Monthly Archives: October 2015


Doctors say no amount or kind of alcohol is safe during pregnancy. People debate on the kind and amount of alcohol that is not safe.

It is not about how much can a woman drink while pregnant, but rather should she drink at all?  The choice here is between following one’s desire to drink now and deal with a lifetime disability caused by alcohol or choosing not to drink and not risk #FASD.


Alcohol and pregnancy 2

Women shouldn’t drink when they’re pregnant — absolutely no alcohol at all, according to the American Academy of Pediatrics. But it’s been getting a lot of pushback about that edict.

After we reported on it last week, the comment stream exploded with hundreds of people arguing over whether moderate drinking in pregnancy is safe.

First, TwentyTwo Over Seven wrote:

Every time that I see anything on this topic it tends to conflate “drinking” (which is binary, you either had any amount of alcohol or you didn’t) with something most people would consider moderate to heavy drinking (several drinks a week or at a time). I’ve also seen repeated studies (mostly out of Europe) that have shown zero effects for those who had 1-2 drinks (or less) a week.

KHolmes countered with:

What you are missing is the nature of alcohol, its toxicity to human cells, and the fragile and rapidly growing brain of the fetus. Nearly anything can be justified by those who wish to justify, but ANY alcohol gets to the brain of the fetus. Articles written with vague assumptions by those wishing to sell magazines, and who know how to write a “feel good” article, do not constitute research.

Inherit the Window added:

Pregnancy is stressful and difficult. Your whole life is changing and it’s about to change even more dramatically. Whatever harm may be vaguely associated with one or two small glasses of wine per week, that you consume over the course of several hours (the strategy I’ve most often seen with light drinking during pregnancy), that harm has to be weighed against the psychological benefits of said consumption.

We probably all know someone who had a few glasses of wine while pregnant and the baby turned out just fine. Up to 10 percent of women say they drank alcohol at some point in pregnancy, according to the Centers for Disease Control and Prevention. And we’re not seeing big problems in 8 to 10 percent of children.

That seems to be fueling the sense that the doctors are being too doctrinaire here.

But Janet Williams, a professor of pediatrics at the University of Texas Health Science Center in San Antonio and lead author of the report, says it’s really impossible to say what level of drinking is safe. “Not finding something is not necessarily the same as being safe. It could be that our tests are not sensitive enough to detect it.”

When fetal alcohol syndrome was first identified in the 1970s, the focus was on serious birth defects and developmental disabilities caused by excessive drinking. But now scientists say they’ve identified many more subtle effects, including learning disabilities and problems with vision and hearing, that are associated with alcohol exposure in the womb.

How much alcohol? We don’t know. We also don’t know who’s most at risk. Susceptibility varies among people, and there’s no way to predict if you, or your baby, are among the vulnerable.

That’s why Janet Williams says she has no problem being an absolutist on this one. “The choice is really between your desire to have a desirable effect from alcohol versus the risk of lifetime harm to the baby. That’s the choice.”

Disclaimer:  The views and opinions in this article are those of the authors and do not necessarily represent the views of the FASD Prevention Conversation Project.

Parenting With Addictions

Parenting with addictions

By Megan Stacey, Woodstock Sentinel-Review


Maybe they go to school without a lunch.

A doctor’s appointment is missed.

Little fingers are without mittens in the frosty winter air.

All parents can relate to that sinking feeling that comes with forgetting something a child needs.

But sometimes those experiences turn from an innocent mistake to a pattern of red flags.

Those red flags could be pointing to an addiction.

— — —

Challenges with substance use are certainly not uncommon in Oxford — a region that once earned the nickname “Oxy County,” and not just because of similarities in name.

The ripple effect that comes with an addiction means children can be caught in the crossfire.

“Anyone who is using a substance is going to struggle to parent, because our substance use impacts our regular abilities, skills, personalities, emotional regulation,” said Lisa Longworth, community services coordinator and counsellor at the Ingersoll Nurse Practitioner-Led Clinic.

“In addition to that, when someone is in withdrawal from a substance, all of those things are exacerbated, because we don’t feel well — emotionally or physically,” she said.

Children’s aid societies are tasked with drawing that line between safety and parental behaviour.

It’s a tough balance to strike, and the Children’s Aid workers in Oxford — the ones who have to ask the tough questions about child safety — know the intricacies that can make any decision infinitely more complicated.

A child protection worker at Oxford Children’s Aid Society, who didn’t want to be identified in order to protect her clients, said there is an important question the agency can use as a barometer when addictions may be a concern.

“We try to identify, what is the impact on the children?”

The agency does tend to err on the side of caution, said director of services Rob Neill.

“In general, we will open (the cases) to check the situation out. So we may have a lot of cases that open, we check it out, maybe there’s some marijuana use or some alcohol use, but we determine that there isn’t a major impact on the children, so we close the investigation stage,” he said.

It’s all about answering that question: Is the addiction affecting children?

“For myself as a worker, and most of the front-line workers, we worry about what impact it has when a parent is actively using in the home,” the protection worker said.

“How does that impact their parenting? Are they less attentive, less available, less patient than they want to be or are normally?”

She outlined some of the other potential impacts:

  • Withdrawal symptoms that make someone physically unable to parent (vomiting, diarrhea, shakes, etc.)
  • Financial problems as a result of buying substances
  • Criminal involvement, even jail time, that could disrupt a child/parent relationship
  • An unsafe environment created by the substances, or by those visiting the home (other users, dealers, etc.)

“Pretty well any bad thing that can happen to a child just gets a little bit worse — or a lot worse — when substance use is involved,” said Pam Hill, director of clinical services at Addiction Services Thames Valley.

— — —

But it’s not necessarily about what a parent is doing. It could also be about what they’re not.

“We look at drug-endangered children where the neglect happens, most of all, when the parent is sleeping it off,” Longworth said.

A sleeping parent can’t prevent accidents, or stop their children from getting into harmful substances, she added.

“One of the things that we’re finding is extremely dangerous now is Fentanyl patches that are disposed of in a garbage can. Even if a child picked that up, they can absorb it through the skin,” Longworth said.

Fentanyl patches are intended to provide the slow release of a powerful painkiller when used as a patch. Even once it comes off the skin, the patch is still potent enough to harm a child. There are many recorded cases of children overdosing after inadvertently picking up the patches or playing with them.

As with most things in life, addictions are very individual. No symptoms are guaranteed just because a parent is using a certain drug.

“The reality for that particular family that you’re working with is much more important than what a textbook says a family might experience when using a drug,” the protection worker said.

In fact, sometimes substance use can actually help a parent have better quality time with their children, Hill said.

“We’ve known women who have a much better time with their kids when they’re using, because it’s managing their pain in some way … But a very advanced addiction will make the drug the centre of a person’s life,” she said.

“It’s a tool for coping, for just helping them feel normal in life, but it’s a coping mechanism that goes awry.”

That’s one of the issues Children’s Aid has to navigate when they investigate a case that involves substance use.

“We certainly try to talk to parents about developing healthy coping skills. When things aren’t going well, and you used to rely on your addiction to meet those needs, we need to find different coping skills, and role modeling that to your children,” the protection worker said.

For parents, fear of losing their kids can be a huge challenge. It may even keep them from seeking treatment.

“They’re terrified — it’s probably the major barrier — that if they ask for help, they will lose control of choices around their children, that they’ll have to be reported to the Children’s Aid Society or Child Protection Services, and that they’ll lose control of everything,” Hill said.

— — —

Of course, substances don’t have to be illegal to lead to an addiction.

Despite the idea that opioids (like OxyContin) reign supreme in Woodstock and other parts of Oxford, statistics suggest that legal substances are wreaking much more havoc than any other drug.

“There’s a lot of fear around ‘hard drugs,’ but what we know is that 53 per cent of the open admissions we had for our clients in Oxford County were about alcohol dependency. That’s been the norm,” said Hill of local residents seeking treatment between 2013 and 2014.

There were more than 2,300 hospitalizations in Oxford due to mental and behavioural disorders that could be linked to substance use between 2002 and 2014, according to stats provided by the county.

But the vast majority of those hospitalizations treated alcohol use, a whopping 56 per cent compared to 8 per cent for opioids.

Tobacco came next, accounting for just over 6 per cent of hospitalizations.

Deaths that were traced back to substance use in the county between 2000 and 2011 (the most recent data available, again provided by Oxford County) were related to alcohol in 79 per cent of cases.

“The legality or illegality of the drug is really an irrelevant issue. The issue is how is it impacting the child? Alcohol, for example, is a legal drug and many people manage their alcohol use responsibly,” said Neill.

The drugs of choice — often those that are most affordable and accessible — have changed since OxyContin was pulled off the market.

“It’s no longer the OxyContin, it’s the hydromorphine and more often, methamphetamines,” said the CAS protection worker.

“As opioids have been harder to get, people are choosing other options such as crystal meth, crack cocaine, heroine,” Longworth added.

“My prediction in looking at what’s trending now with more limited access to opioids, there is a potential for those drugs to become more prominent.”

— — —

“There’s a lot of stigma associated with (addiction), and judgment,” said Neill.

The challenge for Children’s Aid is putting aside stereotypes or particular wishes for a family, and instead assessing whether children are safe.

But for parenting struggling with substance use, the societal stigma can be overwhelming.

Hill said mothers often feel isolated and judged at mommy groups or other community programs. The experts want communities to realize that addicted parents don’t love their kids any less than parents without substance use challenges.

“They love their kids. It’s just that the substance use becomes more of a priority,” Longworth said.

Addiction is enough to cripple any family, and it’s tough to explain to kids.

Children might feel confused or even wonder if they have done something wrong when they see mommy or daddy acting strange, angry, or sick.

“There’s no doubt in my mind that people with addictions issues love their kids as much as anybody else does,” Hill said.

“In fact, the vast majority of them come to us and their motivation is ‘I want to be a better parent. I don’t want my child to have this experience that I’m having.'”

Sometimes working with Children’s Aid can push parents to make a change. Protection workers can also educate parents about where to look for help.

The good news in Oxford County is that those who reach out for help are no longer waiting for months to receive it.

“We’ve gone from having one counsellor come from London … to offering six counsellors (at) shared walk-in intakes across the county,” Longworth explained.

That outreach is a partnership between four local community resources — Thames Valley Addiction Services, Canadian Mental Health Association, the Ingersoll Nurse Practitioner-Led Clinic, and the Woodstock and Area Community Health Centre.

“They can just show up at any one of these walk-in intakes, and they will be seen. We do a full intake and assessment on them, and that helps us determine what the best kind of treatment would be,” Longworth said.

Folks with addiction or gambling issues no longer have to find transportation to London. They no longer have to wait months to talk with someone.

Longworth said clients at these walk-in sessions are usually lined up for their next appointment within three to five days.

The hope is that, one day, these counsellors might work themselves out of a job.

But for now, Children’s Aid is hoping that struggling parents will reach out for help.

“I remember seeing a pamphlet when I worked in Toronto a decade ago, put out by the one of the shelters that also provided addiction therapy,” Neill said.

“The name of the pamphlet was ‘love is not enough.’ You would think it would be, when it came to your children — what more powerful motivator can there be? But where you have a deep-seated addiction issue, it’s an extremely difficult problem to extract yourself from.”

Retrieved from:

New iNAT FASD Intervention Newsletter Coming this Week- Subscribe now!

Check out the iNAT e-newsletter on FASD Interventions, and subscribe now!

FASD Interventions Across the Lifespan

For those of you who are not yet subscribers to our iNAT e-newsletter on FASD Interventions, subscribe now to receive the upcoming Fall 2015 edition. The iNAT e-newsletter focuses on research, news, events, organizations and individual stories pertaining to FASD intervention. This edition will feature research findings from the CanFASD/University of Alberta Caregiver Needs project, as well as a story about an Ontario school that has been in the news regarding its program for youth with FASD, and more.

To access previous copies of the newsletter, visit the iNAT page on the CanFASD website.

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No Amount Of Alcohol In Pregnancy Is Safe, Ever, Pediatricians Group Says

No Amount Of Alcohol In Pregnancy Is Safe, Ever, Pediatricians Group Says

Opinion Piece By: Tara Haelle, Forbes Oct 19, 2015

t’s been just over four decades since fetal alcohol syndrome (FAS) was first described, yet contradictory advice to women about drinking any alcohol at all during pregnancy continues to confuse and frustrate women. Is one glass a day okay? Or once a week maybe? One a month? One time ever, in 40 weeks of gestation?

In a new clinical report, the American Academy of Pediatrics makes the issue crystal clear from their perspective, based on the available research to date: no amount of alcohol is safe to drink during pregnancy, period. No lower threshold of safe consumption has ever been established, and prenatal alcohol remains the “leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities,” the AAP states.

I would once have found this conclusion from the evidence base misleading and draconian. After all, women in Europe drink a little wine with dinner during pregnancy, right? And haven’t lots of studies found that women who drink very lightly during pregnancy — say, no more than a glass a week — have children that turn out just fine or even a little better off than their peers? Yes, many studies have found this result — I read dozens of them while researching the book on science-based parenting that I cowrote with Emily Willingham. In fact, I started researching that section trying to prove myself wrong because I knew I was biased toward believing that a glass here and there couldn’t hurt much, if at all. The thing is, while poring over dozens of studies, I actually succeeded in convincing myself that I was wrong. The evidence showed me I was.

Pregnant woman holding glass of red wine

Pregnant woman holding glass of red wine

The problem with the many studies showing no effect from very light drinking on children is that the women most likely to drink lightly also tend to be more educated women with higher household incomes. The deck is already stacked in favor of their children, who are already more likely to have better cognitive, behavioral and health outcomes than children born to parents with less education, lower incomes or otherwise fewer resources. The majority of these studies attempt to “control” for education and income — that is, make adjustments in the analysis to statistically account for those differences. But no amount of math can overcome the residual confounding that occurs in these studies because women who drink very lightly during pregnancy are so fundamentally different from women who drink more or women who abstain altogether.

The other problem with those studies, I discovered while researching the book, is that they often lack the precision to identify potential effects of alcohol exposure. The harm that can come from alcohol during pregnancy isn’t limited to fetal alcohol syndrome. FAS occurs along a spectrum, and children without physical indications of diagnosed FAS can still exhibit the cognitive and behavioral effects of alcohol exposure in the womb. Perhaps it’s just one IQ point a child doesn’t have (putting aside all the problems with IQ as a measure) because of exposure to several glasses of Merlot during pregnancy. That’s not a difference that will easily show up, if at all, in a study with a couple tests, but the absence is still there.

Furthermore, effects of prenatal alcohol exposure may not show up until adolescence, yet the vast majority of studies investigating light drinking during pregnancy only follow children until toddlerhood or occasionally the preschool or early elementary school years. One series of studies, still ongoing from Denmark, has only assessed children up to 5 years old. Another study of more than 5,000 children did evaluate children up to age 14, but few have done so, and there is disagreement among researchers over which assessments are best for identifying possible problems.

Some things have been well-established for many years: alcohol during the first trimester can have more harmful effects than alcohol during later trimesters. (This fact is especially problematic considering that half of all pregnancies in the US are unplanned.) The type of alcohol — beer, wine or liquor — is irrelevant. And binge drinking — having more than a couple drinks in one sitting — has worse effects on a fetus. Basically, the more a woman drinks while pregnant, the worse the effects on her child usually are. Is having a single drink one time during 40 weeks of incubating your little critter going to have a major pregnant1019aeffect on them? No, probably not, or at least we don’t have a single study saying so. (That’s also why women shouldn’t panic if they found out they were pregnant after a binge; the anxiety caused by worry could, over a pregnancy, end up having greater effects than the alcohol, and what’s done is done.) But women and their metabolism differ, as do the fetuses they’re incubating. There is no way to establish what is potentially “safe” and what is not for one women’s child or another’s. Alcohol is a neurotoxin that crosses the placenta. If a pregnant woman drinks it, her fetus absorbs it — but without an equivalent ability to metabolize it. The only way to be absolutely certain your child does not experience lifelong negative effects from alcohol exposure is to abstain while trying to conceive or not to drink as soon as you find out you’re pregnant.

Retrieved from:

The Holiday Season Is Coming: Get Prepared With A Session About Alcohol and Pregnancy!


Conversation about alcohol and pregnancy affects everyone; from corporate employees to private staff, government and NGOs to community members. We are all affected by this issue directly or indirectly, so let’s talk!

Before the Christmas parties are in full swing, before the holiday gatherings start, why not book a Prevention Conversation Facilitator to come in for a lunch & learn or training session (Alberta, Canada only I’m afraid). Facilitators can deliver a session tailored to your employees’ needs.  It can be a formal presentation or an open discussion alcohol, pregnancy, and how to support healthy choices for healthy babies. You pick a session and time that works for your team and the presenters will deliver it!

Book your session today by emailing

Scientists find a new target in the treatment of addiction

Scientists find a new target in the treatment of addiction

c361e121c8605dee0257ffabaa8ef96aScientists who study addiction know its prevalence is getting worse and extending beyond alcohol and drugs.

In our society, the whole concept of compulsive behaviour is explained—sometimes, too easily—as an addiction. Buy too many things you don’t need? Call it a shopping addiction. Play video games all the time? That’s an addiction too.

Dr. Shimi Kang, an addictions specialists in the department of psychiatry at the University of B.C., says one of the reasons for the growing spread of addiction is the things we’re addicted to are part of our culture and even promoted, like caffeine, sugar, alcohol, smoking.

“For many years, treating addiction wasn’t part of the medical system. There were AA programs but we lacked the competency to understand addiction and its prevalence. For anyone who has experienced it, or know someone who has, they know how truly devastating addiction can be,” she said.

Scientists have made tremendous new discoveries over the last two decades in understanding how or why addition is triggered and the latest one, originating from McGill University, supports the existing science on the genetic underpinnings of addiction, according to Kang.

The study, published in Molecular Psychiatry was led by scientists at McGill University and Douglas Mental Health University Institute in Montreal and at the CNRS INSERM UPMC in Paris, provides some insights into the genetic mechanism that an drive addict’s need to get high.

Brain cells communicate with other brain cells via chemicals known as neurotransmitters and the classical neurotransmitters are dopamine, serotonin, acetylcholine and glutamate. They all trigger different reactions. Fluctuations of serotonin can impact your sleep cycle, pain control and your immune system. Dopamine can both trigger depression or drive our motivation to get thing done.

More than a decade ago, Dr. Salah El Mestikawy and his team first discovered that some neurons use two transmitters, meaning they can respond with both “yes” and “no” signals.

In the latest research published in Molecular Psychiatry, the scientists showed they can now shut down the cell’s “no” response in mice who showed a marked predilection for cocaine.

“We silenced one of the two languages of the neurons, we took away the no system and explored their behaviour in genetically-modified mice and we found out that these mice were ingesting cocaine like crazy,” said El Mestikawy. “Then we wondered whether this was relevant to human beings.”

Their study explains the mechanisms underlying reward behaviour, while identifying an unsuspected target in the treatment of addiction.

The researchers, using a small study group, found humans with the mutation of a key gene were 10 times more vulnerable to very severe forms of addiction. “What we have found is a genetic marker to addiction,” said El Mestikawy.

10 times more common in addicts

The research showed that the gene mutation shows up in 0.5 per cent of the population. But among addicts, it occurs in 5 per cent.

“Even though it’s a huge increase of ten times more among addicts than among people with no psychiatric behaviour, it’s still just 5 per cent of addicts. That means it’s 95 per cent something else, genetic problems, educational problems, many other things. This is only one genetic marker and we can’t predict how many other markers there are,” said El Mastikawy.

El Mestikawy said psychiatric disorders are very complex pathology, not like catching the flu or breaking an arm. “There is not one gene responsible for psychiatric disorders. It’s a combination of genes and this explains why the symptoms of people with psychiatric disorders are so different.”

Kang, the addictions specialist, echoed that sentiment. The study led by El Mestikawy should lead to further research on the neurochemistry underlying that may possibly form future medication therapies.

Dr. Steven Melemis, an addiction medical doctor in Toronto, said the research published inMolecular Psychiatry explains one possible mechanism for addiction.

“Addiction is definitely a multifactorial disease. Other neurochemical mechanisms for addiction have been discovered. Most importantly, understanding the cause of addiction is not necessarily helpful in treating addiction,” he said.

Melemis said the treatment for addiction still is based on developing healthy coping skills. Scientist El Mestikawy said it’s always an interaction between genes and a person’s environment and life history.

The people with that mutated genetic marker are highly motivated by a reward system. For some, this can be channeled into getting higher grades in school, for others it will be directed into addictive behaviour.

“We need to educate kids from a very young age and we need to tell those who need drug or computer games or alcohol we need to tell them early that addiction can happen to them,” he said. “When you have an addiction, something is malfunctioning in your brain.”

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New Website on FASD Prevention: Here For Her

Have you seen it, the ‘Here For Her’ website?

Screen Shot 2015-10-21 at 3.25.48 PM

Just Click!

Why Are We Doing This?


Although most women know that alcohol consumption during pregnancy can harm their developing baby, some women continue to engage in drinking while pregnant. While there are many reasons why expectant mothers may engage in drinking while pregnant, no women drink to intentionally harm their baby. When they drink, it’s for other reasons – a lack of personal or social supports, addiction or any of the other stressors that come with the new responsibility of motherhood.

Women who are most at risk of having a child with Fetal Alcohol Spectrum Disorder(FASD) often describe drinking as a way to cope. They need support from friends, family, the larger community, health care providers and others to address many health, social, financial and relational concerns.

“Here for Her” aims to expand Canadians’ understanding of FASD and to encourage Canadians to offer support to the expectant mothers in their lives. Pregnant women need to know that the rest of us are there to support them through this journey – that we all embrace our role in dealing with this challenge.


What Can We All Do?


Blame can lead to women feeling discouraged or to avoid seeking help.
It adds to the stress and feelings of isolation that can come with pregnancy.


Be open to discussing the stress and pressure of pregnancy, their experiences, coping strategies and needs for healing. We need to be there when they need support, and they need to know we will be.


Pregnancy can be a time of enormous pressure for women. Women receive advice and information from health care providers, websites, friends, family, and even random strangers. Respect the choices that women make to keep themselves and their babies healthy.

What is FASD?

Fetal Alcohol Spectrum Disorder (FASD) is a term used to describe the many effects of prenatal exposure to alcohol when a mother drinks alcohol during pregnancy. Nine out of every 1,000 babies in Canada are born with FASD. It is the leading known case of brain damage among Canadian children.


Executive functioning – difficulty with judging, planning gratification, consequences, organization, impulsivity, memory

Communication – can be highly verbal but lack comprehension skills, both written and verbal

Neuromotor Defects – impaired balance and coordination

Sensory Deficits – challenges with pain, touch, heat, and light

FASD has lifelong impacts on individuals,their families, and society. Individuals with FASD need a range of supports to cope with the disability throughout their lives, and their caregivers need support as well.

All drinks containing alcohol can be harmful to developing babies.

Drinking alcohol can be harmful at any point during pregnancy – the baby’s brain and nervous system develops throughout the entire pregnancy.

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