Behind the Eight Ball:
Sex for Crack Cocaine Exchangeand Poor Black Women

Edited by R. Dennis Shelby, PhD
Binghamton, NY: The Haworth Press, 2005

In Behind The Eight Ball Tanya Telfair Sharpe appears to meet her goal set in the introduction of the book. The author indicates “This analysis sheds light on a neglected dimension of sex-for-crack exchanges and gives voice to the women who engage in the behaviour”. The book documents African American women from inner city Atlanta, and uses verbatim from her ethnographic interviews to demonstrate the effect that crack-cocaine has had on their lives. Tanya Telfair Sharpe, PhD, is a Research Behavioral Scientist with the Centers for Disease Control and Prevention/Division of HIV/AIDS/Capacity Building Branch/Science Application Team.

It should be noted that the girth of the research presented in the book is specifically on sex-for-crack black women who have become pregnant as a result of a sex-for-crack exchange, narrowing the sample size down from 46 to 23 women. Sharpe was not clear on this focus until the Fourth Chapter of the book.

I feel that reading Sharpe’s book can be of great benefit to anyone working with this client group. The benefit for counsellors for instance can be realized when consulting Lawrence Shulman’s work. Shulman advocates for the helping professional to develop preparatory empathy, “It involves the workers effort to get in touch with potential feelings and concerns which the client may bring to the helping encounter” (p. 14). In depth interviews were conducted on 19 of the 23 women who became pregnant as a result of sex-for-crack exchange, and Sharpe presents case studies of a marginalized group that has had few opportunities to have their plights documented. By discussing social and economic precursors, religious beliefs, and gender roles Behind The Eight Ball provides an opportunity for the reader to discover the decision making process of crack addicted black women in inner-city Atlanta and thereby allowing the reader to develop “Preparatory Empathy” for this client group. For instance, one of the participants in the study describes what occurred after her fourth sex-for-crack pregnancy:

I had the baby because I was too lazy. I did not want to stop [using crack]. I was so small that I convinced myself that I was not pregnant. My baby hardly moved, if ever. I never ate. The only time I ate was after days of doing dope. I would be so tired. I can’t tell you how many times I fell asleep eating, literally, and wake up with food in my mouth; in bed in my hands. You know I could’ve died. I could’ve chocked to death.

They asked me how long I smoked dope and I told them every day. The only time I didn’t smoke dope was when I was asleep (p. 147).

Another participant explains that although she wanted to have an abortion her crack use took precedence.

It wasn’t planned for me to keep the baby … I was supposed to be having an abortion, but by me smoking crack every day I just couldn’t seem to get myself to the doctor. I kept saying, “I’m going tomorrow to have an abortion.” I kept putting it off until I just kept getting bigger and bigger. Then I was too far gone … I don’t know who the father is (p. 148-149).

Sharpe reveals that it is quite common for these women to respond to their pregnancy by increasing crack use. Further, the participants rarely make decisions considering long-term consequences, and tend to live moment-by-moment.
Sharpe clearly achieves her goal and Behind the Eight Ball provides an in-depth description of the lives of African American women who exchange sex-for-crack in inner-city Atlanta. She truly provided these women with a voice.

Further research in this area may want to focus on comparison studies between various subgroups of inner-city crack-addicted women. It would be of value to understand the differences in crack-addicted women who exchange sex-for-crack and those that do not. Further, what are the differences between the women who exchange sex-for-crack and become pregnant and those that do not? Sharpe touches on this topic early in Chapter 4 and demonstrates key differences in birth control usage between the two groups, but chose to focus on the women whose lifestyle resulted in pregnancy.

Shulman, Lawrence. (1979). The Skills of Helping Individuals and Groups. Itasca, Ilns:F.E. Peacock Inc. : 14.