Over the past century the Americans have had mixed feelings over the issue of cocaine. In the very early days it was known as a substance of great danger which would effect the CNS, was harmful and addictive and most often life threatening. And so its presence was seen negatively.
However by the 1980 s views changed greatly as the cocoa cola company was publicizing coco cola as a therapeutic nerve and brain tonic because it was made with the coco plant. In addition to this Dr. William A. Hammond promoted it suggesting that it was a safe and effective soother for feeling blue . He encouraged it further by proudly announcing that he

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himself used it regularly, suggesting that even frequent use would not have any negative effects on the user.



However this attitude did not prevail for long, soon the original feelings of hostility towards the drug returned, and again were perceived as a dangerous and addictive substance. This was due to the results of frequent pleasure users having problems with their judgment and also the increase in the promotion of criminal violence by these users. By 1903 cocaine was removed from the coco cola drink and legal laws made it extremely difficult to purchase it except by medical prescription. And so within three decades the public view changed from being extremely relaxed to one of fear and abhorrence of

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both the drug and those who chose to use it. Therefore as time went by cocaine became a thing of the underground world and it was not until the late 1970 s that it rose again, this time in a new recognition, especially as a snuffing powder for the rich and famous. Again the drug was being promoted especially in the media in a positive light. As an easy way of feeling confident and fearless and was being linked as a drug for the high class . However history repeated itself and once again the dark side of drug and especially cocaine abuse came to light again, this time side by side with the great medical side effects which
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ranged from seizures to sudden deaths. As newspapers filled their front pages with cocaine tragedies both the rich and poor came to see what the cocaine addiction was really about.


Only in 1985 were the first serious studies done to determine the effects of cocaine abuse during pregnancy on both the mother and the foetus. The findings of these studies showed how there was an increase in spontaneous abortions, premature labour, growth retardation and many more and severe problems for the children of users. Reports also suggested that cocaine exposed neonates would suffer greatly in terms of neurology especially in the long run. These reports despite their small size and the great deal of methodological problems that could not really

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be clearly interpreted were accepted widely by both the general public and the scientists. One explanation given here as to why this may be the case is that these findings despite their limitations seem to be logical. These people having already seen the effects cocaine was having on the adult users could only infer that the effects on the neonate would be the same or greater.
Both papers and news channels filled their bulletins with scenes and pictures of crack babies , young children in intensive care as a result of being exposed to cocaine whilst in their mother s womb. By this time attitudes of the public were transformed into rage as they cried out for something to
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be done of those who supplied the drugs. But their rage did not stop here, they had a particular rage against the mothers who used drugs and saw them as immortal. So much so that in some states women were being prosecuted for supplying drugs to minors as cocaine was being delivered to the foetus through their umbilical cord. To some this was a step to far. Especially for those that were providing help for addicts, they felt that the only place for these women was in rehabilitation and not prison where instead of being helped they would be punished. As the media and the wider public acted in dramatic ways, drug abuse researchers were going through a period of
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confusion. Whilst the former were sure that the use of these drugs especially during pregnancy was horrific, the latter were not so sure that this was the case as in their units babies despite being exposed to cocaine were not suffering from the severe toxic effects that were being published in the news. This is just one example of how the media played a crucial role in influencing the views of the public.


A recent observational study on the behavior of cocaine-exposed newborns noted more obstetric complications, smaller head circumference, and a greater number of withdrawal symptoms. In addition, these polydrug-exposed infants were slower to habituate. Cocaine-exposed infants were found to have depressed vagal tone, suggesting a parasympathetic-sympathetic imbalance. Given

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the literature on the relationship between low vagal tone and low developmental scores later in infancy, this group may be at risk for delays in cognitive development. It is also noteworthy that dopamine levels were depressed in the cocaine-exposed newborns. Dopamine depletion has recently been implicated in habituation disturbances in the rat model. It is interesting in that light that both dopamine depletion and habituation deficits were reported for cocaine-exposed infants.
Others have reported inferior performance on the Brazelton scale during the first month of life, including poorer motor responses and poorer autonomic regulation and more abnormal reflexes. Both the terms excitable and depressed, or overstimulated and underaroused, have been used to describe cocaine-exposed infants. Cocaine-exposed infants had significantly poorer
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scores on muscle tone, primitive reflexes, and volitional movement. Toddlers who were prenatally exposed to drugs were compared with ADHD children in a study on grade school children; more disturbed classroom behaviors were observed for the former, including more fidgeting, staring into space, off-task behavior, attention-seeking, noncompliant behavior with teachers, and aggressive behavior with peers.


Depression is also a serious problem in drug-using mothers, and compounds the effects of drugs on their infants. It is not surprising given the problems they experienced, including poverty, legal difficulties, homelessness, lack of social support, loss of children to foster care, and ongoing relationships with drug-abusing or alcoholic men.


Depressed women have been found to be less involved and affectionate with their infants. During

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mother-infant interactions, depressed mothers are less spontaneous, happy, vocal, proximal, and reciprocal. Because social interactions between mothers and infants are thought to be critical to language development, problem-solving ability, mastery motivation, and social competence, research on the effects of maternal depression has focused on these early interaction disturbances. Although most infants and children. of depressed mothers are at risk for significant social, emotional, and cognitive deficits, the potential for these problems in the drug-exposed infants of depressed mothers is even greater because there are now two disturbed members of the dyad, the drug use affecting both the mother and the infant.


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