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Article
December 2, 1988

Crack and Fatal Child Abuse

JAMA. 1988;260(21):3132. doi:10.1001/jama.1988.03410210042030
Abstract

To the Editor.—  Crack, a preprocessed cocaine alkaloid, emerged in the Bahamas in 1983.1 In late 1985, crack became available on the streets of New York City.2 This potent, highly addictive smokable form of cocaine has been associated with physical complaints as well as psychiatric complaints that include depression, irritability, paranoia, and violent behavior.3The incidence of child abuse and neglect is known to be higher in families in which parents or caretakers are alcoholics or narcotic addicts. Reporting of child abuse and neglect has increased nationally 212% from 1976 to 1986 to more than 2 million cases a year. The number of fatalities also has risen.4At our hospital, since March 1988 we have seen three unrelated patients, ages 1 month, 2 years, and 3 years, as victims of fatal child abuse from battering. In two of the cases crack was specifically noted to have

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