National Advocates for Pregnant Women Condemns C.R.A.C.K. Campaign Targeting Methadone Clinics

April 29, 2002

National Advocates for Pregnant Women (NAPW) released an open letter to Barbara Harris, executive director of Children Requiring a Caring Kommunity (C.R.A.C.K.) and Project Prevention, condemning a misleading statement by the organization regarding methadone treatment during pregnancy. The open letter was signed by more than 100 doctors, methadone treatment experts, and advocates, including Dr. Lynn Singer of Case Western Reserve University, Dr. Wendy Chavkin of Columbia University, the Institute for Health and Recovery, the National Council on Alcoholism & Drug Dependence, and the National Women's Health Institute.

NAPW's open letter to Ms. Harris urges C.R.A.C.K. to withdraw their letter and to advise the individuals and clinics who received it of the misleading nature of its implications about methadone treatment during pregnancy.

For Immediate Release

Contact: Delacey Skinner,

April 29, 2002

National Advocates for Pregnant Women Condemns C.R.A.C.K. Campaign Targeting Methadone Clinics
Over 100 Methadone Treatment Experts, Doctors, Advocates Object to Misleading Statement


New York, NY - Today, the National Advocates for Pregnant Women (NAPW) released an open letter to Barbara Harris, executive director of Children Requiring a Caring Kommunity (C.R.A.C.K.) and Project Prevention, condemning a misleading statement by the organization regarding methadone treatment during pregnancy. The open letter was signed by more than 100 doctors, methadone treatment experts, and advocates, including Dr. Lynn Singer of Case Western Reserve University, Dr. Wendy Chavkin of Columbia University, the Institute for Health and Recovery, the National Council on Alcoholism & Drug Dependence, and the National Women's Health Institute.


C.R.A.C.K. offers $200 to current and former drug and alcohol users to be sterilized or to use a long-acting contraceptive. One of the organization's chapters has been documented encouraging women who have been in recovery for over ten years to take part in the program. In C.R.A.C.K.'s February 22nd letter, sent to some methadone treatment clinics around the country, Ms. Harris stated "I'm sure one thing most can agree on is that it is important for those using methadone or other drugs to refrain from getting pregnant." "Our primary concern is that this letter could lead to further stigma against women who need methadone treatment and contribute to the many myths and misunderstandings about its value for pregnant and parenting women," said Lynn Paltrow executive director of NAPW. The letter, asserting that C.R.A.C.K. has a "working relationship" with some methadone clinics, has provoked outrage in the methadone treatment community. Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, also condemned C.R.A.C.K.'s statement in a letter copied to over 700 treatment centers.

"Methadone treatment has enormous benefits both for the patients, including women who may become pregnant, and for the community at large," said Dr. Robert Newman, Director of The Edmond de Rothschild Foundation Chemical Dependency Institute of Beth Israel Medical Center.

NAPW's open letter to Ms. Harris urges C.R.A.C.K. to withdraw their letter and to advise the individuals and clinics who received it of the misleading nature of its implications about methadone treatment during pregnancy.

NAPW is a non-profit organization dedicated to protecting the rights of pregnant and parenting women and their children. NAPW seeks to ensure that women do not lose their constitutional and human rights as a result of pregnancy and that addiction and other health and welfare problems that women face during pregnancy are addressed as treatable health issue.

Barbara Harris
Children Requiring A Caring Kommunity's
"Project Prevention"
P.O. Box 74
Stanton, CA 90680
Dear Ms. Harris:

We are writing to express our strong objections to your distribution of highly misleading and completely inaccurate information regarding pregnant women and methadone treatment. In a letter date February 22, 2002, you state, in part:

"We are currently working with several methadone clinics that make our offer known, and available, to the women and men who come through their program. I'm sure one thing most can agree on is that it is important for those using methadone or other drugs to refrain from getting pregnant."

We most certainly do not agree. Your statement, suggesting that it is dangerous for a woman who is receiving clinically prescribed methadone treatment to become pregnant, is simply wrong. Methadone is a highly effective treatment for all opiate dependent patients and, most specifically, for women - both before and after they may become pregnant. In fact, methadone treatment during pregnancy has not been associated with congenital abnormalities or fetal demise. In those cases where neonatal withdrawal symptoms occur (and they frequently do not), these symptoms can be treated readily, with no evidence of any adverse impact on physical or cognitive development. In short, there is simply no medical basis for your suggestion that methadone patients should "refrain from getting pregnant."

For over 30 years, in countries throughout the world, methadone maintenance treatment (MMT) has been shown to substantially reduce illegal opiate use and the crime, illness, suffering, and death with which it is associated. The benefits have been shown to accrue, not only to the individual patient, but to his/her family and the community, as well. The most credible and objective governmental and non-governmental organizations in America and abroad have recognized these positive results with MMT. For example, the US Department of Health and Human Services joins the scientific community in recognizing that MMT greatly benefits the patients as well as the general community. It is specifically recommended for pregnant and breast-feeding patients, which further demonstrates the strong medical consensus supporting methadone treatment, both in general and during pregnancy.

Unfortunately, despite methadone treatment's many benefits, it is available to fewer than 20% of the people who most need it. Women, in particular, face numerous barriers to obtaining this important medical intervention. Your letter and activities, which spread false information and stigmatize current and future mothers who receive this treatment, will make it even more difficult for women who need methadone treatment to receive it.

We therefore urge you to withdraw this letter immediately and to advise each of those individuals and clinics who received it that it was based on misinformation. Furthermore, it is essential that you publicly repudiate the inaccurate message you conveyed on your organization's website and in other public and media context. Not to do so would be irresponsible and a great disservice to those whose interests you claim to have at heart.

Signed,

Signatories

1. Lynn Singer, Ph.D, Professor of Pediatrics and Psychiatry, Case Western Reserve University, School of Medicine
2. Stephen Kandall, MD, Retired Professor of Pediatrics, Albert Einstein College of Medicine
3. Daniel Neuspiel, MD, MPH, Associate Chairman of Pediatrics, Beth Israel Medical Center
4. Robert Newman, MD, Director, Baron Edmond de Rothschild Chemical Dependency Institute of Beth Israel Medical Center
5. Barry Lester, Ph.D., Director, Infant Development Center, Women and Infants' Hospital
6. Mary Faith Marshall, Ph.D., Professor of Medicine and Bioethics, Kansas University Medical Center
7. Maryann Amodeo, Ph.D., Professor, Boston University School of Social Work, Alcohol and Drug Institute for Policy, Research and Training
8. Denise Paone, Ph.D., Evaluation and Training Consultant, Former Assistant Director of Research, Chemical Dependency Institute, Beth Israel Medical Center
9. John J. Botti, MD, Director, Maternal Fetal Medicine, Penn State Hershey Medical Center
10. Mary Mahowald, Ph.D., Professor, Dept. of OB/GYN, University of Chicago
11. Machelle Allen, MD, Assistant Professor, Department of OB/GYN, NYU School of Medicine
12. Wendy Chavkin, MD, MPH, Clinical Professor of Public Health and OB/GYN, Columbia University, Mailman School of Public Health
13. Marjorie Greenfield MD, Associate Professor of OB/GYN, University Hospitals of Cleveland, Case Western Reserve University School of Medicine
14. Hytham Imseis, MD, Mountain Area Health Education Center, Dept. of OB/GYN
15. Dona Upson, MD, Associate Professor of Medicine, University of New Mexico
16. Mack Lipkin, Jr., MD, Director of Primary Care, NYU School of Medicine
17. Ernest Drucker, Ph.D., Professor of Epidemiology and Social Medicine, Montefiore Medical Center/Albert Einstein School of Medicine
18. Angela R. Holder, LLM, Professor of the Practice of Medical Ethics, Center for the Study of Medical Ethics and Humanities, Duke University Medical Center
19. Sydney L. Hans, Ph.D., Research Associate Professor, Department of Psychiatry, University of Chicago
20. Craig Reinarman, Ph.D., Chair and Professor, Dept. of Sociology, UC Santa Cruz
21. Rachel Roth, Ph.D., Assistant Professor, Washington University
22. Monica J. Casper, Ph.D., Associate Professor of Sociology, UC Santa Cruz
23. Anthony R. Kovner, Ph.D., Professor of Health Policy and Management, Wagner/NYU
24. Susan L. Adams, Ph.D., RN, Associate Professor of Nursing, Women's Health Nurse Practitioner, Perinatal Addiction, Dominican University of California
25. Nina Peskoe Peyser, Former Executive Director of the Chemical Dependency Institute at Beth Israel Medical Center
26. Holly Catania, Baron Edmond de Rothschild Chemical Dependency Institute of Beth Israel Medical Center
27. Nancy D. Campbell, Ph.D., Assistant Professor, Rensselaer Polytechnic Institute
28. Jerome Richardson, Assistant Professor, University of Illinois at Chicago
29. Karyn L. Pomerantz, MLS, MPH, GW School of Public Health & Health Services
30. Janet Lynne Golden, Ph.D., Associate Professor, Rutgers University
31. Cynthia Daniels, Ph.D., Associate Professor, Rutgers University
32. Drew Humphries, Ph.D., Department of Sociology, Anthropology and Criminal Justice, Rutgers University
33. Elizabeth M. Armstong, Ph.D., Assistant Professor, Princeton University
34. Jael Silliman, Ed.D., Associate Professor, University of Iowa
35. Jeanne Flavin, Ph.D., Associate Professor, Fordham University
36. Victor J. Bernstein, Ph.D., Associate Professor, University of Chicago
37. Grace Chang, Ph.D., Evergreen State College
38. Mario A. Caro, Ph.D. Candidate, Professor, Evergreen State College
39. Phillip Coffin, MIA, Project Director, Center for Urban Epidemiologic Studies, New York Academy of Medicine
40. Sheigla Murphy, Ph.D., Institute for Scientific Analysis
41. Leslie D. McCrory, Clinical Supervisor, Health Partners
42. Ann D. Brown, CNM, MSN, Dept. of OB/GYN, Mountain Area Health Education Center
43. Shelley Galvin, MA, Research & Grants Coordinator, Dept. of OB/GYN, Mountain Area Health Education Center
44. Susan Shinn, RNC, Women's Health, Mountain Area Health Education Center
45. Melissa McClure, Medical Records Coordinator, Mountain Area Perinatal Substance Abuse Program
46. Cheryl Timbs, Clinical Supervisor, Mountain Area Perinatal Substance Abuse Program
47. Elizabeth Finger, LWW, Director of Behavior Medicine, Mountain Area Health Education Center
48. Terry Sutton, Program Assistant, Mountain Area Health Education Center
49. Jean Cassidy, Dept. of OB/GYN, Mountain Area Health Education Center
50. Steve Allison, Certified Clinical Addiction Specialist, Mountain Area Health Education Center
51. Gregory McCoy, Mountain Area Perinatal Substance Abuse Program
52. Michael Eisenberg, MD, MPH, President, ASPIRE
53. Luciano Colonna, Executive Director, Harm Reduction Project
54. Michael R. Aldrich, Ph.D
55. Ivan Zimmerman, J.D.
56. Rickie Solinger, Ph.D., Historian
57. National Women's Health Network
58. National Black Women's Health Project
59. National Association for Public Health Policy Council on Illicit Drugs
60. Institute for Health and Recovery
61. Advocates for Recovery through Medicine (ARM)
62. Advocates for Recovery through Medicine (ARM) of Arkansas & Oklahoma
63. Advocates for Recovery through Medicine (ARM) of DC
64. Connecticut Women's Consortium
65. Casa Segura
66. Lower East Side Harm Reduction Center
67. Addiction Treatment Watchdog
68. CAP Quality Care Methadone Clinic
69. Virginia Alliance of Methadone Advocates
70. Vermont Harm Reduction Coalition
71. San Francisco AIDS Foundation HIV Prevention Project
72. AIDS Project New Haven
73. HIV Law Project
74. ASPIRE
75. Drug Policy Alliance
76. Urban Justice Center
77. Criminal Justice Policy Institute
78. Center for Human Rights Education
79. Family Watch
80. Committee on Women, Population, and the Environment
81. Cambridge Cares About AIDS
82. California Coalition for Women Prisoners
83. Legal Services for Prisoners With Children
84. NORML Foundation
85. Common Sense for Drug Policy
86. Drug Policy Forum of Hawaii
87. ReconsiDer
88. Communities Against Rape and Abuse
89. Mikki Norris, Human Rights and the Drug War
90. Alice Diorio, President, Vermont Harm Reduction Coalition
91. Kevin Zeese, Executive Director, Common Sense for Drug Policy
92. Donna M. Shea, Legal Director, NORML
93. Mark Beresky, Secretary/Treasurer, Vermont Harm Reduction Coalition
94. Marc Shinderman, MD, CAP Quality Care Methadone Clinic
95. Cassie Pierson, Staff Attorney, Legal Services for Prisoners with Children
96. Monique Tula, Director of Harm Reduction Services, Cambridge Cares About AIDS
97. Eliza Wheeler, Needle Exchange Program Coordinator, Cambridge Cares About AIDS
98. Robin Clark-Smith, AIDS Program, Bridgeport Health Department
99. Terri Bogage, Institute for Health and Recovery
100. Syd Lindsley, Committee on Women, Population, and the Environment
101. Jacqueline Robarge, Power Inside
102. Stephanie Manfre, Children's Case Manager, Riley Center
103. Ann Beck, Riley Center
104. Jennifer Grant, Director, Riley Center
105. Teresa Martyny, Riley Center
106. Kylie Chow, Brennan House
107. JoAnn Yang, Riley Center
108. Michelle Rivera, Riley Center
109. Carolina Alaniz, Riley Center
110. Idoia Irastorza, Riley Center
111. Megan Koroshetz, Riley Center
112. Stacy Benedict, Riley Center
113. Liliana Diaz, San Francisco Department of Public Health
114. Ellenie Tuazon, San Francisco Department of Public Health
115. Elba Warner, San Francisco Department of Public Health
116. Ebone Colbert, Communities Against Rape and Abuse
117. Theryn Kigvamasud'Vashti, Communities Against Rape and Abuse
118. Alisa Bierria, Program Coordinator, Communities Against Rape and Abuse
119. Shane Felles
120. Brion Roberts
121. Susan Yanow, Director, Abortion Access Project
122. Shiela VanDerveer, Development Director, NARAL ­ NH
123. NOW Legal Defense and Education Fund
124. Marsha Rosenbaum, Ph.D., Director, Safety First Project, Drug Policy Alliance
125. Ann M. Boyer, MD, MS, Mt. Sinai Medical Center
126. Nancy Mamis-King, Associate Executive Director, Neighborhood Youth & Family Services
127. Maureen Denman, Atlantic Health System
128. Shelly Carter, Health Educator, New Mexico Prenatal Care Network, University of New Mexico
129. National Council on Alcoholism & Drug Dependence
130. National Advocates for Pregnant Women