Monthly Archives: August 2015

The Risks of Drinking Alcohol When Trying to Get Pregnant

Most women know to stop drinking during pregnancy because of the risks to their developing fetus. But a new study shed light on the risk of women drinking alcohol while trying to conceive. The study on laboratory rats found an increased risk of type 2 diabetes in the offspring of rats that were given alcohol around the time of conception.

pregnancy and wine

“There is now a lot of evidence that events occurring very early in pregnancy can influence lifelong health,” says Karen Moritz, PhD, associate professor at the School of Biomedical Sciences, University of Queensland, Australia, and the lead author of the study. “We know that poor nutrition, either too little food or too much, during pregnancy, can lead to children with increased risk of diabetes, high blood pressure and other chronic diseases.”

Moritz fed the rats the equivalent of five drinks during a period four days before conception until day four of gestation. They found that the offspring had elevated fasting glucose, impaired glucose tolerance, and decreased insulin sensitivity at six months of age. Together these raise the risk that they would develop type 2 diabetes and obesity in early middle age.

“Before the egg implants, before any organs start to develop, alcohol consumption somehow causes changes to the embryo,” says Moritz. “We think the alcohol exposure around conception has caused changes in the very early embryo. This may be changes in expression of genes necessary for normal development or the metabolism of the embryo.”

The researchers also wanted to compare the effects of alcohol to the effects of a high fat and sugar diet, like the typical Western diet, which when consumed by pregnant women, has also been associated with an increased risk of type 2 diabetes and obesity. They placed some offspring, both control animals and those exposed to alcohol, on a Western diet when they were young adults. They found that the degree of insulin resistance (a precursor to diabetes) was similar in control rats (no alcohol) exposed to a Western diet and those exposed to alcohol but on a non-Western diet.

“This suggested that alcohol exposure around the time of conception was equally able to induce insulin resistance as consumption of the high fat diet in adult life,” says Moritz.

The study is the first to show an effect of alcohol consumption around conception on metabolism in offspring, but it is preliminary. “This study demonstrates the association, but it is important to remember that it is an animal model, “says Siobhan Dolan, MD, MPH, medical advisor to the March of Dimes. “So now it needs to be tested in women.” In the meantime, Dr. Dolan recommends women trying to conceive skip alcohol. “There are many reasons to abstain from drinking alcohol when you are trying to conceive or are pregnant, and this is yet another,” she says.

Source: http://www.endocrineweb.com/news/reproductionsexuality/16068-steer-clear-alcohol-when-trying-get-pregnant

Study: Alcohol Involvement in Sexual Behaviour and Adverse Sexual Health Outcomes from 26 to 38 Years of Age

Bar guide for Gambit

Alcohol Involvement in Sexual Behaviour and Adverse Sexual Health Outcomes from 26 to 38 Years of Age

PLOS

  • Published: August 12, 2015
  • DOI: 10.1371/journal.pone.0135660

Introduction

The relationships between alcohol consumption and sexual behaviour are complex, with empirical support for causal relationships in both directions, and for shared causes of both behaviours, depending on the context and population [13]. Apart from selected high risk populations such as those infected with HIV [4], most published research has focused on adolescents and young adults. Among young people, the high prevalence of hazardous alcohol consumption, risk-taking, and sensation-seeking activities has made it difficult to quantify the causal elements of commonly observed associations between alcohol and sexual outcomes [15 6]. However, there is substantial evidence for the cognitive effects of alcohol affecting decision-making and resulting in riskier choices regarding sexual activity [1 68], and a recent systematic review concluded that blood alcohol concentration is an independent risk factor for the intention to engage in unprotected sex among young adults (mean age 24.0 years) in North American college and community settings [9].

In general populations, the prevalence of hazardous alcohol consumption is typically lower in older age groups [10], along with lower levels of other risk-taking behaviours, and in concert with the formation of long term sexual partnerships. However, cross-sectional surveys do not separate age and cohort effects on alcohol consumption, and changes in the last two decades suggest that alcohol’s role in sexual behaviour beyond young adulthood may have become more relevant to sexual health outcomes.

Adults currently in their late thirties in most English-speaking countries have been exposed to a youth culture where hazardous drinking behaviour has been common from early teenage years [11] and where, at least in the UK, first sexual intercourse is more likely to have been experienced when intoxicated than previously [12]. Young women’s drinking has increased sharply in a single generation [13], and gender convergence of drinking patterns is commonly seen [11 14], with increased drinking among women of all ages during the last two decades [15].

Breakdown of long term relationships, and initiation of new ones, are not uncommon in the 30–40 year age group and there are a number of roles alcohol use might play in these transitions, particularly if there has been a persistence of, or return to, drinking behaviour experienced as a young adult [16]. Among the potential adverse consequences of heavy drinking for sexual health in this age group are those already identified in younger people, such as sexually transmitted infections, unwanted pregnancies, and regretted sexual experiences [17].

Little has been published in the last twenty years describing alcohol use in the context of sexual behaviour of heterosexual adults over 30 in the general population, or quantifying associations of their alcohol use with sexual behaviour and/or health. Most studies have been conducted in non-representative groups such as military personnel [18], men who have sex with men, or STI clinic attenders [19]. One exception is a 1994 population-based cross-sectional study in the U.S. which analysed several drinking measures in relation to being sexually active, having more than one partner in the past year, and condom use [20]. However, no age- or sex-specific findings were reported. Another is the Natsal-2 study in the UK, which compared nationally representative surveys of 16–44 year olds in 2000/1 and 1990/1 with respect to alcohol use at first heterosexual intercourse, and quantified the association of heavier drinking (defined as an average level above current guidelines) with a range of outcomes: numbers of sexual partners, unprotected sex, prevalence of sexually transmitted infections (STIs), sexual function problems, terminations of pregnancy (TOPs) and emergency contraception use [12]. However, this study published age-adjusted rather than age-specific findings, and did not investigate the association of frequency of heavy drinking episodes with sexual risk behaviours or outcomes, even though the implicit mechanism of effect is intoxication.

In this paper we report on alcohol’s role in sexual behaviour and outcomes among 38 year olds from a New Zealand birth cohort. In particular we describe, for men and women separately, 1. self-reported use of alcohol in relation to sexual activity and perceived consequences of that use, 2. cross-sectional associations of heavy drinking frequency with self-reported alcohol involvement in sex, 3. associations of heavy drinking frequency with partner numbers, STIs and TOPs, and 4. whether associations of heavy drinking with these three outcomes have changed since the 26–32 year old period of the same cohort.

Methods

Members of the Dunedin Study birth cohort answered computer-presented questions about sexual behaviour and outcomes, and interviewer-administered alcohol consumption questions, at age 26, 32 and 38 years.

Results

Response level was >90% at each assessment. At 38, drinking before or during sex in the previous year was common (8.2% of men; 14.6% of women reported “usually/always”), and unwanted consequences were reported by 13.5% of men and 11.9% of women, including regretted sex or failure to use contraception or condoms. Frequent heavy drinkers were more likely to “use alcohol to make it easier to have sex” and regret partner choice, particularly women. Heavy drinking frequency was strongly associated with partner numbers for men and women at 32, but only for women at 38. Significantly higher odds of STIs amongst the heaviest drinking men, and TOPs amongst the heaviest drinking women were seen at 32–38.

Conclusions

Alcohol involvement in sex continues beyond young adulthood where it has been well documented, and is common at 38. Women appear to be more affected than men, and heavy drinking is associated with poorer outcomes for both. Improving sexual health and wellbeing throughout the life course needs to take account of the role of alcohol in sexual behaviour.

For full paper visit: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135660

NOFAS Statement on the Stigma of FASD

NOFAS_main-logo2NOFAS Statement on the Stigma of FASD

People affected by FASD (Fetal Alcohol Spectrum Disorders) are often stigmatized, including individuals living with FASD and their family members and caregivers.

Birth Mothers

One group that faces overwhelming stigma, even within the FASD community, is birth mothers of children with FASD. These are women who used alcohol (and sometimes other drugs) while pregnant and have a child or children affected by FASD. These women often feel tremendous guilt, shame, and embarrassment from knowing that prenatal alcohol exposure caused lifelong problems to their own children.

The stigma placed on birth mothers is a major barrier to the goal of preventing FASD and helping individuals living with FASD. Blaming and shaming birth mothers of children with FASD and their families does not help to prevent FASD. Having the courage to speak out as a birth mother and share one’s story takes courage and DOES help to prevent FASD.

The stigma and fear of judgment is one of the reasons that women will not disclose to healthcare providers or others that they drank during their pregnancy. The stigma can sometimes prevent physicians from asking women about their alcohol use.

Some doctors have reported that they won’t diagnose a child with an FASD, even when they believe that it is an accurate diagnosis. They say that it is less complicated to diagnose the symptoms of FASD, such as ADHD or bi-polar disorder. They don’t want to stigmatize the birth mother, her family, or her child. Stigma is a major reason that FASD is substantially under diagnosed and helps explain why FASD remains a largely “hidden disability.”

The NOFAS Circle of Hope (COH) peer-mentoring program works to reduce the stigma birth mothers face by connecting them with other women who have the same experience and can relate to them with empathy, understanding, and love. The majority of members of the COH are actively involved in recovery from alcoholism or addiction and now live sober lives. The recovery process involves addressing stigma issues, through a process of admitting, accepting, and making amends for one’s past. The stigma of being a birth mother is reduced when the woman is no longer drinking, in recovery (for the members that have substance use disorders), and engaged in a supportive community of empathetic peers.

At NOFAS, we talk with women from all walks of life that drank during pregnancy. In our experience, we find that pregnant women do not drink in order to intentionally cause harm to her child. Women who drink during pregnancy and have children with FASD nearly always fall into these three categories:

  1. They suffer from the disease of alcoholism and can’t stop alcohol use on their own
  2. They are not aware that they are pregnant
  3. They are unaware of or are misinformed about the risks of alcohol to their unborn baby

NOFAS strongly believes that physicians and healthcare providers should ask women about their alcohol use and learn to communicate with them in a non-judgmental tone, and with empathy and concern. Women with substance abuse disorders (SUD) need support to stop their alcohol or other drug use. Additionally, NOFAS believes that alcohol use during pregnancy should be treated as a public health problem, not as a criminal offense. Communities need to provide appropriate treatment and resources that women, pregnant women, and women with children need to recover from the disease of alcoholism.

One way that professionals can help to reduce the stigma when discussing or writing about the topic of FASD is to use language that is less blaming towards the mother. For example, defining FASD as “The range of effects that occur when a developing baby is prenatally exposed to alcohol” carries much less stigma than a definition like “FASD is what happens when a mother drinks alcohol while she’s pregnant.” The term “prenatal alcohol exposure” carries less of a stigma than “maternal alcohol exposure.”

Adoptive and Foster Parents/Caregivers

Many adoptive and foster parents of children with FASD also deal with stigma. A disproportionality high number of children both formally diagnosed with FASD and undiagnosed are raised by adoptive or foster parents. The stigma of the birth mother and family is often quickly understood when talking with adoptive and foster families. Sometimes unknowingly, adoptive and foster parents acknowledge and perpetuate the stigma by emphasizing that they are not the birth parent when introducing themselves by saying “I’m an adoptive or foster mother of a child with FASD.”

They may request information or resources specifically targeted towards adoptive parents, even though there is no demonstrated need for such a differentiation. When it comes to treating the needs of a child or adult, it makes no difference whether the individual lives with their birth family, an adoptive family, or neither.

Adoptive and foster parents deal with the stigma and myths surrounding an FASD diagnosis. Some communities and schools will write off students with an FASD, believing that “children with an FASD can’t learn.” Some educators, professionals, and care providers believe that all children with an FASD will grow up to be criminals and will rage at their families. Adoptive families are often in a position of trying to convince others that their child can learn and can demonstrate appropriate behavior.

The stigma can be reduced when adoptive parents get to know other parents of children with FASD, including birth mothers, and listen to their stories. Adoptive parents can also help reduce the stigma by educating themselves about the disease of alcoholism and the recovery process, so as to better empathize with the birth mother of their child.

Children with FASD

Children with any type of disability often struggle with feeling stigmatized, and this is especially true for children with FASD. Much of the stigma is the result of the way FASD plays out in the behavior of the child. These children feel “stupid” as FASD impairs their learning skills, and they struggle in school. They feel “weird” as FASD affects their social skills, and they have trouble making friends. They feel “bad” as FASD inhibits their judgment and planning skills, and they get in trouble, at home and at school. Being labeled stupid, weird, and bad are some of the most stigmatizing identities for a child.

Children can also struggle with the stigma placed on their birth mother. They are embarrassed to tell their friends. Friends may react in a negative way, “why would your mother do that to you? “She must have been an awful person!” Children with an FASD, especially those that know and live with their birth families deal with issues of trying to protect their parent from the blame and shame.

In most instances, the stigma is often reduced when the child is formally diagnosed with FASD, and they can accept the disability. Once diagnosed, there are a number of beneficial interventions for children with FASD that can improve their behavioral and learning skills, and thus reduce the stigma even further.

 Adults with FASD 

Adults with FASD face a tremendous amount of stigma and are an underserved population. Many public support services that help children with FASD are cut off once the child reaches age 18. Adults deal with the same sort of stigma that children do, but with the added difficulty of less public services and having much higher expectations placed on them. Adults are expected to live independently and may be judged and stigmatized for still living with their parents into adulthood. This is an issue for people with FASD who may lack the executive functioning and planning skills needed to live independently.

Adults are expected to behave appropriately and often face harsh penalties when they fail to do so. Most people assume that an adult who is behaving inappropriately is being rude, difficult, or selfish and don’t consider that they may have organic brain damage that impairs certain behavioral abilities. Due to poor judgment, lack of ability to read social cues, understanding cause and effect relationships, and susceptibility to malicious manipulation, adults with FASD are overrepresented in the criminal justice system.

Adults with FASD often have a maturity level substantially below their actual age, yet most people and institutions with which they interact do not understand this. People with FASD may face serious criminal charges upon reaching age 18 while still having the emotional development of a child. Since the degree of impairment varies so widely with FASD, there is no simple or easy standard that institutions can use to determine the relative age of an adult with FASD.

Having a diagnosis and the ability to understand and accept their diagnosis helps adults with an FASD. The diagnosis enables them to have the language to help others they interact with to understand the learning deficits and learning style. Adults with an FASD report that having the diagnosis helped them to understand themselves and to stop judging themselves so harshly.

Click here to Join the NOFAS Stamp Out Stigma Campaign

Webinar: “Caregiving, FASD, and Alcohol: Caring about FASD Prevention” – September 9, 2015

The Canadian Association of Pediatric Health Centres is hosting a free webinar on International FASD Day, September 9th, 2015.

Award-winning journalist and author, Ann Dowsett Johnston will discuss dismantling stigma and how to address an alcogenic culture that blames and shames the FASD community.

Dr. Dorothy Badry and Dr. Deb Goodman will discuss a practical set of tools and resources that will be useful to healthcare practitioners and caregivers. The Caregiver Curriculum on FASD and the website www.fasdchildwelfare.ca were developed in response to an identified need for training on FASD that was accessible and available to caregivers supporting individuals with this lifelong disability on a day to day basis.

The webinar will be held on September 9th from 11:00am-12:30pm EST. Click here for more information and to register.

screenshot2

Retrieved from: https://fasdprevention.wordpress.com/

Learning about FASD Training Package for Post-Secondary Instructors

screenshotDeveloped by the Saskatchewan Prevention Institute, the FASD Training Package for Post-Secondary Instructors is a resource  for post-secondary instructors and professors.

The focus of the resource is on understanding and preventing FASD. It can be used to provide information and education about Fetal Alcohol Spectrum Disorder (FASD) to students enrolled in professional programs leading to a career working with women of child bearing age.

Examples of programs include that this resource might be helpful for include: health care, education, justice, addictions, psychology, social work, and other community services’ programs (e.g., Early Childhood Education, Disability Support Worker, and Correctional Studies.)

The teaching package contains 11 modules with references. These modules provide evidence-based information on topics such as “What is FASD”, “Alcohol, Women, and Pregnancy”, “Prevention of FASD”, and “Primary and Secondary Disabilities”.

A downloadable PowerPoint with teaching notes is ready for use in class. Both the PowerPoint and written modules contain case studies, activities, and discussion questions that may be used with any group.

Download the package from the Saskatchewan Prevention Institute’s website.

toc

Young people drinking too much, says UVic study

drinking-620

A new study shows that young Canadians are tipping back more drinks than national guidelines recommend.

The study, published in the Canadian Journal of Public Healthshows as many as 60 per cent of young people, aged 18 to 24, were consistently drinking above daily consumption guidelines.

The study was conducted by researchers at the University of Victoria’s Centre for Addictions Research of B.C. The study’s sample consisted of 43,242 Canadians aged 15 and over who responded to the Canadian Alcohol and Drug Use Monitoring Survey between 2008 and 2010.

The centre’s study painted a bleaker picture than a national survey conducted between 2008 to 2012 by Health Canada. That study showed that just 18 per cent of young drinkers, aged 15 to 24, drank above the national guidelines.

The B.C. study also shows that nearly 40 per cent of all Canadian drinkers are exceeding daily drinking limits, established to minimize short-term health effects, such as accidents, injuries and acute illnesses. Those guidelines set a limit of three drinks a day for women and four for men.

Many drinkers exceed limits

The B.C. study found that another 27 per cent of people surveyed exceed weekly limits set to minimize risk for long-term health problems. The weekly maximum recommended to reduce problems such as cancer and liver disease is 10 drinks for women and 15 for men.

One of the study’s co-authors, Tim Stockwell, said health professionals need to take heavy drinking more seriously.

“More Canadians, particularly young people, are putting themselves at risk for long and short-term harms, ranging from car crashes to cancer,”  Stockwell said.

He argues policy-makers and health agencies use national statistics that underestimate those risks.

Retrieved from: http://www.cbc.ca/news/canada/british-columbia/young-people-drinking-too-much-says-uvic-study-1.3197132

Adverse Childhood Experiences and Alcohol Use during Pregnancy

aces_original

 

Adverse childhood experiences (ACEs) is a term that describes potentially traumatic events that can have lasting negative effects on health and well-being. Research has shown a clear connection between ACEs on alcohol use and misuse in adults.

An emerging area of research also suggests that a history of childhood stressors, such as physical, sexual, and emotional abuse, may influence alcohol use among pregnant women.

In a recent study, researchers used data from the 2010 Nevada Behavioral Risk Factor Surveillance System to learn more about this relationship. They found a dose–response relationship between ACEs and alcohol use during pregnancy that remained even after controlling for pre-pregnancy drinking and other known factors that influence drinking during pregnancy.

This study contributes to a growing body of research demonstrating that factors affecting alcohol use during pregnancy begin long before pregnancy.

It also suggests the importance of initiatives and movements such as ‘trauma-informed’ practice and their application to FASD prevention. Learn more about trauma-informed practice, alcohol, and pregnancy use on the Coalescing on Women and Substance use website.

For more on this topic, see earlier blog posts from ‘Girls, Women, Alcohol and Pregnancy’:

5_preganancy

 

Reblogged from: https://fasdprevention.wordpress.com/

 

 

« Older Entries