men is no longer evident. After discussing the process regarding how men and women receive money for undergoing sterilization or obtaining long-term birth control, the question of how participants spend the money they receive is raised. The website offers the following: What does she do with the money she has earned from us? We do not monitor where our money is spent, any more than the government monitors where welfare or other related money are spent. We know of several of our clients that have used the $200 for rent payments, diapers and other child related goods (Project Prevention, 2003). Through the exclusion of men from this statement and the linking of clients to welfare recipients, the program is able to convey the idea that poor fertile women are a drain on resources and that they are responsible for bringing damaged children into the world who will continue to be a drain on resources. All of the testimonies from "paid clients" (Project Prevention, 2003) are by women and all of the horror stories included on the website are in regard to children bom to mothers unable to care for them, not fathers. In interviews, Barbara Harris has also made disturbing comments about substance using women, likening drug addicted women who have children to dogs having litters of puppies (Vega, 2003). This sort of misogynistic attitude ftirther serves to alienate poor women and relegate them to second-class citizen status. It also does nothing to help women who find themselves addicted to substances and without options for family planning. Though Project Prevention's website promotes the idea that sterilizing women is actually in the best interest of women and contributes to better self-esteem and more opportunities for these women, as evidenced by the number of testimonies from former clients and the justification for these services provided in the narrative of the website, there is very little that is pro-woman about this program. Tubal ligations, Norpiant, and DepoProvera do not prevent a woman from contracting STDS, such as syphilis. Human Papillomavims (HPV), or HIV/AIDS, all of which can be detrimental to a woman's health. They do not prevent her from experiencing domestic violence or rape, nor do they help a women obtain needed treatment, or navigate the legal system to regain custody of children who may be in foster care. These forms of birth control are designed simply to prevent concep-
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tion. In short, nothing about Project Prevention helps women to change their lives. Though the main focus of Project Prevention is to prevent births of drug affected babies, the narrative on the website reinforces the idea that the organization is helping women and children by changing women's lives. However, the only thing that Project Prevention succeeds in doing in preying upon low-income women who may not be able to make sound and logical decisions about their futures due to their drug addiction. Assumptions Related to Race Of the 1,126 "paid clients," 553 (49.11%) were Caucasian, 371 (32.94%) were African American, 113 (10.03%) were Latino, and 89 (7.9%) were listed as being of other ethnic backgrounds (Project Prevention, 2003). Though Project Prevention claims to not over serve any one group belonging to a specific racial category, it is alarming to see how many of their clients are from minority groups. Slightly less than half of the men and women who utilize this program are Caucasian. Anytime the percentage of a population does not reflect the percentage of clients being served, it means that certain groups are being served at disproportionate rates. This is the case with Project Prevention. According to the Substance Abuse and Mental Health Services Administration Office of Applied Studies (SAMHSA) (2003), results from the 2002 National Survey on Drug Use and Health, pregnant women were significantly less likely to have used substances in the last month than non pregnant women (3.3% versus 10.3%). Additionally, rates for drug use in the last year were similar for Caucasian and African American (9.3% versus 9.5%) (SAMHSA, 2003). According to the Drug Policy Alliance (2003) only 12.2% of the U.S population and 13% of drug users are African American, yet 32.94% of Project Prevention's (2003) clients are African American, indicating that African Americans, in particular, African American women, are being disproportionately targeted and served through this program. Additionally, the Drug Policy Alliance (2003) states that the rates of drug use during pregnancy are almost equal for all groups. Based on the clientele being served by Project Prevention, it would appear that certain minority groups are being overserved with sterilization. African American children are often disproportionately represented in the child welfare system. This is largely due to the fact that, though rates of abuse have been found to be similar regardless of the race of the parent (Roberts, 2002), African American women are ten times more likely to be reported to child welfare agencies than women from other groups for prenatal drug use (Drug Policy Alliance, 2003). For Americans aware of the disproportionate treatment of African Americans and other minority groups, this is not surprising. This is due to preconceived ideas that many hold about certain communities and populations, including the belief that some populations are not fit to raise their own children or make their own decisions regarding their bodies and their lives. But when most people look at the population in the child welfare system, they do not realize the issues of disproportionate treatment or overrepresentation of certain children that plague child welfare systems across the country. Instead they see children who were taken away from undeserving parents. This sort of misinformation is helpful to an organization like Project
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Prevention. The website for Project Prevention features pictures of children, the majority of whom appear to be African American. By using these images, in addition to the text. Project Prevention is able to able to play upon stereotypes held by many Americans that substance abuse and the neglect of children are primarily problems experienced by communities of color. This also may make it easier for supporters to buy into the notion of damaged children who cannot be saved, or who perhaps we do not want to save since they are not white. In order to dismiss the claims of any racial bias. Project Prevention actually turns the question of racism around and accuses critics of being racists. Under the "Frequently Asked Questions" section of their website, the question "Are you targeting blacks?" is posed. Project Prevention ofFers the following answer: Definitely not. It is racist, or at least ignorant, for someone to leam about our program and assume that only black addicts will be calling us. Not all drug addicts are black. Project Prevention targets a behavior not a racial demographic. If someone is a drug addict or alcoholic and could get pregnant, then we hope they will take our cash incentive offer and get on birth control until they get off drugs (Project Prevention, 2003).
In an interview published for the online magazine. Salon, Ms. Harris herself dismissed the claim that she is a racist based on the fact that she is married to an African American man and has African American children (Costello, 2003). But what Ms. Harris fails to understand is that simply associating with people of color does not automatically make one culturally sensitive. In fact the lack of cultural sensitivity is demonstrated over and over again with Project Prevention by Ms. Harris's outright dismissal of racism and her claims of understanding just what racism is. Regardless of what Project Prevention claims, the evidence showing that this program disproportionately serves African American women cannot be ignored. It is ludicrous for Project Prevention to assert that anyone asking this question is in fact racist. The organization started out under the name "C.R.A.C.K.," a drug that is perceived to be associated with low-income African Americans in inner cities, even though this is based on myth and not reality. Barbara Harris did not choose to name the program M.E.T.H. or M.A.R.I.J.U.A.N.A., drugs that are typically associated with Caucasian drug users. There also are not an overwhelming number of pictures of Caucasian children on the website. When it comes down to it, the use of pictures and of the name itself are part of a clever marketing ploy designed to gain support from people who have little respect for their target population. By infusing stereotypes based on classist and racist ideas, and by making the women served by this program "the other," mainstream white Americans may be more eager to support their efforts. Assumptions Regarding Substance Users As with eugenics and welfare reform. Project Prevention uses misinformation about a marginalized group in order to justify their actions. Project Prevention fails to look at the facts in regard to women, pregnancy and substance abuse. Their website leads readers to believe that substance using women who get pregnant are the causes of many social ills and that they themselves are lost causes. While Project
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Prevention states that their program is cost effective, others have found cost effective methods to help pregnant women with substance abuse issues that are less controversial and that have been proven to be effective. For example, the Child Welfare League of America (2003) details the cost effectiveness of treatment for substance using pregnant women. They cite several studies that have found the following: For each dollar spent for substance abuse treatment services, more than $ 11 are saved in social costs. The Rand Corporation reports that treatment to all addicts would save more than 150 billion in social costs over the next 15 years. Research form Brandeis University listed addiction treatment in the top 10% of more than 500 health and life-saving measures. Services to enhance maintenance recovery ranked among the most cost effective forms of treatment compared to other chronic conditions. In Ohio, 1,908 drug free babies of women who entered special treatment programs for pregnant addicts were bom between 1993-1997. The estimated coats savings was $88.2 million.
Additionally, though Project Prevention assures us that not all children exposed prenatally to drugs are damaged (in fact going as far to point out the "superstars" that Barbara Harris herself adopted who, while exposed to drugs, are successflil today) they still promote the idea that children bom to drug addicted women are inherently damaged in some form. Though countless studies have come out disputing the idea that children bom to dmg addicted women are damaged, some of which are detailed later in this article, Project Prevention's supporters choose to ignore these studies. What many of Project Prevention's supporters do not know, or may choose to ignore, is that substance using women who have children often face many obstacles that make decisions related to pregnancy and motherhood fundamentally different from what is experienced by women who are not addicted to substances. In a qualitative study, conducted with pregnant and parenting women in a long-term residential treatment center, analyses of in-depth interviews with seventeen women indicated the consistent theme that their pregnancy was in fact the impetus for change in their lives and that they sought treatment after discovering they were pregnant (Baker and Carson, 1999). However, as is always the case with pregnant and mothering women, their status as mothers makes it hard to obtain services, in this case treatment, due to issues around child care. Cost is also a factor that prevents many women from entering treatment. Additionally, because women, in particular poor women or women of color, often fall into the category of "hard to reach populations" they may not be aware of treatment options or family planning options since providers either do not provide services to them or have a hard time reaching them. Women also receive treatment at lower rates than their male counterparts. According to the SAMHSA's 2002 National Survey on Drug Use and Health, men were
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more likely to have received some form of treatment than women who were using substances in the last year. Barbara Harris and Project Prevention also ignore the links between rape and violence and pregnancy for substance using women. A study conducted with 8,627 mothers and infants found that women who used substances were significantly more likely to have been hospitalized due to the violence they had experienced than women who did not use substances during pregnancy (Klitsch, 2002). Sales and Murphy (2000) noted that "women's drug use further increases their likelihood of being assaulted. Studies have indicated that pregnant abusers of illegal drugs suffer from physical abuse more often than other pregnant women." In their study, conducted with substance using women in the San Francisco area, they found that: Seventy-five percent of the women who had altercations with their partners reportedly experienced physical violence. Twenty-five (36%) were forcibly raped; 15 (21%) were kicked; 14 (20%) were threatened with a knife or gun; 11 (16%) were beaten with an object; and 5 (7%) were injured with a knife or gun. For many of these women, these acts were repeated many times throughout their pregnancies (Sales & Murphy, 2000). Additionally, women in violent relationships may have less input within their sexual relationships regarding "reproductive decision-making" (Moore, 1999, p. 302) and may "feel or be rendered powerless by abusive experiences, which could make it difficult for them to negotiate condom use and other health behaviors within their sexual relationships and during pregnancy." Women may experience unintended pregnancy due to sexual abuse (Moore, 1999). Though Project Prevention blames substance using women for the number of children in foster care, one cannot ignore the facts that demonstrate that women alone do not bear the burden of unplanned pregnancies. Barbara Harris and Project Prevention would be wise to focus on evidence based methods to help substance addicted pregnant and parenting women rather than promote stereot)q)es and the sterilization of women and men. Sadly, this is not likely to change in the near future. Assumptions Related to the "Crack Baby Myth" Project Prevention states that drug addicted pregnancies pose several problems, which include phildren suffering from developmental and health problems immediately after or soon following birth. This idea perpetuates the crack baby myth, which implies that babies bom to crack addicted mothers have severe and irreversible emotional and cognitive damage (Harvard Mental Health Letter, 2001). According to the Harvard Mental Health Letter (2001), 36 studies have been conducted to refiite the claims that this syndrome exists. Furthermore, most of the problems faced by children are from poor living conditions, domestic violence, and abuse and neglect. The letter goes on to warn that continuing to label these children born to substance abusing moms can only lend to a self-fulfilling prophecy, which in turn perpetuates the problem. Reuters Health (1999) states that poverty has the greater impact on a young child's brain to process, think, and problem-solve than cocaine. Studies published in the Journal of Developmental and Behavioral Pedi-
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atrics show that there was no difference between poor children exposed to cocaine and poor children not exposed to cocaine (Reuters Health, 1999). Echoing these findings, a study conducted with 83 cocaine exposed babies and 63 non-exposed babies found that prenatal exposure to substances was not directly related to how children were fairing by the age of 2 years (Brown et al., 2004). Instead the researchers found that outcomes were related to the environment in which the children were raised. Another study conducted with 101 prenatally exposed children and 130 non-exposed children found, that though children exposed prenatally to cocaine were more likely to score less on tests related to visual motor and motor skills, that this had more to do with the environments that exposed children grew up in than with prenatal exposure (Arendt et al., 2004). Lower IQ scores for children who had been exposed to cocaine prenatally were also found to be associated more with the home environment than with the prenatal exposure in another longitudinal study that was conducted (Singer et al., 2004). Countless studies have come to similar conclusions, including one conducted with 1,227 prenatally exposed infants that found that exposure to cocaine and opiates prenatally did not have bearing on developmental deficits when controlling for birth weight and the environments in which children lived (Messinger et al., 2004). Although the myth has been discredited among qualified researchers all over the country, it has been engraved through society's awareness creating a social construction of reality, which lends to racial, classist, and sexist scapegoating. No doubt using any substance while pregnant can be harmful, cocaine like tobacco effects low birth weight, not the intellectual or emotional functioning of a child (Jackson, 1998). Perpetuating the myth of the crack baby causes several problems. First, women that are the focus of C.R.A.C.K. are being demonized and characterized as unfit, unloving mothers. These women may want help in giving birth to healthy babies but are scared away from receiving prenatal care due to the fear of being guilty of abuse for exposing their unborn baby to drugs (Ford, 2000). This fear is especially outstanding among African-Americans and Latinos who are often discriminated against, and more often tested for drug exposure (Ford, 2000). It would then be safe to say that programs designed with parenting skills, reunification, and socioeconomic living conditions would be better suited for the monies raised by Project Prevention. With an organization like Project Prevention permeating social consciousness; will sterilization begin to occur for those who are considered undesirables? Will women who have disabilities, are homeless, poor, or even suffer from mental illness be the next targets? Perhaps a redirection should occur and a focus be placed on prevention methods such as treatment, family planning, and other socially focused themes in order to stop future abuses of women's bodies for the Band-Aid approach of sterilization. The bottom line seems to be that crack babies should really be poverty babies and the poverty should be addressed.
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There is a war being waged over women's bodies in this country, and nowhere is it more evident than with Project Prevention. The message being sent by Project Prevention is clear-once women lose their ability to reproduce, they are no longer of concern to Project Prevention or its supporters; therefore, no official services are offered to help women obtain treatment or leam safe sexual practices. Rather than help poor women become sober or self sufficient, or to be reunified with their children who may be in custody of the state or living with other relatives, Barbara Harris and other supporters offer misguided, overly simplistic solutions to very complex problems. No one can argue that the number of children in foster care due to parental substance abuse is alarming or that it is a major issue that we as Americans must tackle; these problems require complex solutions. Sterilizing women who are not in a place to make sound decisions regarding their futures is not the answer. References Arendt, R.E., Short, E,, Singer, L.T, Minnes, S,, Hewitt, J,, Flynn, S., Carlson, L., Min, M,0., Klien, N,, Flannery, D. (2004), Children prenatally exposed to cocaine: Developmental outcomes and environmental risks at seven years of age. Journal of Developmentat and Behavioral Pediatrics, 25 (2), 93-90, Baker, RL,, & Carson, A. (1999), "I take care of my kids": Mothering practices of substance-abusing women. Gender and Society, 13 (3), 347-363, Brown, J,V, Bakeman, R,, Coles, CD., Platzman, K.A,, & Lynch, M,E, (2004), Prenatal cocaine exposure: A comparison of 2-year-old children in parental and nonparental care. Child Development, 75 (4), 1282-1295. Carlson, P. (2003, February 25). A chilling triumph of 'science' over sanity. The Washington Post, pp, COL Child Welfare League of America (2003), Chemical dependencyfact sheet. Retrieved on January 4, 2004, fromhttp://www.cwla,org/programs/chemcial/chemdepfactsheet.htm, Costello, D, (2003). Is CRACK wack? Retrieved on January 11, 2004, from http://www,salon,com/ mwt/feature/2003/04/08/crack. Drug Policy Alliance (2003). Race and the Drug War. Retrieved on January 5, 2004, from http:// www.drugpolicy,org/race. Donovan, P, (1996). Taking family planning services to hard-to-reach populations. Family Planning Perspectives, 28 (4), 120-126. Ford, K,M, (2000), The crack baby myth. Retrieved on January 22,2004, from http;//www.holycross, edu/departments/socant/goldstein/cocasite/kellyford/kellyford,html. Harvard Mental Health Letter (2001). The Crack Baby Myth. Harvard Mental Health Letter, 18 (3), 4-6. Klitsch, M, (2002), Prenatal cocaine and opiate use linked to a wide variety of health hazards. Contemporary Women's Issues, 34 (4), 218, Jackson, J: (1998). US: The myth of the "crack baby," Extra! The Magazine of FAIR. 98. (809), 9, Retrieved on January 22,2004, from http://www,mapinc.org/drugnews/v98/n809/a07,html. Moore, M. (1999), Reproductive health and intimate partner violence. Family Planning Perspectives, 31 {6), lQ2-7,\2. Project Prevention. (2003), How we help the children. Retrieved on December 13,2003, from http:/ /www.projectprevention,org/program/index,html. Project Prevention, (2003), Statistics. Retrieved on December 13, 2003, from http://www. cashforbirthcontrol,com/reasons/statitics,html.
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Project Prevention, (2003), Frequently asked questions. Retrieved on December 13, 2003, from http://www,cashforbirthcontrol.come/program/faqs,html. Project Prevention. (2004). Objectives. Retrieved from web January 22, 2004, at http:// www.projectprevention.org/cause/objectives.html, Reilly. P.R, (1987), Involuntary sterilization in the United States: A surgical solution. The Quarterly Review of Biology, 62 (2), 153-170, Reuters Health. (1999). Poverty has a greater impact than cocaine on young brain. Retrieved on January 22, 2004, from http://www,netaxs,com/~sparky/policy/crack-baby,htm, Roberts, D, (2002). Shattered bonds: The color of child welfare. New York: Basic Books. Sales, P, & Murphy, S. (2000). Surviving violence: Pregnancy and drug use. Journal of Drug Issues, 30 (4), 695-724, Substance Abuse and Mental Health Services Administration Office of Applied Studies. (2003). Results from the 2002 national survey on drug use and health: National findings. Retrieved August 18, 2004, from http://oas.samhsa,gov/nhsda/2k2nsduh/Results/2k2Results,htm#toc. Scully, J, (2000), Cracking open CRACK: Unethical sterilization movement gains momentum. Population and Development Program at Hampshire College, 2. Spring, Singer, L.T, Minnes, S,, Short, E., Arendt, R,, Farkas,, K., Lewis, B,, Klein, N,, Russ, S., Min, M,0,, & Kirchner, H.L, (2004). Cognitive outcomes of preschool children with prenatal cocaine exposure. Journal of American Medical Association, 291 (20), 2448-2456, Thomas, S.L. (1998). Race, gender, and welfare reform: The antinatalist response. Journal of Black Studies, 28 {A), A\9-^A6. Vega, CM. (2003, January 6). Sterilization offer to addicts reopens ethics issue. The New York Times, pp. B1.