Children of the Opioid Epidemic

Mothers struggle with addiction, the U.S.-Russia imbroglio and more. View in [Browser]( | Add nytdirect@nytimes.com to your address book. [The New York Times]( [The New York Times]( Friday, May 11, 2018 [NYTimes.com »]( [Children of the Opioid Epidemic]( By THE NEW YORK TIMES MAGAZINE [Jennifer Egan writes about mothers addicted to drugs who struggle to get off them — for their babies' sake, and their own.]( Jennifer Egan writes about mothers addicted to drugs who struggle to get off them — for their babies' sake, and their own. Alec Soth/Magnum, for The New York Times Dear Reader, This week’s cover story is a masterful piece of reporting, writing and human empathy from the novelist and journalist Jennifer Egan, who spent many months [documenting the lives of women who are addicted to opioids and become pregnant.]( This is an aspect of the opioid crisis that we haven’t heard as much about, in part, perhaps, because it seems so tragic. But Egan’s story is a vitally important one. As she explains, the number of pregnant women addicted to opioids has grown significantly in recent years; and there has been a similar increase in the number of newborns experiencing the opioid-withdrawal condition known as neonatal abstinence syndrome, or NAS. Egan’s story explores the complex emotional and physical struggles that these women and their children go through. As Egan notes, the tendency in many areas to villainize these women, to treat them as criminals (or at least criminally irresponsible), is a dangerous one, not only because it risks compounding their cycles of addiction with shame and persecution but also because it fails to recognize that a newborn baby can often become a lifeline for a woman who has struggled in vain for years to quit using drugs. As she writes: “Addiction is now widely recognized as a mental disorder, and the medical establishment and communities are more likely to treat people with drug dependency as victims of an illness. But this more generous spirit rarely extends to pregnant women in the grip of addiction, who are still widely seen as perpetrators. In 24 states and the District of Columbia, the use of any illegal substance during pregnancy constitutes child abuse, and in Minnesota, South Dakota and Wisconsin, it is grounds for civil commitment.” It was critically important to Egan that her story treat these women with respect and empathy. But she also recognized that this same spirit of understanding has not been extended to all mothers with drug problems. As she notes: “Widespread horror at the thought of newborns in withdrawal has led, some experts feel, to a cultural overreaction reminiscent of the ‘crack baby’ hysteria of the late 1980s and early 1990s, which wildly overstated the negative effects cocaine would have on the children of pregnant women who smoked it. ‘Crack moms’ were nearly always represented as African-American, adding racism to the mix of distortions at play in that perceived crisis. Race has worked the opposite way in our current epidemic — indeed, the perception of our opioid crisis as an epidemic, rather than a racial pathology, owes much to the fact that white Americans have been hard hit.’’ We posted Egan’s story online on Wednesday, along with the cover, which shows a powerful photograph, by Alec Soth, of a woman with her head buried in her baby’s back. This is Elizabeth, one of the women from Egan’s story. The response on Twitter to this cover was swift and heavily negative, with readers posting comments like “In 1980s-1990s the narrative was slightly different. . . . I wonder why?” or “Where was all this compassion during the Crack Boom?” or “My. Mind. Is. Blown. You labeled little black and brown addicted children ‘Crack Babies’ and wrote them off as mentally inferior ... never capable of having a future. Hallelujah! But now we have an ‘epidemic’ of white children going through the SAME scenario and you want sympathy?” Fair points. We are definitely aware of the racist and harmful ways in which black mothers and children caught up in the crack epidemic were portrayed in the 1980s, and of the role The New York Times and other media outlets played in that negative portrayal. In fact, as you can see from the second quote above, it is in part because Egan is well aware of the history of unfair, mean, destructive and racist treatment of pregnant black women who used or were addicted to crack that she was determined to bring so much empathy to this story. The same empathy that the women, children and men who suffered through the crack epidemic deserved in their time. There is never enough empathy, either in the world or in journalism. I hope Egan’s story helps us think about that. Onward, Jake Silverstein There are some other great stories in the magazine this week. See below for a few highlights . . . [DANCE DANCE REVOLUTION]( If you haven’t been to the ballet in a while, you may be surprised by the idiosyncrasies in the work of Justin Peck, a soloist and resident choreographer at the New York City Ballet. The form is known for demanding perfection and adherence to tradition, which might seem incongruous when Peck choreographs a ballet to be danced in sneakers or casts a same-sex pair for a tender, sensual duet. Yet as the magazine’s culture editor, Sasha Weiss, writes in her profile of him, “Peck doesn’t reject ballet’s conventions outright, but he makes dances that reflect the moment he lives in, when power relations between men and women are constantly shifting, and gender and sexuality are more fluid.” [RUSSIA HANDS]( Keith Gessen probes the mystery of failed America-Russia relations over the past 25 years by asking the handful of experts who have steered policy on the U.S. side of the imbroglio. Some “Russia hands” have served Republican presidents, others have served Democrats but a vast majority served both parties. Gessen recounts each misstep since the end of the Cold War in the experts’ own telling. [THE BURDEN OF ‘NECESSARY’ ART]( Have you ever felt as if you flunked as a moral being for neglecting to watch or enjoy a particular show or other work of art so important for its politics that it has been deemed “necessary”? Lauren Oyler examines the imposition of such a designation and the history of debating art’s utility from the tastes of the French Revolution to “Paddington 2.” [A KID’S CAKE FOR GROWN-UP NOSTALGIA]( There’s baking, and then there’s baking the birthday cake.This week, Dorie Greenspan shares her recipe for a double-layer chocolate cake that she bakes only for her son’s birthday. It gets its color and flavor from both cocoa powder and melted bittersweet chocolate, and its layers are generously filled with an all-American butter cream. Most of all, it gets grown-ups remembering their own childhoods: noisy birthday parties and chocolate-smudged lips, with a glass of cold milk on the side. [WHEN SURGICAL CHECKLISTS DON’T WORK]( Last year, Siddhartha Mukherjee witnessed surgical staff at an Ohio hospital use a simple, effective method to stave off a devastating but avoidable human error: leaving a needle or sponge inside a patient’s body. The “checklist” method, first introduced by Atul Gawande, has helped reduce human errors during surgery at a staggering rate. But once in a while, it doesn’t work. In On Medicine, we learn why this happened in the ‘‘checklist in childbirth’’ trial in India: Human behavior changed, but it didn’t change enough. [A SHAMELESS COLLEAGUE . . .]( . . . and a feminist friend who plans to sell her late husband’s vintage collection of Playboy magazines in the #MeToo world. This week, readers write to the Ethicist about dilemmas on ethical hypocrisy. Should one report a colleague to higher authorities, and is the other wrong in feeling queasy about the sale? “The desire to see the guilty punished is a common feature in those who uphold ethical norms,” writes our columnist, before giving us answers. [LOOKING BACK: THE LIVES OF SALLY MANN’S CHILDREN]( In 1992, the photographer Sally Mann published her third book of photographs, “Immediate Family,” containing 60 photographs from a decade-long series of her children Emmett, Jessie and Virginia, growing up on a farm in Virginia Hills. The response to her book was overwhelming, in part because of [a cover story by Richard B. Woodward]( that appeared in this magazine at the time of the book’s release. More than two decades later, Mann herself [wrote for the magazine]( addressing the controversy that ensued around her children’s welfare, and how a mother and the public can see dangerously different things. [Caramelized-Scallion Sauce Will Never Go Viral (But It Should)]( By FRANCIS LAM It isn’t pretty, but it tastes fantastic on everything it touches. [Letter of Recommendation: Tiny Museums]( By SAMANTH SUBRAMANIAN There ought to be 7.6 billion of them all over the world. ADVERTISEMENT [New Sentences: From Meredith Goldstein’s ‘Can’t Help Myself’]( By SAM ANDERSON The word “so” offers a lot of opportunities for unexpected comedy. [Poem: Examples of Justice]( By TONY HOAGLAND Selected by Terrance Hayes. If you enjoy our newsletter forward this email to a friend and help the magazine grow. Getting this from a friend? [Sign up to get the magazine newsletter](. Let us know how we can improve at: [newsletters@nytimes.com](mailto:newsletters@nytimes.com?subject=Newsletter%20Feedback%20NYT%20Magazine) Check out our [full list of free newsletters]( including [Summer in the City]( The best of what to see and do and eat and drink each week. 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