The Prevention Conversation: A Shared Responsibility Project

Kathleen 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.

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.”

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.

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 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.

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.

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 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.

‘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

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/

By ANN DOWSETT JOHNSTON

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 France, advise 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.”

By: ALLISON AUBREY

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