Cocaine, Pregnancy, and the Growing Child

The emergence of cocaine in the early 1980s as a drug of choice among large portions of the US population marked a new era in perinatal medicine, for here was a drug that was viewed as safe and nonaddictive and did not need to be injected, all of which made it very attractive to clinicians.

Abstract

Substance abuse is not a new phenomenon. In the 1930s in the United States, there were epidemics of cocaine and alcohol abuse. In the 1960s and 197Os, marijuana, alcohol, and heroin were the most commonly abused drugs. However, the thalidomide tragedy of the 1960s gave rise to serious concerns that any substances a pregnant woman ingested could have a potential impact on her developing fetus. In the early 197Os, the modern description of the fetal alcohol syndrome’ turned clinicians’ attention to recreational drugs a woman might use during gestation, and this was soon followed by the description of the neonatal abstinence syndrome in newborns undergoing withdrawal from their mothers’ use of opiates, especially heroin, during pregnancy.2 The emergence of cocaine in the early 1980s as a drug of choice among large portions of the US population marked a new era in perinatal medicine, for here was a drug that was viewed as safe and nonaddictive and did not need to be injected, all of which made it very attractive to