Monthly Archives: January 2016

OHRC report strongly links mental illness to poverty, unemployment

OHRC report strongly links mental illness to poverty, unemployment

CAMH file

Those who suffer from mental illness or addiction are much more likely to be poor, unemployed and living in inadequate housing, especially when they also suffer from other forms of disability, a new report finds.

Compiled using federal data and published by the Ontario Human Rights Commission, data from the report suggests that regarding several factors — housing, income, employment, and attainment of education — those who suffer from mental illness or addiction don’t just face worse outcomes when compared to the general population, they also fare worse than those who report other forms of disability.

“When controlling by disability type, the results show that people with mental health and addiction disabilities fare worse on most indicators than people with other types of disabilities,” the report’s authors state.

But the report states as many as 90 per cent of those who suffer from mental health or addiction issues also report other forms of disability.

“Having a chronic physical condition can be a risk factor for developing a mental health disability and vice versa,” the report’s authors write.

When it comes to shelter, the Commission says that 29 per cent of Ontario residents who report mental health illness live in housing that they struggle to afford, is in poor condition, or is too small for the size of their household.

Only 14 per cent of Ontarians who do not report a physical or mental disability experience the same housing constraints. Sixteen per cent of Ontarians who report another type of disability experience similar housing difficulties.

When it comes to income, 20 per cent of Ontarians who report a mental disability fell below the low income after tax status in 2010, compared to eight per cent of those with physical disabilities and 10 per cent who report no disability.

“When controlling for disability type, mental health and addiction disabilities appear to be highly correlated with being in low income and other disabilities less so,” the report’s authors state, adding that they believe that trend needs to be researched further.

While only 7.7 per cent of Ontario workers were unemployed in 2011, including nine per cent of those with a physical disability, 20 per cent of Ontario workers who reported mental illness or addiction were unemployed.

And while nearly one quarter of all Ontarian adults have a university degree, only 11 per cent of those who live with a physical disability have the same, and only nine per cent of those reporting a mental disability or addition issue have attained the same level of education.

The report also found indigenous Ontarians living off reserve are close to three times more likely to report a mental health disability or addiction than non-indigenous Ontarians, the report states.

In all, more than 376,000 Ontarians reported suffering from a “severe” or “very severe” mental or psychological disability in 2012.

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Independent Journal reports on four women who drank alcohol while pregnant and how their children are doing right now.  Here is the full report.

Doctors have long warned women of the risks associated with drinking while pregnant, but for one reason or another, it doesn’t stop some expecting moms from doing just that.

The American Academy of Pediatrics recently identified prenatal exposure to alcohol as the leading cause of preventable birth defects, such as intellectual and cognitive disabilities appearing later in life.

While you often hear this story told through a doctor’s perspective, here are four people who are living proof that drinking while pregnant can have life-long effects:

Rebecca Tillou

As the National Organization on Fetal Alcohol Syndrome reports, Tillou was adopted at birth, but her parents say they suspect her birth mom was drinking while pregnant with her. While nothing was confirmed, she recalls getting ear infections as a child, not eating and not really talking to people in school.

It wasn’t until just recently that the 34-year-old was diagnosed with Fetal Alcohol Syndrome, which she says ‘makes total sense’ of her self-proclaimed ‘selfish’ demeanor:

I act selfish…a lot, which is part of fetal alcohol, because my brain will sometimes act like an egotistical child — like an eight or nine year old where I want what I want and I don’t really care about other people.”

Today, Tillou is a claims representative at an insurance company in Albany, New York. She’s married and has two ‘beautiful and very, very smart’ children.

Avery McHugh

Avery was adopted by his parents, Mike and Peter, at the age of three, but even then, his life before had been anything but ideal.

According to the Delaware News Journal, Avery had endured ‘severe neglect and abuse’ throughout his five foster homes, reportedly cursing and being restless at a very young age. As he got older, he was diagnosed with ADHD, but the medication wasn’t working.

Then doctors finally figured out he was suffering from FASD, and everything came into focus.

The now-20-year-old is currently working as a salesman at an electronic store, lives in a group home and sees his parents and girlfriend as much as he can.

Karli Schrider

Image Credit: Screenshot

Independent Journal Review recently reported on the life of 43-year-old, Karli Schrider, who has the ‘development skills of a first grader.’

Much like Rebecca, Karli had ear infections as a young child, which led doctors to believe they were the reason for her slow intellectual growth. As she continued to struggle with developmental issues, Karli was diagnosed with Cerebral Palsy.

It wasn’t until her mom, Kathy, started learning about FASD as a certified addictions counselor that she realized Karli’s symptoms were comparable to the disease.

Kathy admitted to drinking while pregnant, which, at the time, was considered ‘safe’ for expecting mothers. Karli was diagnosed at the age of 16 with FASD.

In 1999, she received a presidential award for her volunteer work with the National Organization on Fetal Alcohol Syndrome. Today, the 43-year-old likes playing with Hello Kitty dolls and colouring.

Image Credit: Screenshot

Annie Stanley

All Annie has ever wanted to be is a cheerleader. But for the 11-year-old from Texas, it doesn’t come as easy as other girls.

Annie has FASD and her adoptive mom, Cherie, writes on their blog“Giving Them a Voice”:

“An FASD child may wake up mad at the world for no apparent reason. I’ve learned to cope with this by counting her complaints. It tends to slow it down. Sometimes she’ll even ask how many. Lol. There is no trying to figure out that brain. She’ll be mad and yell/fuss all the way to the front of the school.”

But Annie’s not letting that stop her from cheering. Cherie claims her daughter works ‘twice as hard’ at practice to overcome some of the symptoms of the disease, and that she’s not letting it stop her from fulfilling her dreams.

According to the Centers for Disease Control and Prevention, the cost for just one person suffering from FASD is about $2 million, spent throughout their lifetime.

Between 2011 and 2013, one in every ten pregnant women in the United States reported drinking alcohol while carrying their child.


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.

Is it safe to drink during pregnancy?

4928Is it safe to drink during pregnancy?

This article, written by Amy Westervelt and published in The Guardian highlights the continued debate around alcohol consumption when pregnant and showcases why conversations about alcohol and pregnancy are so important. The FASD Prevention Conversation supports the Public Health Agency of Canada’s official recommenation that:

There is no safe amount or safe time to drink alcohol during pregnancy or when planning to be pregnant.

When I hit the sixth month of my pregnancy, a strange thing happened: everywhere I went, people offered me a drink. Checking in at a hotel, the front desk clerk offered me a glass of champagne. Ordering dinner at a restaurant, the waitress asked if I’d like a glass of wine with my meal. At a friend’s barbecue, at least six people asked if I wanted a beer, or maybe a margarita. Each time I had the same reaction: first, surprise. Then, the sense that I should automatically just point to my belly and say no. And finally, a wave of, well, maybe just one drink, or a half of one, would be okay.

It turns out I am not alone. At some point in their pregnancy, most expectant mothers find themselves facing a glass of wine or a bottle of beer and have to consider the difficult question of whether or not to drink it. To make matters worse, even after decades of debate, there still doesn’t seem to be a definitive answer.

The norms around drinking while pregnant seem to change every couple of decades. During the 1950s and 1960s, it was perfectly acceptable for pregnant women to drink – and smoke, for that matter. In fact, in the 1960s, some doctors even prescribed alcohol to avoid premature labor.

In the 1970s, the cultural attitude toward drinking during pregnancy swung to the other extreme when researchers determined that alcohol could lead to malformations in embryos. In 1973, doctors coined the term fetal alcohol syndrome to describe a combination of features common to babies born to alcoholic mothers, including low birth weight, slow growth, small eyes, cleft palates and severe cognitive disabilities. Every international medical association proclaimed it unsafe for pregnant women to have even a drop of alcohol.

Some of these warnings still stand. Recently, the American Academy of Pediatrics reaffirmed its recommendation that pregnant women don’t drink. However, it also acknowledged that, while doctors agree about the negative effects of alcohol abuse during pregnancy, there is no evidence to prove that occasional drinking is hazardous to unborn babies. That’s largely due to the fact that it’s not exactly ethical to set up a clinical trial in which one group of pregnant women abstains and the other drinks occasionally.

The US isn’t the only country that encourages teetotaling: the ministries of health in Ireland, New Zealand and Australia also recommend that pregnant – and, in Australia’s case, breastfeeding – women abstain from alcohol. On the other hand, studies are beginning to pile up that indicate the odd drink here or there is harmless. A series of five studies conducted in Denmark showed that – as of age five – the children of mothers who had drunk moderately during pregnancy suffered no ill effects, and a 2010 UK study found that children born to light drinkers fared better on cognitive development tests than the offspring of teetotalers. In fact the UK Royal College of Obstetricians and Gynecologists has consistently stated that “women should avoid drinking excessive amounts of alcohol when pregnant but there is no evidence that drinking one to two units once or twice a week is harmful”.

But while conclusions differ, the consensus is that pregnant women should avoid drinking in their first trimester. Early last year, even the Royal College of Obstetricians and Gynecologists pulled its support for occasional drinking for newly pregnant women. Of course, first trimester teetotaling can be problematic, given that the majority of women don’t know the exact moment when conception occurs. In my case, when I was newly pregnant with my first son, I was living it up at an Irish wedding, blissfully unaware of how much time I’d be spending worrying about birth defects in the coming months. Thankfully, my doctor was unconcerned and reassured me that despite all of the cautions around first trimester drinking, I should stop worrying about it.

Ultimately, the aggregate of all this advice on pregnant drinking comes down to a few simple guidelines: every medical organization agrees that expectant mothers shouldn’t binge drink, drink in their first trimester, or drink more than one or two drinks once or twice a week. Beyond that, most experts seem to agree, each woman should do what feels right to her. One friend of mine drank one glass of wine once a week during her pregnancy; another, who’s pregnant now, has a half-glass of wine whenever she feels like it; yet another decided that it’s not worth it at all. On the other hand, I’ve also had friends who have beaten themselves up for their decision after the fact, as doctors and family members have blamed their drinking during pregnancy for everything from hyperactivity to a cleft palate.

As for actual, peer-reviewed research, the findings are inconclusive – doctors simply don’t know what amount of alcohol will cause which issues in a particular fetus with a particular mother. That’s why so many of the guidelines err on the side of caution. As the latest American Association of Pediatrics guideline states: “There is no known absolutely safe quantity, frequency, type, or timing of alcohol consumption during pregnancy, but we know that having no prenatal alcohol exposure (PAE) translates into no fetal alcohol spectrum disorders (FASD).”

As for me, I’ve waffled back and forth on the issue, unsure of the safety and advisability of reaching for a glass of wine or a highball – and, beyond that, unsure of the point exactly. For that reason, more than any other, I’m mostly of the “not worth it” mindset. I’ll have the occasional half-glass of wine when a dinner particularly calls for it, or if I’m out at some sort of celebration, but – thankfully – there are other options, and I’ve spent the last few trimesters enjoying the increasingly wide world of fancy juices and sodas that are on the market.

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An alcoholic therapist’s search for an evidence-based treatment

Maureen Palmer and Mike Pond.

Maureen Palmer and Mike Pond.

Alcoholism nearly killed therapist Michael Pond. Now, he’s looking for answers on why substance-abuse treatment can be so hard to find.

Michael Pond is a Vancouver psychotherapist who lost his practice and his family after alcoholism took a hold of his life and nearly killed him. Despite many unsuccessful attempts at sobriety, Pond eventually succeeded. Soon after, he met Maureen Palmer, a documentarian who became his partner. Together, they are telling Pond’s story of addiction through a new book and film to raise awareness about evidence-based treatment options that exist for substance abusers and their families—but which aren’t always easily accessed in Canada. Wasted: An Alcoholic Therapist’s Fight for Recovery in a Flawed Treatment System was released today; a companion film will air on Thursday on CBC’s The Nature of Things. They pair have also co-launched to spread their message.

Q: What motivated you to put your story out there?

Pond: I was a professional for many years, and I would refer people to treatment centres and recovery houses all the time. When I ended up in them, two of the worst, I realized that’s where most people wind up—young people, and people suffering from mental illness, eating garbage for food basically, and treatment was a ride to the next AA [Alcoholics Anonymous] meeting. When I got sober, I was saying, “Somebody’s got to do something about this.”

Q: You bounced from treatment facilities, the streets, psych wards and recovery houses. Is there a common theme about how you were treated, or how they failed to treat you?

Pond: I don’t like to focus on the negative because I want to practice what I preach. But the common thread was the shaming, and the lack of kindness and science. Even in facilities like hospitals, clinics, doctor’s offices, ER—they’re all professionals, they’re all educated, they’re all wonderful people, but probably they are worn out, exhausted. I know, I’ve worked in all of those facilities. And there’s still the stigma. My ex-wife talks in the film about how hard it was for her to take me to ER because she could see them murmuring.

Q: AA is synonymous with alcohol addiction treatment but Mike, you say it didn’t work for you. Why doesn’t AA work for everyone?

Pond: My personal experience with it was bad, but I met some amazing people in the program. They saved my life. When I was on my last big bender, it was the guys from AA who would come and check on me. I was in the hospital for 29 days. The only people who visited me were AA people. So I’m not here to bash AA. That’s not what this is about. This is about the treatment industry, where you pay up to $100,000 to go to a place and have equine therapy, and then have a 12-step meeting or two, and maybe get one counselling session a week with somebody who is not qualified. So AA started 80 years ago, 1935—there’s been a lot of changes in the world, and in science and medicine since then.

Palmer: Dr. Bill Miller is in the film and a world-renowned expert on AA. You know the notion of having to admit you’re powerless? Generally speaking, when AA was first invented it was a white male population. Dr. Miller says there’s a whole group of people in our society who already feel disenfranchised. Admitting your powerlessness is going to make you feel worse. The idea of spirituality—and to be fair to AA, it says a God of your own understanding—that’s a turn-off for a lot of people. As much as the original intent of AA was not shame or blame, if you go to some meetings, it is quite prevalent.

Q: So you set out on this search for evidence-based addiction treatment. What do you mean by that?

Palmer: If you look at any other illnesses where people get severely ill and die, they get evidence-based medicine—you get chemo or radiation because there’s lots of science that says it works. Both the Canadian Medical Association and the American Medical Association decree that this is a disease. There are enlightened groups, including here at St. Paul’s Hospital in Vancouver and the Centre for Addiction and Mental Health in Toronto, where they now say we have to give the same level of compassion and care, and that means evidence-based: “Is this scientifically proven to work?”

Q: I think a lot of people would be surprised to learn of an injectable drug that, Mike, you’ve received to treat alcoholism. It curbs cravings. I gather that the injectable drug Vivitrol isn’t approved for use in Canada?

Pond: Right. It is a chemical medication, a 30-day injectable with a delayed or long-term effect. It’s powerful.

Q: Can you describe your experience?

Pond: When I had the first relapse I got the first injection in Bellingham, Wash. It’s right across the border. That was Feb. 9, 2015. I relapsed after a motorcycle accident. When I got that injection, I knew within half an hour it was taking effect. I could feel the agitation go down, this calming effect, and cravings were completely gone. It was remarkable. That was the best thousand bucks we ever spent. So I’ve gone down five times or six.

Palmer: Mike went down for five months. What this drug is supposed to do it apparently did for Mike, which is build up a critical mass in your system so that he doesn’t require it anymore. It is part of a drug trial now at St. Paul’s Hospital.

Q: Do you continue to use it, Mike?

Pond: I don’t go for the injectable. But I can tell when I’m struggling. I know the precursors to a recurrence [and] I’ll take a Naltrexone pill. That’s Vivitrol in oral [form, which is approved for use in Canada].

Q: Does it seem to have the same effect on you?

Pond: It’s more unsettling because you’re getting that one pill and it’s going to last for 24 hours. I get a little bit [of] nausea but it does immediately take away any craving.

Q: What is the pill version that’s approved for use in Canada used for?

Pond: It’s supposed to be used for alcohol addiction. It’s an opioid antagonist that’s designed to treat heroin addicts.

Palmer: Here’s the core of the problem in Canada. Dr. Evan Wood, who you see in the film, explains that probably less than 10 per cent, probably closer to one per cent, of Canadians battling substance abuse get Naltrexone or any other approved medication.

Q: So besides this drug, did you discover other things in the evidence-based category?

Pond: Motivational interviewing, community reinforcement and family training (CRAFT), I use it all the time now in my work. That’s for the loved ones. Behavioural couples therapy is very effective. This is a systemic problem. With CRAFT you start off excluding the substance user. You work just with the family, empower them, and give them different ways of coping.

Q: Mike, your father and grandfather struggled with alcoholism. What have you learned about how that has shaped you, psychologically and genetically?

Pond: It’s both. Looking back, I remember what my dad’s father was like: he was a risk taker. He was renowned for the crazy things he would do. My dad was the same, very impulsive. So there are these genetic traits that I definitely inherited and predisposed me to substance misuse.

Palmer: The experts said that 60 per cent of addiction is genetic-based.

Q: Mike, you have three sons, you’re rebuilding relationships now. Do you think about how family history might affect them?

Pond: I think about it, and we talk about it, but no so much. They went through so much trauma themselves and hardship. Before the drinking got bad our family was pretty wonderful. It didn’t get bad until my oldest was about 14 and my youngest was nine. So they lost somebody that they really loved. That made it that much worse for them. Now, you see the healing in them. In terms of worrying about them ending up the way I did, I don’t worry about it, that’s not the word; I have some concern. But I have optimism.

Q: What’s your message to people with addictions, to the families, doctors?

Pond: The main message is the system has to change. Our doctors have to be trained and educated about this problem. And there is hope. I don’t even use the word hopeless anymore. I don’t care who it is and how severe the problem. There’s always hope.

Palmer: Underscored in that message is that there’s an expanded toolkit to treat this problem. AA works for millions; it doesn’t work for everybody. There are a lot of other things that do and we need to get the word out.

Q: Mike, what do you hope for?

Pond: I hope that my sons will have a wonderful, happy, fulfilling, flourishing life. And also, that we can be a part of helping change this system that is flawed.

Confirmed: alcohol consumption in the West also has a genetic component

imgresHow much alcohol you drink and how hard it affects you are rooted in your DNA. Much studied in Asian populations, this study at the University of Valencia contributes conclusive evidence to an emerging Western scientific literature on the subject.

A study carried out at the Universitat de València (University of Valencia, UV) has underlined the genetic component to the consumption and effects of alcohol. Specifically, it points to a “lazy” variant of the Alcohol Dehydrogenase 1B (ADH1B) gene, known to regulate the activity of a key group of enzymes.

When we drink, the alcohol rushes into our bloodsteam, where the alcohol dehydrogenase enzymes metabolise, or break down, the ethanol into acetaldehyde. If this happens quickly, lots of acetaldehyde accumulates in a short amount of time, which can lead to adverse effects such as flushing, nausea, and headaches. Conversely, if the ethanol is metabolised slowly, the alcohol remains intact in the blood for longer periods, prolonging its more pleasant, euphoric effects.

The speed at which this process takes place, the metabolic rate of ethanol, is where the ADH1B gene comes in. A super efficient gene can make the effects of alcohol more unpleasant, while carriers of a “lazy” variant enjoy longer highs. This may influence the tendency of carriers of one or the other variant to drink more or less alcohol.

Francesc Francés, at the Department of Legal and Forensic Medicine at the UV, summarises: “The main conclusion of this work is that this genetic polymorphism [the different variants of ADH1B carried by different people] seems to be linked to levels of alcohol consumption”, adding that “this association is even more evident in the male population, perhaps due to the existence of fewer inhibiting social stereotypes”.

The link between the “lazy” variant of the ADH1B gene and a greater alcohol consumption has long been proven by science within Asian populations. This study is one of the first to offer conclusive proof of this also being the case in the West.

Better treatment

Although, as Francés points out, science is still in the early stages of understanding the influence of genes on certain behaviours, the findings of this study can be applied, for instance, in alcohol detox treatments. Knowing whether a patient has this “lazy” gene variant can help determine the relative weight of genetic predisposition and environmental factors in their drinking habits, indicating one course of treatment or another.

On the longer term, this kind of study may have applications within legal and forensic medicine, given the strong association between crime and alcohol consumption.

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Wednesday, fetal alcohol spectrum disorder (FASD) was trending on Facebook after a profound article was featured by the Washington Post that told the tragic story of a woman named Kathy Mitchell, who caused her own daughter’s disability. Kathy later learned her daughter, Karli, suffered from fetal alcohol syndrome (FAS), which was caused by her own alcohol consumption while she was pregnant.

Kathy admits she battled alcoholism, but in her defense, the Washington Post pointed out that in 1973, when Kathy gave birth to Karli, doctors barely knew of the effects that alcohol consumption or even binge drinking had on a fetus. At that time, mothers were told that drinking wine was good for blood flow and was probably even healthy to consume during pregnancy.

Readers’ reactions included shock that anyone could think that binge drinking wouldn’t hurt a fetus, but even today, public awareness about alcohol consumption during pregnancy is limited. For example, social media posts and comments indicate that the Washington Post article was going overboard by warning that there is no safe amount of alcohol to consume during pregnancy.

“Good grief. She didn’t ‘drink alcohol’ she was an alcoholic who drank excessively! And smoked. There is a BIG difference. Journalists should know that and not sensationalize. Lots of us have mothers who drank occasionally while pregnant and have no problems,” one reader commented on the Washington Post’s Facebook post.

The truth is that the article sensationalized nothing. Alcohol’s damage to a fetus can be just as insidious when a mother drinks lightly or moderately — it is just less obvious sometimes. For a person exposed to alcohol prenatally, if the brain damage is so severe that their IQ is drastically lowered, while it destroys the life they would have otherwise had, it also offers some protective qualities. A low IQ means more services, less expectations. There are still other victims of prenatal alcohol exposure, though, and in their invisible disabilities, alcohol still manages to permanently alter the course of their lives.

Screen Shot 2016-01-21 at 7.16.16 AM

Fetal alcohol spectrum disorder covers a range of impairments. The Washington Post author wrote that the “effects can include impaired growth, intellectual disabilities and such neurological, emotional and behavioral issues as attention-deficit hyperactivity disorder, vision problems and speech and language delays,” but this description fails to describe the actual impact the brain damage can have and also fails to describe the secondary and tertiary effects of living with a FASD, even on the so-called higher functioning end of the spectrum.

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Val Surbey’s adoptive son Christopher was found stabbed to death in 2005 after sneaking out in the middle of the night. Christopher spoke well and looked normal, but while normally people consider consequences before acting, because Christopher was exposed to alcohol prenatally, he did not. Once, before he died, he went to court for assaulting a staff member and damaging property at Macdonald Youth Services.

“He had to sign a paper that he really had no idea what he was signing: He had to keep the peace, he couldn’t bear firearms, and he couldn’t do this or that, and of course, he breached every one of those in the first week. He didn’t get it. He could probably recite it to you, but couldn’t put it into practice,” Surbey said.

Although his brain was damaged through no fault of his own, he seemed normal, according to a featured article in the Winnipeg Free Press. His struggles with the justice system are common for people living with a FASD.

According to the U.S. Department of Health and Human Services, people affected by prenatal exposure to alcohol are often imprisoned because their invisible disability causes a lack of impulse control, trouble thinking of the future consequences of current behavior, difficulty planning, difficulty empathizing, lack of responsibility, trouble delaying gratification, and poor judgment. The literature also cites a tendency towards explosive episodes and a vulnerability to peer pressure as additional reasons for habitual incarceration among people with a FASD.

A teen with a FASD is estimated to have a 19 times higher risk of becoming incarcerated than a teen without a FASD, according to the Conversation. The prevalence of having a disruptive school experience (such as an expulsion) is 61 percent, being in trouble with the law is 60 percent, repeatedly exhibiting inappropriate sexual behaviors is 49 percent, and having drug and/or alcohol problems is 35 percent among people with a FASD.

Here’s the thing, though. If a person is given their diagnosis at an early age while simultaneously reared in a stable environment, the odds of escaping these secondary outcomes is increased two- to four-fold. That is why it is so critical that the public is made more fully aware of what it means to be prenatally exposed to alcohol, experts say. Some caregivers have seen less severe secondary and tertiary side effects by implementing strategies detailed by Diane Malbin in Trying Differently Rather Than Harder, but without greater awareness and adequate diagnoses, too many Americans living with effects from fetal alcohol exposure will never benefit from this alternative upbringing.

Additionally, alcohol during pregnancy is now linked to a multitude of conditions that most people do not associate with FASD.

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The general public is unaware that life-altering brain damage could occur even when a mother does not drink heavily, even though in 2013, a study in PLOS One showed that even a relatively small amount of alcohol during fetal development could lead to long-term brain alterations. Even a small amount of alcohol could cause anxiety-like behavior and could cause structural changes with the basolateral amygdala which is, according to the Journal of Neuroscience, “intimately involved in the development of conditional fear.” Meanwhile, research from the University of Queensland found that women who “drank two 150ml glasses of wine or about two stubbies of full-strength beer during pregnancy” had children who had lower test scores at age 11. Furthermore, according to Medical Daily, FASDs are commonly misdiagnosed as ADHD.

What is your current impression of the damage that alcohol can do to a fetus? Does any of the recent research clash with what you were previously told about FASDs?

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Understanding Stigma to Improve the Lives of Families Affected by FASD

In recent years, legal and social challenges in different parts of the world have exposed some of the stigmatized reactions towards women who drink during pregnancy and their children who may suffer from FASD. Brought to the surface are negative public attitudes and prejudices about women who consume alcohol during pregnancy that, in turn, stereotype families and affected individuals. Consequently, those affected by FASD (children, adolescents, adults, and biological and non-biological families) may experience negative self-esteem, isolation, and reduced opportunities.

These effects reverberate throughout families and over the life course. We need a better picture of the stigma experienced by those affected by FASD, and opportunities to reflect on the messages about alcohol use and FASD that are communicated when we interact with pregnant women, children and their families.  We need others to understand the implications of alcohol use during pregnancy, especially on brain and behavior. This not only applies in the health system, but also in the education, social services and legal systems where families affected by FASD may be frequently encountered. 

Dr. Emily Bell will share a model of the stigma experienced by those affected by FASD to springboard discussion about whether and why understanding the negative beliefs and attitudes that fuel stigma is worthwhile. She will make the case that designing public health messages should include routine examination of the potential effects of messages on psychological wellbeing of those affected by FASD. Using the example of screening women for drinking alcohol during pregnancy and screening for possible prenatal alcohol exposure, Dr. Jocelynn Cook will discuss how education and training can provide valuable opportunities for professional self-reflection. She will discuss how education impacts the way that front-line personnel interact with women during screening and can alter the health outcomes for mothers and their children. Together, we are working in partnership to improve outcomes and experiences of those living with FASD.


IMG1378.jpgDr. Emily Bell

Dr. Emily Bell obtained her PhD (psychiatry) from the University of Alberta in 2007 and later did postdoctoral research in the area of neuroethics. Until recently, she was Associate Researcher at the Neuroethics Research Unit in Montreal where her research focused on vulnerability and informed consent in invasive psychiatric research trials, ethical challenges in the development and application of biomarkers for neurodevelopmental disorders, and examination of the ethical implications of stigma in fetal alcohol spectrum disorders (FASD). Much of this research was conducted while she was a member of the Neuroethics Core of NeuroDevNet, a Canadian Network of Centre of Excellence. She remains deeply interested in health policy and youth mental health.



Dr. Jocelynn Cook 

Dr. Jocelynn Cook graduated with a PhD in Reproductive Physiology from the Medical University of South Carolina in 1997 and spent 10 years in an academic setting as graduate student, a post-doctoral fellow and an Assistant Professor. Wanting to expand her skillset beyond the basic science laboratory, she embarked on a Masters of Business Administration, and graduated from the University of Saskatchewan with an MBA, specializing in Economics and Health Policy. Her professional career has focused on issues related to maternal-fetal medicine; specifically, substance abuse during pregnancy, preterm birth, Fetal Alcohol Spectrum Disorder (FASD) and Assisted Human Reproduction. She has gained expertise in clinical research and issues related to clinical practice for pregnant women and their children and program evaluation, as well as experience with population and epidemiology research. Early on in her career, she became involved with Aboriginal Health research, especially as it related to the social determinants of health. This broadened her research perspective and she gained expertise related to suicide prevention, mental health and addictions, child development, communicable diseases, chronic diseases, health surveillance and National and International trends in morbidity and mortality.   

Dr. Cook joined the Society of Obstetricians and Gynaecologists of Canada as its first Scientific Director in 2014 and oversees all work related to Continuing Medical Education, Clinical Practice Guidelines, Research, Accreditation, Global Health and Indigenous Health. 

Dr. Cook is an Adjunct Professor to the department of Obstetrics and Gynecology at the University of Ottawa, appointed in 2002. 

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