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December 24, 1997

Substance and Shadow: Women and Addiction in the United States

Author Affiliations

Carnegie Mellon University Pittsburgh, Pa

JAMA. 1997;278(24):2195. doi:10.1001/jama.1997.03550240087049

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In various policy contexts receiving heavy media attention, women have been increasingly demonized—especially if they use drugs or deviate from conventional norms for maternal behavior. In the public mind, women bear sub-stantial blame for the welfare crisis, children's poor performance in school, and the collapse of the family. Pregnant women who smoke crack and bear drug-exposed infants receive the heaviest condemnation. In Substance and Shadow: Women and Addiction in the United States, Stephen R. Kandall offers a much needed corrective to these lurid public images.

A pediatrician who has long specialized in the medical problems of drug-dependent women and their newborns, Kandall was prompted to explore the history of women's drug use when he was called in 1989 to testify on behalf of a Florida woman who was prosecuted for delivering cocaine to her newborn infant through the umbilical cord. Kandall wanted to understand why society would turn to prosecution