Monthly Archives: July 2015

International Alliance for Responsible Drinking: Determinants of Drinking

iard-logoThe International Alliance For Responsible Drinking (IARD) are a not-for-profit organization dedicated to addressing the global public health issue of harmful drinking. They are also committed to promoting responsible drinking worldwide, and acknowledge that this can only be achieved by a collective effort shared by governments, producers, retailers, consumers, and civil society. As a global public health NGO, they work together with these stakeholders to promote policy dialogue, assess the evidence, and seek local solutions to harmful drinking globally.

IARD’s Issues Briefings address various topics relevant to alcohol policies, providing the balance of available evidence regarding impact, caveats, and limitations. The excerpt below is taken from ‘Determinants of Drinking’.

The Issue in Brief: Determinants of Drinking

Much attention has been paid to the various determinants—biological and environmental—that influence drinking behavior, particularly among young people, and to their relative impact. These can fall into four groups:

  • genetic predisposition;
  • individual characteristics;
  • social and economic factors;
  • environmental determinants.

Research often focuses on just one group of factors at a time. However, their influence is complex and interrelated, and effects cannot easily be disaggregated. While there is broad agreement that multiple factors have a role in drinking behavior, considerable debate surrounds the following questions:

Which are the most influential determinants?

How do they interact?

How can they best be addressed through interventions?

The evidence:

Genetic predisposition plays an important role in shaping both drinking patterns and outcomes but is modified by interaction with social and economic variables. Various individual characteristics—including current age, the age at which drinking commences, personality traits, and physical and mental health status—affect the development of drinking patterns. Socioeconomic status, notably social marginalization and economic deprivation, influences the relationship between drinking and problems. Family is pivotal to forming alcohol expectancies and drinking behavior, as are peer interactions and influences, both of which have a role in social networks.

Finally, the broader environment within which drinking develops, including general drinking culture, its norms and practices, religious beliefs, and the availability of alcohol and its saliency, is also significant in how drinking patterns develop and progress. The complexity of the interactions among different factors makes cause-and-effect relationships difficult to ascertain. Individual influences cannot be uncoupled from other factors that are strong in people’s lives and shape perceptions and behaviors.

What Is the Issue?

Much attention has been paid to the relative impact of various factors that influence drinking behavior, particularly among young people. Determinants of drinking include biological, social, and economic factors, as well as the wider drinking environment.

These factors have a significant impact on individual response to alcohol consumption and outcomes, and help shape consumer choices and behaviors. Research often focuses on these factors one by one; however, their influence is complex and interrelated, and effects cannot easily be disaggregated.

Substantial interdisciplinary research is needed to better understand how different determinants interact. Similarly, there is a need for multi-component approaches to policy and prevention that simultaneously address these determinants.

What Is the Debate?

While there is broad agreement that multiple factors have a role in drinking behavior, considerable debate surrounds the following questions:

  • Which are the most influential determinants?
  • How do they interact?
  • How can they best be addressed through interventions?

Some argue that, when it comes to young people, family, peers, and the general drinking culture are central in determining drinking:

“While adolescents are experiencing community-level influences related to the place of alcohol in our society, each adolescent is also making decisions about drinking within a particular social setting. Of particular importance with regard to social influences are adolescents’ peers and friendship networks and their changing relationships with their parents. The effect of parents’ and peers’ alcohol consumption on adolescents’ drinking patterns is both direct, through observation and modeling, and indirect, through its influence on alcohol-related expectancies and attitudes.”

Others focus on influences such alcohol availability and marketing and their impact on shaping drinking behavior and outcomes:

“Longitudinal studies consistently suggest that exposure to media and commercial communications on alcohol is associated with the likelihood that adolescents will start to drink alcohol, and with increased drinking amongst baseline drinkers. Based on the strength of this association, the consistency of findings across numerous observational studies, temporality of exposure and drinking behaviours observed, dose-response relationships, as well as the theoretical plausibility regarding the impact of media exposure and commercial communications, we conclude that alcohol advertising and promotion increase the likelihood that adolescents will start to use alcohol, and to drink more if they are already using alcohol.” 

This debate also extends to identifying the most appropriate and effective approaches to prevention and interventions, whether through education and social interventions or restrictions on access and exposure to alcohol.

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Determinants of Drinking


Read the full briefing here!

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Click to download.

Celebrate the changes: Perfect reason to avoid alcohol when pregnant

I’m not sure how many of you have already seen this video, but with a long weekend approaching in Canada, this video provides an excellent reason as to why before you consume alcohol, make sure you are not pregnant!

(Thank you Foothills Fetal Alcohol Society for sharing on Facebook.)


One Alberta3835970261_HAPPY_BEER_answer_103_xlarge blogger is taking up the challenge of going alcohol-free for the next 30 days in the hopes of not only tracking changes in her mind, body, and soul but answering the question, “Why do I drink so much?”.

Interesting in being part of the challenge or tracking her experiences? Check out:

Read her first post:

Who doesn’t like booze?

I know I do…greatly – follow my progress through this next 30 days of being alcohol free. Maybe you want to try it along with me and post what your experiences are in the comments..up for the challenge!?!?

Do you know what a standard drink looks like? Do you usually pour yourself a glass of wine and notice that a quarter of the bottle is in your glass?

One Standard Drink equals:

  • 341 ml (12 oz) bottle of 5% alcohol beer, cider or cooler
  • 43 ml (1.5 oz) shot of 40% hard liquor (vodka, rum, whisky, gin etc.)
  • 142 ml (5oz) glass of 12% wine

Canada has developed low risk drinking guidelines which is 10 drinks for a women per week with no more than 2 per most days and 15 drinks per week for a man with no more than 3 drinks per most days.

I can say that I probably exceed those guidelines more often than not. I drink at least 4 evenings during the work week with 2-3 beers or 1 non standard glass of wine and this doesn’t include my weekend drinking. I consume the same if not more on Friday and Saturday. To me I don’t see or feel the effects of my drinking habits; I don’t see it impacting my life or health in anyway. However from what I have read it is more than likely is effecting my health and well-being more than I realize. I have also been having conversations with colleagues and friends lately about why we feel the need to have a drink after a hard days of work – it is like we are entitled to this drink. Why do we feel the need to have a drink or 4 when we are out for dinner with friends or family. Why when we are camping do we start the day with baileys and crack a beer before noon…

With all of the above being said I have decided to go without alcohol for 30 days (which started on Monday) to see if I will notice anything different within my mind, body and soul. Considering alcohol has been such a big part of my personal and social life I believe this will be a considerable challenge that I am excited to venture down.

So far in all honesty the avoidance of booze has not been all that difficult…however it is only Wednesday. Yesterday on my drive home I had a fleeting thought about a nice cold beer waiting for me at home and then I quickly pushed that thought out and wondered what else I could drink besides water. I brewed myself some iced tea and cooked dinner.

I think tonight will be a challenge; I am meeting friends for dinner after work. I would normally have two pints during a dinner like this, but tonight I will be drinking probably….wait for it…..lemon water <<< does not sound as wonderful as a beer now does it.

Then we have this long weekend of camping – camping comes with an extreme expectation to drink high quantities of alcohol — for me anyways. This will be my test of all tests.

Tune in on Sunday/Monday to see how the next few days go for me and my personal challenge to avoid alcohol for 30 days.

Thank you for reading.

On Love, Adoption and Raising 3 Kids With FASD: Parent Perspective

By | July 29, 2015

Not many people wish to raise a child with a fetal alcohol spectrum disorder, or FASD. Diane Lohrey is no different. But when she and her husband adopted three children, all later diagnosed with an FASD, they accepted the hardships and the rewards.

When you walk into the Lohrey household, kids seem to materialize out of thin air.

“We have five of our own and one foster, so six kids right now,” says the mom, Diane Lohrey.

The Lohrey family. From left to right: Elena, Kylie, John, Kristyanna, Diane (holding a foster child) and Emilyanne. Elena, Kylie and Kristyanna have all been diagnosed with FASD. (Photo by Lisa Phu/KTOO)

Two are biological, three are adopted and the foster child is through the state Office of Children’s Services.

“And they just called us a few minutes ago to see if we would take an 8-year-old boy, but we have no room right now,” Lohrey says.

They’ve already converted their garage into a comfortable bedroom. At least a dozen foster children have passed through the four-bedroom house since 2005, staying anywhere from one night to 18 months.

The Lohreys’ first adoption was Elena from Russia in 2004.

“Within two days, I knew something was wrong,” she says.

Elena was 21 months old. Lohrey says she was different than the other Russian infants getting adopted.

“She would stare at things. She didn’t know how to play with toys. She would play with a little piece of lint more than she would a toy,” Lohrey explains.

Years later, the Lohreys adopted biological sisters Kylie and Kristyanna from Juneau through OCS.

They receive a stipend from the state for the two girls, who are now ages 5 and 6, and any foster children that pass through. Lohrey is a stay-at-home mom and her husband is a highway engineer.

Elena Lohrey, 12, looks at pictures from an FASD Family Camp her family attended in Arizona earlier this summer. (Photo by Lisa Phu/KTOO)

All three adopted kids were diagnosed with fetal alcohol spectrum disorders at the FASD clinic in Juneau. Medical professionals at the clinic require some kind of evidence that the biological mother drank during pregnancy in order to do the diagnosis.

That was hard for Lohrey. She pleaded with Kylie and Kristyanna’s biological mom, “‘Go to OCS and write down that you drank or that you drank before you knew you were pregnant. That is the greatest gift you can give these children,’ and she did it,” says Lohrey, crying.

Emilyanne, 21, is one of Lohrey’s biological children. She says the diagnosis opens the doors for getting help, “and for, like, other people to understand, they’re not just bad kids. There’s a logical explanation for why they are the way they are, and how to give more ideas how to help them and not discard them like trash.”

FASD is an umbrella term that’s used to describe a range of disabilities, minor to severe. Lohrey says each of her three adopted kids falls in different areas. Issues include short attention spans, disorganization and being overly trusting. One of her kids has a tendency to lie and steal.

Elena, who’s also been diagnosed with an autism spectrum disorder, doesn’t communicate her own needs.

“She won’t voluntarily say, ‘I need something,’ or ‘I need help,’ or ‘I’m lost.’ So one of the things they told us is that she might need long-term care, that she might not be able to live on her own. And that was like – that hurt,” Lohrey says.

The Lohreys converted the garage into a bedroom that Kristyanna, 6, and Kylie, 5, share. (Photo by Lisa Phu/KTOO)

It’s tough to accept that your child has a lifetime disability for which there’s no cure, Lohrey says. In most cases, you can’t tell by looking that someone has an FASD.

“A lot of times, you’re out in the community and your kids are doing something stupid and you’re embarrassed and some people will say really rude things to you, like ‘You need to control your child,’ and you’re like, ‘Wait a minute, I’m doing the best I can. You have no idea.’ And sometimes I would love to wear a shirt that says, ‘My child has FASD. Don’t judge us,’” Lohrey says.

The Lohreys did not set out to adopt three kids with fetal alcohol spectrum disorders.

“And there are days when I’m like, ‘Oh, I wish I had never adopted.’ I think that’s with your typical family, too. I think there are days where parents say, ‘I wish I didn’t have any kids.’ I think that’s normal,” Lohrey says.

She admits she may say it more than other parents, but there are times when she can’t imagine not adopting.

“Each little child that you adopt, each little child that you foster, hopefully you’re giving them something that will make this world a better place and better understanding and teach more empathy,” Lohrey says.

Lohrey sometimes blames the biological parents, but she knows that’s pointless. She says you can’t change the past. You can only focus on the here and now, and the future.

Retrieved from:

Research on Adolescents and Adults: If Not Now, When? The 7th National Biennial Conference on Adolescents and Adults with Fetal Alcohol Spectrum Disorder (FASD), Vancouver, British Columbia, Canada, 6 – 9 April 2016



Wednesday, April 6 – Saturday, April 9, 2016


The Hyatt Regency Vancouver
655 Burrard Street,
Vancouver, British Columbia, Canada V6C 2R7


Although there have been thousands of published articles in FASD in general, there has been limited research specifically on adolescents and adults with FASD or on individuals across the lifespan. As those individuals diagnosed with FASD continue to age, the “need to know” across a broad spectrum of areas is becoming critically important for identifying clinically relevant research questions and directions. This is especially true for questions which answers have the potential to prevent the long-lasting effects of fetal alcohol exposure on cognition, behaviour, physical and mental health, addiction, immune function, and metabolism, and to improve quality of life.

Arising from the work of previous conferences and experience-based practices, there is a clear need to examine relevant global research (especially in areas that are new and emerging in animal models and both basic and clinical science), literature, programs and policies and the ethics surrounding them with implications for the future. What do the highlights of existing or emerging research tell us? Are the results transferable from country to country and/or from laboratory to real life? Are there clinical implications of results from any of these areas of which we should be aware? What are the changes in our thinking, practice and directions that will be required to improve outcomes? What are the ethical issues and implications for the future?

This interactive 2016 conference will provide an opportunity to be at the forefront of addressing these issues. We will leverage the experience of the diverse group of professionals, researchers, students, families and individuals with FASD who attend to stimulate the discussion of research, evidence for practice, models, and ideas to expand our knowledge of how we can sustain and enhance the lives of those with FASD.

Goals and Objectives:

  • Identify, explore and examine existing, new and emerging research and the implications for those with FASD, families and caregivers, systems and services
  • Connect the identified needs of community workers, healthcare providers, and families with the research community
  • Discuss emerging research findings and how they might better assist ethical policy and decision making and the development of integrated and collaborative approaches across systems
  • Examine practice-based evidence, projects and programs to understand the potential connections to research and potential longitudinal studies
  • Engage in knowledge exchange and dialogue through sessions, networking and the direct experience of those with FASD

Who Should Attend:

The conference will be essential for those living or working with adults with FASD. It will also be of critical interest for those supporting adolescents with FASD and planning for their futures. It will be of particular interest to the following professionals/individuals noted below. And as always, we are honoured to have individuals with FASD as our guests.

  • Administrators/Managers
  • Alcohol & Drug Workers
  • Corrections Workers
  • Counsellors
  • Educators/Administrators
  • Elected Officials/Hereditary Officials
  • Employment Services
  • Ethicists
  • Family Members
  • Financial Planners
  • First Nations, Metis and Inuit Communities
  • Government Officials
  • Housing Officials/Providers
  • Individuals with FASD
  • Judges
  • Lawyers
  • Members of Faith Communities
  • Mental Health Specialists
  • Nurses
  • Occupational Therapists
  • Physicians
  • Police Officers
  • Policymakers
  • Private/Public Funders
  • Program Providers
  • Psychiatrists
  • Psychologists
  • Researchers
  • Social Service Providers
  • Social Workers
  • Speech Language Pathologists
  • Spouses/Partners
  • Students
  • Vocational Rehab Service Providers

View the Advance Notice & Call for Abstracts

In collaboration with:

Canada FASD Research Network logo

Social Reference Prices for Alcohol: A Tool for Canadian Governments to Promote a Culture of Moderation


Most provincial liquor distribution and control authorities in Canada set social reference prices (SRPs) for alcoholic beverages, otherwise known as “floor” or “minimum” prices. Published research confirms SRPs can help reduce harmful patterns of alcohol use and related problems. The way SRPs are applied differs widely across Canadian provinces and territories.

In this paper, the National Alcohol Strategy Advisory Committee (NASAC) provides a comprehensive set of recommendations for SRPs for alcohol sold from off-premise retail outlets. Recommendations for Social Reference Pricing in Canada Based on existing Canadian examples of best practice, NASAC recommends that liquor boards and commissions:

 Apply SRPs to all types of alcoholic beverage.

 Ensure SRPs reflect the alcohol content of drinks within each major beverage class.

 Regularly review, maintain and update the value of SRPs relative to provincial consumer price indices (CPI).

 Close existing loopholes that allow the sale of alcohol below SRPs.


In 2007, the Canadian Centre on Substance Abuse led the development of the first National Alcohol Strategy (NAS) for Canada and produced a document entitled Reducing Alcohol-related Harm in Canada: Towards a Culture of Moderation (NASAC, 2007).

A wide variety of representatives from civil society, public health, transportation safety, First Nations, criminal justice, law enforcement, liquor administration, academia and the alcohol industry were involved in the process. NASAC continues to oversee the implementation of the 41 recommendations in that report. The current report focuses on the following NAS alcohol pricing recommendations:

Recommendation 26: Adopt minimum retail social-reference prices for alcohol and index these prices, at least annually, to the Consumer Price Index (CPI).

Recommendation 28: Create incentives, whether through tax or price adjustments, to promote the production and marketing of lower-alcohol content beers and coolers, with the overall goal of reducing the volume of absolute alcohol consumed per capita in Canada.

These recommendations from the NAS are based on evidence that the price of alcohol can have a significant relationship with level of consumption, albeit sometimes offset to a degree by increased cross-border purchases and home production. Nonetheless, impartial reviews of published studies estimate that a 10% increase in the average price of alcoholic beverages leads on average to a 4-5% reduction in total consumption (Gallet, 2007; Wagenaar, Saloi, & Komro, 2009). These recommendations also recognized that SRPs were likely to have a greater impact on those experiencing alcohol-related harms and less impact on individuals who drink within low-risk drinking guidelines.

Researchers have estimated the impacts of setting different floor prices for a given “unit” or “standard drink” of alcohol on different types of drinkers both in European jurisdictions (Purshouse, Meier, Brennan, Taylor, & Rafia, 2010) and Canadian provinces (Hill-McManus et al., 2012). These studies estimate minimal impacts on moderate drinkers, but reductions in consumption, alcohol related deaths, crimes and hospital admissions for those drinking above low-risk drinking guidelines.

Recent Canadian research found evidence of an inverse relationship between alcohol-related deaths and hospital admissions, on the one hand, and changes in SRP rates on the other. For example, in British Columbia it was estimated that increases in the average SRP for alcohol were associated with reductions in alcohol-related hospital admissions (Stockwell et al., 2013). Other research has shown that frequent heavy drinkers are more likely to drink the cheapest alcohol (Kerr & Greenfield, 2007) and, further, the consumption of cheap alcohol is more responsive to price increases than is consumption of expensive alcohol products (Gruenewald, Ponicki, Holder, & Romelsjo , 2006).

While the evidence has grown that the use of SRPs can be a well-targeted strategy for reducing alcohol-related harm, it has also been highlighted that practice in setting SRPs varies substantially from province to province (Thomas, 2012). Giesbrecht et al. (2013) highlighted the following best and promising practices in some provinces:

1. Indexation of SRPs to the cost of living (e.g. Quebec and Ontario);

2. Application of higher prices for higher strength varieties within beverage types in Saskatchewan (e.g., 8.5%+ strength beers have higher SRPs than 5% beers);

3. Higher overall SRPs in some Atlantic provinces, such as Nova Scotia and Newfoundland, when calculated per Canadian standard drink (i.e., 13.45 g ethanol or the amount in a 12 ounce 5% beer, 5 ounce 12% wine or 1.5 ounce 40% spirit-based drink), mostly in the range of $1.50 to $1.75.

More recently, further examples of good practice have emerged. Manitoba announced the introduction of a sliding scale for beer SRPs according to exact alcohol content, starting June 2, 2014 (Lambert, 2014). New Brunswick and Manitoba imposed stricter conditions on SRPs by disallowing heavy discounts on product lines that were not selling well. However, many provinces do not regularly update SRPs with inflation, and many allow loopholes that permit the sale of alcohol below SRPs.

Local economic and cultural factors will incline Canadian provinces and territories to develop their own unique alcohol pricing strategies. Variation in the rates of provincial liquor sales taxes is a particularly important factor determining final retail prices over and above SRP rates. Giesbrecht et al. (2013) noted considerable potential for strengthened public health policy in this area by applying existing best practices in Canada across all jurisdictions. In this document we offer guiding principles rather than exact prescriptions.

Read the full report!


Read full report here!

The Role of the Social Worker in Preventing, Identifying and Treating FASD

Did you watch this new webinar by NOFAS?

This webinar examines the role of the social worker in the prevention, identification and treatment of Fetal Alcohol Spectrum Disorders. The webinar offers a discussion on how the social worker can utilize alcohol screening and brief intervention with their female clients to prevent them from having an alcohol-exposed pregnancy.

The webinar provides what we currently know in how to identify clients who may present with symptoms of having a potential FASD. Dr. Tenkku Lepper will discuss what is currently available for helping the social worker in treatment programs for those who are diagnosed with having a diagnosis of any of the conditions along the spectrum of disorders. The webinar will outline the primary roles for the social worker at both the micro and macro levels.

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