Fact Sheet on Positive Prevention/CRACK (Children Requiring A Caring Kommunity)

Author(s): Communities Against Rape and Abuse (CARA) and the Black People's Project (BPP)
Date Published: July 13, 2006

Positive Prevention, a population control organization in Seattle, offers a $200.00 cash incentive to people who are addicted to drugs and alcohol to undergo a form of long-term or permanent birth control. Their mission is to "save our welfare system and the world from the exorbitant cost to the taxpayer for each drug addicted birth" by offering "effective preventive measures to reduce the tragedy of numerous drug-affected pregnancies." We believe that pregnant mothers who abuse substances during pregnancy need comprehensive drug treatment and consistent low cost or free prenatal care. Positive Prevention's approach is dangerous because the use of payment as an incentive to receive birth control undermines the very notion of reproductive choice, drug treatment, and is reminiscent of the Eugenics movement, which had the greatest momentum in the United States (1907-1941). Positive Prevention's strategy is also coercive because it targets people during a significantly vulnerable period due to their chemical addiction, lack of resources, and economic desperation. Positive Prevention is the Seattle chapter for Children Requiring a Caring Kommunity (CRACK) founded by Barbara Harris in 1994 at her home in Anaheim, California. CRACK is now based in Fresno.1

There has been resistance in other cities where CRACK has opened offices like Chicago (July, 1999), Houston (January, 2000), Pittsburgh, Cleveland and Florida (April 2001). Some of Harris' initial billboards read "Don't let a Pregnancy Ruin Your Drug Habit."2 However in Seattle, Positive Prevention advertisements have not been that bold. Positive Prevention's "$200.00 Cash" flyers have tabbed phone numbers at the bottom of the sheet so people may tear off the 1-800 phone number. In the Belltown neighborhood resistance activists have removed the "$200.00 Cash" flyers off of garbage dumpsters, alleys walls, inside the doors of homeless shelters for women and Street Outreach Services on (1st and Pike), and off of Metro bus shelters windows, walls and bunches of hand sized flyers crammed together in the crevasses between the windows and the walls.

1) Positive Prevention/CRACK ignores rape, sexual trade and sexual coercion for drugs, money, food or shelter, the overall complex nature of sex and sexual activity among women substance abusers. Positive Prevention/CRACK fails to acknowledge the correlation between childhood sexual and physical violence and drug addiction.


• "Divorced or separated, urban, poor women, ages 16-24 experience the highest rates of rape/assault."3

• "Women in house holds of $15, 000.00 or less are 3 times more likely to be raped or sexually assaulted and Black women are more likely to be poor."4

• "Rape victims have higher rates of drug and alcohol consumption and a greater likelihood of having drug and alcohol-related problems than non-victims."5

• "Rape victims with rape related posttraumatic stress disorder (RR PTSD) are 13.4 times more likely to have two or more major alcohol problems and 26 times more likely to have two or more major serious drug abuse problems."6

Positive Prevention acknowledges that their offer of $200.00 is more appealing to poor women than to middle class women but they do not draw any other connections between chemically addicted women living in poverty and the fact that these women are most likely to be homeless and at greater risk for rape.

Physical abuse, sexual abuse, and partner violence tend to be intercorrelated. These forms of abuse have been associated with lower self-esteem, lower perceived health status, and lower life satisfaction. In addition to these circumstances, chemically addicted individuals are also at greater risk for symptoms of depression, self-destructive behavior, and difficulties in interpersonal relationships.7

2) Positive Prevention/CRACK lacks a complex analysis of substance abuse therefore ignoring poverty as context for the intersection between the lack of economic and medical resources, disabilities, homelessness, drug addiction and racial disproportionality. Chemically addicted people who are most likely to accept birth control for the $200.00 cash are people who, because of poverty, also experience disproportionate rates of sexual and physical violence, HIV, mental illness, homelessness, instability, imprisonment and death row sentences, posttraumatic stress disorder and repetitive micro and macroaggression and insults8 as a result of oppression. For example, African Americans encounter a variety of assaults to their health and well being. Rates of HIV among women continue to increase even as overall national rates have begun to decrease. In Los Angeles County, African American women account for 45% of AIDS cases, despite being 10% of the female population (Los Angeles County Department of Health Services, 1999).9 Yet Positive Prevention/CRACK support birth control methods that do not protect people from HIV coupled with the fact that Positive Prevention and CRACK specifically target communities of color (often Black and Latino communities) and those most likely to be homeless as a result of their addictions with their billboard ads, Metro Bus ads (which are subsidized two for one in Seattle), and "$200.00 cash" flyers. Further, "CRACK does not offer or encourage drug treatment for drug problems. The Committee on Women, Population, and the Environment (CWPE) makes the point that CRACK's quick fix approach effectively gives up on treatment as a solution to addiction."10

3) Positive Prevention/CRACK targets the bodies of women of color and poor women ignoring the history of sterilization, Norplant, and Depo-Provera used against Black, Indigenous and poor women Positive Prevention boasts that it does not matter what race the woman is as long as the women are interested in the offer. Admittedly, however, when asked about the location of CRACK ads being placed in predominantly black neighborhoods, Lyle Keller, a licensed social worker and founder of CRACK Chicago, responded that it was a matter of cost (implying that if CRACK Chicago had more funding then they would have been able to spread their advertising over several neighborhoods that were not just Black and Latino communities) and CRACK Chicago wanted to start "where people who need the offer can see it." "The offer of $200.00 appeals more to the poor than it does to the rich. Therefore, it is more practical to post fliers in areas where poor people live and congregate."11

It is because of oppression that racial disproportionality contributes greatly to the assault against the reproductive rights of Black women. "The sheer scope of restrictions on Black women's maternity both tangible (punitive public policies) and intangible (a lack of positive images of Black motherhood) has shaped the meaning of reproductive freedom in this country."12 Additionally, "women with substance abuse problems need drug treatment, decent jobs, educational opportunities, and mental health and childcare services. It is the lack of respectful comprehensive healthcare along with the denial of human dignity, which exacerbates conditions of poverty, racism, social status and gender discrimination. These conditions can lead to women seeking out substances to medicate pain. Oppression needs to be eliminated, not the reproductive capacity of women."13

4) Positive Prevention/CRACK asserts an able-bodied supremacist notion of "value" by alleging that the babies born drug exposed are doomed to fail and the lives of their parents are expendable.14

Consider Positive Prevention /CRACK's decision to refer to babies born to the drug users as "damaged babies." This is not a casual choice of language. CRACK has intentionally chosen this negative reference to establish that infants born to drug users are worth less than those born to non-drug users. This idea of diminished worth is based on the assumption that these babies will experience short and long term health effects based on their parents drug use. The trouble is that it is inaccurate to say that all babies born to drug users will be in poor health. Some will be affected but even so, health is a poor and subjective criterion for determining the value of a human life. Too often the standard for judging what a quality life is, is an able-bodied standard. Positive Prevention /CRACK's has determined that it is better not to be born than to be born a "damaged baby" and this is the ultimate example of able-bodied supremacy.15

"Damaged" babies do not have less inherent value than babies that are not "damaged." All babies have potential and we do not know what the potential looks like from here. The assumption that drug-exposed babies will inevitably fail is a myth. Drug exposure at birth is not a guarantee of failure. It is the environment that the child is likely to be returned to that has the greatest impact on that child's ability to thrive. The environmental needs of drug-exposed babies must be supported. The answer does not lie in not creating babies but how do created babies get support.16

Another motivation for discouraging the birth of "damaged babies" is the judgment that such babies are likely to be burdens on society. There are components to the argument that a person can be a burden to society: capitalism, utilitarianism, and the importance of self-sufficiency.17

The value of people with disabilities is too often measured in capitalist terms-- in fact when officials are determining if a person meets the federal definition of disability one of the ten criteria considered is whether the person is economically self sufficient.18

Just as one's ability to make an economic contribution is a criterion used by federal officials to determine if a person has a disability, capitalistic considerations play an important role in CRACK's evaluation of whether these "damaged babies" will be burdens to society.19

Remember this is an organization that places a two hundred dollar monetary value on reproduction so there is clear evidence that the organization is invested in capitalism. CRACK, again acting on an assumption, figures that babies born to drug users will automatically cost taxpayers more than they will ever contribute to the tax base.20

Altering the bodies of the drug addicted means that we don't recognize the sovereignty they have over their own bodies. It is able-bodied supremacy that informs our perception that we have a right to control what we believe is an "out of control disabled body." In our culture a chemical addicted body is a body out of control. Therefore, chemically addicted people are disabled by their out of control body and minds. Positive Prevention/CRACK's mission concludes that it is their responsibility to control the bodies of "drug addicts. "21

5) Positive Prevention/CRACK uses coercion, intimidation and guilt as a means of gaining compliance with people when they are at their most vulnerable-and/or homeless with a serious chemical addiction. Contrary to popular belief, women who struggle with chemical addiction are not intentionally having babies because they just love giving birth to children they can not support.

The culture of drug use and drug sales is such that sex is the most available means of acquiring money for drugs or for the drug itself particularly for women. Getting pregnant is a consequence of intercourse and women who use sex to support their drug habit are at hirer risk for pregnancy. When chemically addicted women become pregnant it is the pregnancy itself that actually motivates women to seek drug treatment.22 However, waiting lists to enter drug treatment programs are often so long that women become discouraged and stop trying. Also, because there are very few long-term drug treatment centers that offer prenatal care for pregnant drug users the cards stacked against these women to resources grows even hirer.

So, chemically addicted women who become pregnant, then, look for help get discouraged when there is little to no help available and are then placed in a profoundly vulnerable position. When these women see Positive Prevention/CRACK's offer of $200.00 as a "cash incentive to encourage them to choose birth control,"23 the message is; "since you (the woman) can not control your drug habit we will pay you money to stop getting pregnant." (Note: $200.00 is not a lot of money and is even less money when it comes to supporting a drug addiction). Which in turn gets internalized as "you can not control yourself and creating more people like you can not be allowed and therefore, we do not care about what you do to yourself. Since we do not believe you have any value neither do the children you are creating."

Of the women who rationalize "I do not deserve to be saved so why should I be able to have children," do so out of being intimidated and publicly shamed by a society that is rejecting them by saying they have no value and that, as non-persons, they do not deserve the right to have children. This message creates an enormous guilt and is the piece that reflects coercion. The experience of guilt layered by the nihilism of desperation, forces a number of women to accept the offer of $200.00.

6) Positive Prevention/CRACK practices sneaky and anonymous flyering techniques at locations where Black, Indigenous and poor women are likely to gather. In their "Do's and Don'ts of Pamphleteering" Project Prevention advises that in order for their offer of $200.00 to be seen it must first be distributed in "areas where substance abusers are likely to spot them."24 (Having consulted Seattle Police reports to determine the downtown areas that are the most popular sites for drug related arrest). Project Prevention suggests that their volunteers "keep a low profile." Project Prevention goes as far as to tell volunteers that they should intentionally be discrete in order that their people "avoid conversations with angry types who might try to challenge you about the controversial aspects of this program"25 by "developing techniques that make your activities undetectable to people nearby."

Committee on Women, Population, and the Environment is a multi-racial alliance of feminist activists, health practitioners and scholars. We are committed to promoting the social and economic empowerment of women in a context of global peace and justice; and to eliminating poverty, inequality, racism, and environmental degradation. (CWPE has been very helpful in getting information to us about CRACK opposition organizing in places like Washington D.C., Chicago, and Baltimore. CWPE has also shared information from our efforts with Family Watch and Prevention Works: Needle Exchange in the Nation's Capital).

The American Public Health Association (APHA) is the oldest and largest organization of public health professionals in the world, representing more than 50,000 members from over 50 occupations of public health. The Association and its members have been influencing policies and setting priorities in public health since 1872.

Family Watch is a network of groups and individuals concerned about the impact of drug policy on families, women and children. The goals of the network are to increase communication, identify opportunities for collaboration and strengthen each of our voices by joining together in our call for change. We aim to push issues related to families, women and children to the forefront of the drug policy debate, and help create progressive policies which preserve the health and well-being of the family unit and each of its individual members, particularly the children.

National Advocates for Pregnant Women (NAPW) is dedicated to protecting the rights of pregnant and parenting women and their children. NAPW seeks to ensure that all women have access to a full range of reproductive health services and choices including abortion, that women are not punished for pregnancy or addiction during pregnancy and that families are not needlessly separated based on medical and public health misinformation. NAPW believes that pregnancy and addiction should be treated, as public health issues not criminal justice issues.

National Black Women's Health Project (NBWHP) seeks to improve the health of Black Women by providing wellness education and services, health information and advocacy. Run by black women for Black women, NBWHP is committed to improving the health status and lives of America's 17.8 million Black women.

1 O'Neill, Anne-Marie and Kelly Carter (September 27, 1999). Desperate Measure. People Weekly, 145-149.
2 Smith, Andrea (Winter 2000-2001). Better Dead Than Pregnant. ColorLines, 22-23.
3 National Black Woman's Health Project: Violence and Black Women: Homicide, Rape, and Domestic Violence website. <http://www.nationalblackwomenshealthproject.org/healthissues/fs-crack.htm> . First viewed on April 2001.
4 NVWHP, 2001
5 Kilpatrick, Dean. National Victim Assistance Academy, Chapter 9: Sexual Assault, 1999. <http://www.ojp.usdoj.gov/ovc/assist/nvaa99/welcome.html>. First viewed on May 28, 2001
6 Kilpatrick, 1999.
7 NVWHP, 2001
8 Bell, Carl C. and Jacqueline Mattis. "The Importance of Cultural Competence in Ministering to African American Victims of Domestic Violence." Violence Against Women Wyatt et al. (May 2000) : 515-532.
9 Axelrod, Julie, Jennifer Vargas Carmona, Dorothy Chin, Tamara Burns Loeb, Gail E. Wyatt. "Examining Patterns of Vulnerability to Domestic Violence Among African American Women." Violence Against Women Wyatt et al. (May 2000) : 495-512.
10 Green, Linda, Karyn Pomerantz, Kathleen Stoll, April J. Taylor. "Opposition to the CRACK Campaign." American Public Health Association Late-Breaker Resolution, 2000.
11 Project Prevention "The Do's and Don'ts of Pamphleteering." Received from Ella Sonnenberg, Executive Director of Positive Prevention in Seattle. March 2001.
12 Brennan, Moira. Interview "Dorothy Roberts: What we talk about when we talk about reproductive rights." Ms. Magazine. April/May 2001
13 Hartmann, Betsy. "Cracking Open CRACK." October 22, 1999. First viewed on the web April 2000. <http://www.zmag.org>
14 Brouner, Joelle. "From One "Damaged Baby" To Another: Why People With Disabilities Should Oppose CRACK And The Effort To Positively Prevent You And Me." April 2001.
15 Brouner, April 2001.
16 Brouner, April 2001.
17 Brouner, April 2001.
18 Brouner, April 2001.
19 Brouner, April 2001.
20 Brouner, April 2001.
21 Brouner, April 2001.
22 Hartmann, Betsy. "Cracking Open CRACK." First viewed on the Internet April 2000.
23 Project Prevention "$200.00 CASH" flyer removed from the side of a garbage dumpster in the Belltown neighborhood of downtown Seattle, Washington. April 2001.
24 "The Do's and Don'ts of Pamphleteering." 2001.
25 "The Do's and Don'ts of Pamphleteering." 2001.