28 days on the land: Is this the future of addictions treatment in Nunavut?

kathleen-hogaluk-and-eva-avadlukKathleen Hogaluk, left, and her mother, Cecilia, at the addictions treatment program in Cambridge Bay. (Kate Kyle/CBC)

Kathleen Hogaluk is nervous about what the next 28 days will bring.

The 36-year-old single mother of seven from Cambridge Bay, Nunavut, has struggled with alcohol on and off for years.

But it was after her eldest son died by suicide five months ago that her binge drinking accelerated.

“Sometimes I can go for weeks without eating and seeing my children,” said Hogaluk, weeping. Weekly counselling sessions weren’t enough, she said, and leaving her children to get treatment in the south wasn’t an option.

Now Hogaluk is getting help on her own terms: in her home community.

Cambridge Bay addictions camp

The mobile treatment program is held at a camp eight kilometres from Cambridge Bay. (Kate Kyle/CBC)

Mobile treatment

After nearly two decades without a residential addictions treatment facility in Nunavut, the community of Cambridge Bay has found its own culturally-tailored solution — a mobile treatment centre.

Hogaluk is one of 16 women taking part in a new program for women, run by the hamlet’s Wellness Centre. A session for men wrapped up earlier this summer.

There have been programs like this in the past, but this is the first to be entirely held on the land. It’s called a mobile treatment centre because the program can be held anywhere.

“I’m willing to do anything in my power to do a program like this,” said Hogaluk.

“I am ready to move forward with my addictions. I want healthy grieving and healing with the loss of my son.”

Cambridge Bay addictions treatment

Kathleen Hogaluk, far right, relaxes inside the main cabin at the mobile treatment centre. (Kate Kyle/CBC)

Travelling for treatment

Nunavut’s only residential addiction treatment facility in Apex, near Iqaluit, closed in 1998, after seven years in operation.

While many communities have counsellors and various healing programs both on and off the land — such as those run by the Ilisaqsivik Society in Clyde River — none of the on-the-land programs are specifically designed to target addictions treatment, according to the Nunavut government.

Most people who opt for a residential treatment experience are sent down south at a hefty financial cost to the government, and often a personal cost to those seeking treatment.

Families visit

Hogaluk with her son Robert. Participants don’t leave the camp but families are invited to visit. (Kate Kyle/CBC)

According to the government, 49 people were sent south for addictions treatment last year.

The Nunavut government has hired a consulting firm to study if the territory should open a trauma and addictions centre in Nunavut or deliver treatment in another way.

Janet Stafford, the director of community wellness for Cambridge Bay, says people in her community can’t wait for a report: they need help now.

Janet Stafford

Janet Stafford is director of community wellness for Cambridge Bay. (Kate Kyle/CBC)

“If we had to wait for a building — if that’s what research is looking at — we might be waiting for a long time,” said Stafford, who describes the need for addictions treatment as high in Cambridge Bay.

She says many people who take the step to get into a southern program often change their minds before completing the lengthy screening and assessment process.

“This is something that is doable,” said Stafford.

Addictions camp

The main cabin is a gathering place during the 28-day program. (Kate Kyle/CBC)

‘It’s the connections’

The camp is eight kilometres from Cambridge Bay on Victoria Island, within sight of the Arctic Ocean.

Clients stay in canvas tents overlooking a rocky beach and fish-drying racks. A two-bedroom cabin on the property has been converted into a healing retreat centre.

During the day, the focus is on clinical programming; the evening is all about cultural healing.

“It’s the connections,” said Stafford. “It’s connecting everyone to each other, to the land and to the community.” A connection, she says, that was missing from past programs.

Eva Avadluk

Elder Eva Avadluk, 67, works with program participants in Inuinnaqtun. (Kate Kyle/CBC)

Live-in Inuit guides set fish nets and take participants on hunts for eggs and geese.

Elders such as Eva Avadluk, 67, are on site to help in English and Inuinnaqtun, the regional Inuit language.

Avadluk recalls attending a very different rehab program in the 1990s.

“I had no choice but to speak English, because there was no one to speak Inuinnaqtun,” she said in her language. “But people have choices today, which is very nice and comfortable for them.”

Women set fish nets

Women set fish nets as part of Cambridge Bay’s addictions treatment program. (Kate Kyle/CBC)

And the program is already proving it can work. Three out of six men completed the summer program. The wellness centre considers a 50 per cent completion rate a “success.”

Nearly double the number of women have signed up for the fall session.

The Wellness Centre is looking at opening up the program and tailoring it for other Kitikmeot communities next year, including youth.

Kathleen Hogaluk

‘I know my kids will be happier to see me sober, and I’ll be happier as well,’ says Kathleen Hogaluk. (Kate Kyle/CBC)

Hogaluk knows the program is just the beginning of her healing journey. “I know my kids will be happier to see me sober, and I’ll be happier as well.

“To see my kids sober, that’s the greatest feeling. When I am sober on weekends I say to my mom, ‘I finally get to see the weekend with my kids.”

By Kate Kyle, CBC News

Retrieved from: http://www.cbc.ca/news/canada/north/cambridge-bay-mobile-addictions-treatment-1.4292309

No, Scientists Didn’t Say Drinking Alcohol While Pregnant Is Okay


There were quite a few headlines making the rounds last week that light drinking during pregnancy “might be okay”. This was apparently based on a recent study.

There’s just one problem – the study most definitely did not say this. Instead, it pointed out how little information we have on the effects of drinking alcohol during pregnancy.

The paper, led by the University of Bristol in the UK, was published in the journal BMJ Open. Looking for data on the issue the researchers found just 24 studies. Although unable to make any full conclusions, the study noted that the effects of drinking a small amount of alcohol during pregnancy “is sparse”. This was apparently enough for some outlets to run with the headline that drinking whilst being pregnant is okay.

It’s even more bizarre given that the literal next sentence of the study recommends not drinking as the best course of action.

“As there was some evidence that even light prenatal alcohol consumption is associated with being SGA [small for gestational age] and preterm delivery, guidance could advise abstention as a precautionary principle but should explain the paucity of evidence,” the authors wrote.

We already know that excessive drinking can be incredibly harmful to an unborn baby. As noted by Popular Science, the problem at the moment is that “we don’t know where the line is”. But we can’t exactly give pregnant mothers alcohol to find out, hence the lack of available data.

“This science paper was not meant for you – it was a call to researchers that this is something that needs further studying,” added Gizmodo.

Abstention is obviously the safest route, but a lot of people do drink while pregnant. One study found that more than 10 percent of pregnant women in the US drink, with a third of those binge drinking (four drinks or more on one occasion). In the UK, the number is as high as 40 percent.

Finding out what effects drinking alcohol has on an unborn baby would be pretty useful so we can supply some solid data on the subject. The NHS in the UK said “the safest approach is not to drink at all while you’re expecting” as the jury is still out.

On issues like this, it’s probably best to trust medical advice, rather than tabloid newspapers. The effects of alcohol on an unborn baby may well be less than we thought, but they could just as well be worse, too. For the sake of a human that has no choice in the matter, it’s probably best to lay off the drink during pregnancy until we know more.

Retrieved from: http://www.iflscience.com/health-and-medicine/no-scientists-didnt-say-drinking-alcohol-while-pregnant-is-okay/

New Infographic for FASD Awareness Day – Prevention means supporting pregnant women


For International FASD Awareness Day on September 9th, the CanFASD Research Network, through its Prevention Network Action Team (pNAT) and the Centre of Excellence for Women’s Health, developed this infographic on what we know about alcohol use and preventing FASD. You can download a PDF version here.

CanFASD focuses on all aspects of FASD that impact women, individuals, caregivers, and service providers through its network action teams, each with a different focus – prevention, intervention, research, and policy and service providers. These teams aim to put forth knowledge in a way that is useful to communities and organizations in Canada in developing effective programs and policies.

You can search hashtags #FASDay2017 #CanFASD on Twitter to see examples of what others in Canada, or visit some of our pNAT partners.


Mixing booze, babies not harmless fun



Call me sensitive: my mother was a severe alcoholic. Call me a killjoy: yes, I’ve had my own issues with alcohol. But something just isn’t sitting right when I see the promotion for the upcoming “A Very Mommy Wine Festival.”

Advertised with the tagline “Baby on the hips, wine on the lips,” the event is hosted by MomsTO, which proclaims: “It’s going to be an amazing afternoon of drinking, baby feeding and having hella (sic) good time with some of the coolest moms in Toronto.” “Get Your Wine On. Big Time,” the website blares.

This event is just one of many wine-themed MomsTO gatherings. In fact, the group claims to be re-inventing maternity leave with its weekly “very boozy Rose playdates,” which start at 11:30 on “Fri-yay” mornings. Call me critical, but is there not something intrinsically disturbing about mothers getting “their wine on — big time” while they bounce their babies? Have a gander at the MomsTO trailer reel: a series of happy infants are interspersed with images of glowing wine glasses. Hey, what could go wrong?

Since when did wine and motherhood become synonymous? Is there not something a little creepy about the meme of the wine label: “The most expensive part of having kids is all the wine you have to buy.” How about Indigo selling wine glasses emblazoned with: “Best Mom Ever”? Or Real Simple magazine announcing the “Best. News. Ever.” Namely, Amazon Prime will now deliver wine to your doorstep within the hour.

As North Americans, we live in an alcogenic culture with surround-sound messaging: booze is fun, booze is sophisticated, booze is the fastest way to decompress. No surprise: female risky drinking is on the rise. According to Gerald Thomas, director of alcohol policy at the B.C. Ministry of Health, there has been a steady and statistically significant increasing trend in female drinking in Canada since 2003.

And according to a major study in JAMA Psychiatry last month, the incidence of female alcohol abuse and dependence in the United States increased 83.7 per cent between 2002 and 2013. The researchers warn of a public health crisis, given that high-risk drinking is linked to more than 200 diseases and cancers, as well as psychiatric problems, violence and more.

Meanwhile, in Canada, 62 per cent of babies are born to women between the ages of 25 and 34, the age group with the largest spike in risky drinking. Bear in mind that in this country, roughly 3,000 babies are born each year with fetal alcohol spectrum disorder, a totally preventable disability.

I reached out to MomsTO, suggesting we might go for coffee. They didn’t respond. Had they done so, I would have suggested they boost the information on their website.

They might share the news that alcohol consumed by a mother passes easily into her breast milk at concentrations similar to those found in her own blood; that the alcohol level in breast milk peaks 30 to 60 minutes after she drinks; that consuming alcohol while breastfeeding can impair a baby’s motor development. They might share the news that if any of the moms in the community are trying to get pregnant again, there is no known safe amount of alcohol that can be consumed safely during pregnancy. Finally, they might want to have some information on postpartum depression: alcohol is a known depressant.

I am not blaming MomsTO for trying to create a community of mothers. But why wine? I blame our culture, one which pushes such products as Mommyjuice and Happy Bitch wine; one which messages that alcohol is an essential survival tool for overstressed parents.

For those of us who lived through the era of the two-martini playdate, who owned the book Sippy Cups are not for Chardonnay, who remember the tragic story of Diane Schuler driving the wrong way on New York state’s Taconic Parkway with her young daughter and nieces in the car, a jumbo Absolut vodka bottle rolling around in the back, the MomsTO events provoke a profound sense of déjà vu.

I am no prohibitionist; far from it. But this is not harmless fun. More than one young mother I know drove drunk with children in the car; more than one gave birth to a child with fetal alcohol spectrum disorder. And many more ended up with serious alcohol problems. Their children suffered.

In other words, craving connection is one thing. Mixing booze and babies is another.

Ann Dowsett Johnston is the author of Drink: The Intimate Relationship Between Women and Alcohol.

Retreieved from: https://www.thestar.com/opinion/commentary/2017/09/10/mixing-booze-babies-not-harmless-fun.html

Is One Drink OK For Pregnant Women? Around The Globe, The Answer Is No


When it comes to drinking alcohol during pregnancy, some women wonder: Is it OK to have one drink?

“I do get that question often,” says David Garry, a maternal-fetal medicine specialist at Stony Brook University Hospital. And, he says his answer is clear.

“There is no safe level of alcohol use during pregnancy,” Garry explains, citing guidance from the American Congress of Obstetricians & Gynecologists.

The majority of women in the U.S. seem to be on board with this message. According to the CDC, about 90 percent of pregnant women say they refrain, though some may drink without disclosing it. “There’s a social stigma to drinking in pregnancy, which is a good thing,” Garry says.

In other countries, however, alcohol use during pregnancy appears to be more common. A 2015 study found that alcohol consumption ranged from 20 percent to 80 percent among cohorts of women in Australia, New Zealand, Ireland and the United Kingdom. The study found that some pregnant women may have had just one drink — say, a glass of bubbly at a special event such as a wedding; others reported consuming a drink or two more regularly.

So, how risky is this? A new analysis, published this week in BMJ Open, aimed to answer this question. Researchers collected all the available data they could find from prior studies that had assessed the risks of drinking while pregnant.

“We compared drinking once or twice a week [at low levels] compared to not drinking at all,” explains study author Luisa Zuccolo, a health epidemiologist at the University of Bristol.

Zuccolo and her co-authors found that consuming up to 32 grams of alcohol a week ( which is between two and three drinks) was associated with a 10 percent increased risk of preterm birth. However, it’s not clear if this increased risk is caused by the alcohol exposure, or by other factors.

Overall, Zuccolo says, “we were surprised by how few studies have been published … on such an important topic.”

She says that, given the lack of robust data, it’s hard to answer the question: Is one drink during pregnancy safe? And she and her co-authors conclude that further studies are needed to provide “a better estimation of the likely effects.”

But experts say the lack of evidence is not a reason to challenge the current advice to avoid alcohol entirely during pregnancy.

“We don’t 100 percent understand exactly when and how — and at what point in pregnancy — the effects occur from alcohol [consumption],” says David Garry, who is also a spokesperson for the American Congress of Obstetricians & Gynecologists.

But he says, think of it this way. The harms of alcohol consumption during pregnancy, especially heavy drinking, can be far-reaching. Fetal alcohol spectrum disorder can lead to everything from birth defects to intellectual development problems to struggles with mental health. “It’s everything from mild to severe problems.”

“By simply not drinking, you can prevent the problem,” says Garry. So, why take a risk?

This precautionary principle has become the basis of guidelines around the globe.Even countries where wine is woven into the culture, such as Franceadvise women that it is safest not to drink alcohol at all during pregnancy.

And, recently, Italy updated its guidance as well. This information leaflet for Italian women says “50-60 percent of pregnant women in Italy consume some alcoholic beverages.” Then, it warns: “Even minimal amounts of alcohol [during pregnancy] could harm the baby’s health and development.”


Retrieved from: http://www.npr.org/sections/thesalt/2017/09/12/550152771/is-one-drink-ok-for-pregnant-women-around-the-globe-the-answer-is-no?utm_campaign=storyshare&utm_source=twitter.com&utm_medium=social

Message from the Minister of Health – International Fetal Alcohol Spectrum Disorder Awareness Day 2017



International Fetal Alcohol Spectrum Disorder (FASD) Awareness Day is marked annually on September 9 to raise awareness about the risks of drinking alcohol during pregnancy and about the challenges that individuals with FASD and their families face.

FASD is a brain injury that can occur when an unborn baby is exposed to alcohol in the womb and the result is a lifelong disorder with effects that include physical, mental and behavioural disabilities. FASD is the leading known cause of preventable developmental disabilities among Canadians.

Children and adults living with FASD, often encounter a great deal of stigma and judgement. This stigma can keep women from openly discussing alcohol consumption with their health care providers, preventing them from accessing the programs, services, and supports they need.

Many factors can contribute to FASD, and there is no single solution to preventing it. That is why the Government of Canada is partnering with provincial and territorial governments, communities, Indigenous organizations and experts to support a variety of education and prevention initiatives.

For example, we are funding five projects that focus on developing knowledge and skills among health professionals on how to screen, counsel and discuss alcohol use with girls and women. The goal of these projects is to help prevent alcohol use during pregnancy and to promote behaviours that set the conditions for lifelong health. We are also supporting the Kids’ Brain Health Network to provide health care professionals, policy makers, caregivers and families with tools and information to promote earlier diagnosis, better treatment and optimal outcomes for children with neurodevelopmental disorders, including FASD.

In order to increase awareness of FASD among First Nations and Inuit communities, as well as educate front-line workers, our government is also developing culturally appropriate prevention and intervention programs that educate and raise awareness about the impacts of FASD. We  are also exploring opportunities to advance the Truth and Reconciliation Calls to Action #33 and #34 related to FASD by working in collaboration with Indigenous people to implement preventive programs that can be delivered in a culturally appropriate manner.

By working together, we can encourage healthy pregnancies and support those living with FASD. This month, learn more about FASD prevention and join the conversation on social media by using the hashtag #FASD.

Ginette Petitpas Taylor
Minister of Health

During Fetal Alcohol Spectrum Disorders Awareness Month, experts underscore danger of drinking while pregnant


Kris Rife adopted her son as a baby more 20 years ago but didn’t find out until he was 14 that he had probably been exposed to alcohol in his birth mother’s womb.

In retrospect, the diagnosis of a fetal alcohol spectrum disorder made sense, she said. His fifth-grade teacher suspected he might suffer from fetal alcohol exposure. But Rife shrugged off the teacher’s concerns. Her son had none of the distinct facial features associated with fetal alcohol syndrome, such as a flat nose bridge or a thin upper lip. His doctors didn’t think he was at risk.

But he did struggle behaviorally and developmentally. He had trouble remembering things and controlling his temper, grasping concepts involving space and time. He would forget to think through what he said before he said it. That’s why Rife and her husband, who live in Mount Pleasant, thought their son might have autism.

Then, during an autism evaluation at the University of Utah, a birth defects expert noticed that his head was a little small, which is another, more subtle sign of fetal alcohol exposure.

That expert also noted that Rife’s son, a teenager at that point, was very personable, even among strangers, a personality trait at odds with some autism spectrum disorders. All of those clues informed the final diagnosis.

“It was horrible,” Rife said. “They’re still babies at 14.”

Nearly a decade after her son’s diagnosis, Rife now pours her time and energy into advocacy. She is trying to raise awareness about the dangers of fetal alcohol exposure through the S.C. Fetal Alcohol Spectrum Disorders Collaborative, an undertaking made more difficult by the fact that the state government invests little money to address the problem. One state employee at the Department of Disabilities and Special Needs spends about 15 percent of her time working on fetal alcohol spectrum disorders, Rife said. She thinks the issue deserves more attention.

“When people think it’s not a big problem, it’s because it’s not recognized,” she said.

Rife specifically wants to sound a call to women that no amount of alcohol is known to be safe during pregnancy. But she conceded that her message is different from the advice of some doctors who assure their pregnant patients an occasional drink won’t harm their babies.

“It is very frustrating,” Rife said. “There is not the science that says you cannot have one drink during pregnancy. You can’t prove that. But we can tell you that you might have a problem with a child if you have one drink. Do you want to take that risk?”

Last year, leaders at the Centers for Disease Control and Prevention posed the same question.

The agency told health care providers that they should warn their patients of child-bearing age “not to drink at all if she is pregnant, trying to get pregnant or sexually active and not using birth control.”

Agency officials explained that most women expose their unborn children to alcohol in the womb before they even realize they are pregnant. Nearly half of all pregnancies in the United States are unplanned each year. Often, when a woman first finds out she is pregnant, the damage has already been done.

But unanticipated backlash to the CDC advisory was intense. One critic, in Time, called the recommendation a “scare tactic” and accused the CDC of prioritizing an unborn fetus over a “woman’s right to her own body.” Professors from Harvard and Yale wrote in the Boston Globe that the agency’s advisory “damages its credibility as a source of clear, balanced advice about health risks.”

 Dr. Connie Guille, a reproductive psychiatrist who works with pregnant patients at the Medical University of South Carolina’s Department of Psychiatry and Behavioral Sciences, said conflicting information regarding what’s safe and what’s not can be confusing for patients.
“It’s one of those controversies that will just continue to cycle through,” Guille said.

Scientists will never be able to study fetal alcohol exposure in a randomized, controlled clinical trial, the industry’s gold standard, because such a study would be unethical, she said.

“What we’re kind of left with is looking at studies that do demonstrate very clearly that there is risk associated with alcohol use in pregnancy,” she said.

The general public may not realize fetal alcohol spectrum disorders are so problematic and so prevalent because the majority of cases are never diagnosed, Guille said. And most people who suffer from one of these disorders do not have any of the distinct facial features associated with fetal alcohol syndrome, she said.

The American Academy of Pediatrics estimates that fetal alcohol spectrum disorders may affect up to 4.8 percent of all children. And Guille cited studies that have shown, for example, the rates of these disorders are quite common among prisoners.

“The impact goes well beyond the individual,” she said. “This has a big impact on our society as well.”

September is Fetal Alcohol Spectrum Disorders Awareness Month.

Retrieved from: http://www.postandcourier.com/features/your_health/during-fetal-alcohol-spectrum-disorders-awareness-month-experts-underscore-danger/article_0464032e-930d-11e7-8ce1-2f6f85dfc739.html

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