Tuesday, July 18, 2017

What Happened To The 80's Crack Babies?


theatlantic |  Epidemics are hard to cover. Navigating the gaps between the private, personal, and societal and managing to be relatable while also true to science is a tough part of health reporting, generally. Doing those things in the middle of public panic—and its attendant misinformation—requires deftness. And performing them while also minding the social issues that accompany every epidemic means reporters have to dig deep, both into multiple disciplines and into ethics. With multiple competing narratives, politics, and the sheer scale of disease, it’s often easy to forget the individuals who suffer.

That’s why I was struck by a recent article in the New York Times by Catherine Saint Louis that chronicles approaches for caring for newborns born to mothers who are addicted to opioids. The article is remarkable in its command and explanation of the medical and policy issues at play in the ongoing epidemic, but its success derives from something more than that. Saint Louis expertly captures the human stories at the intersection of the wonder of childbirth and the grip of drug dependency in a Kentucky hospital, all while keeping the epidemic in view.

One particular passage stands out:

Jay’la Cy’anne was born with a head of raven hair and a dependence on buprenorphine. Ms. Clay took the drug under the supervision of Dr. Barton to help reduce her oxycodone cravings and keep her off illicit drugs.
“Dr. Barton saved my life, and he saved my baby’s life,” Ms. Clay said. She also used cocaine on occasion in the first trimester, she said, but quit with his encouragement.
[...]
For months, Ms. Clay had stayed sober, expecting that she’d be allowed to take her baby home. Standing in the hospital corridor, her dark hair up in a loose ponytail, she said, “I’m torn up in my heart.”
Generally, treatment for drug-dependent babies is expensive and can go on for months. Nationally, hospitalization costs rose to $1.5 billion in 2012, from $732 million in 2009, according to researchers at Vanderbilt University.
In the space of a few paragraphs, the story introduces a mother and child and the drug dependency with which they both struggle, and also expands its scope outwards to note the nature of the epidemic in which they are snared. It doesn’t ignore the personal choices involved in drug abuse, but—as is typical for reporting on other health problems—it considers those choices among a constellation of etiologies. In a word, the article is humanizing, and as any public health official will attest, humanization and the empathy it allows are critical in combating any epidemic.

The article is an exemplar in a field of public-health-oriented writing about the opioid crisis—the most deadly and pervasive drug epidemic in American history—that has shaped popular and policy attitudes about the crisis. But the wisdom of that field has not been applied equally in recent history. The story of Jamie Clay and Jay’la Cy’anne stood out to me because it is so incongruous with the stories of “crack babies” and their mothers that I’d grown up reading and watching.