Monthly Archives: April 2016

How do we heal trauma suffered by Native communities? BY GABOR MATE’

How do we heal trauma suffered by Native communities?

BY GABOR MATE’

It is not enough that the Attawapiskat First Nation has declared a state of emergency over the epidemic of suicides and suicide attempts among its youth. Our entire country should declare a state of emergency about the appalling health status, physical and mental, of First Nations and Inuit communities. Would we not have already if, instead of Nunavut or Attawapiskat, it was, say, the teens of Westmount, Forest Hill or Kitsilano who were killing themselves at 10 times the national rate?

I am often asked to visit First Nations communities across Canada to speak about addiction, stress-related illness and child development. The ordinary Canadian citizen simply has no idea, cannot even begin to imagine, what misfortunes, tragedies and other kinds of adversity many native young people experience by the time they reach adolescence – how many deaths of loved ones they witness, what abuse they endure, what despair they feel, what self-loathing plagues them, what barriers to a life of freedom and meaning they face.

At the core of the suicide pandemic is unresolved trauma, passed almost inexorably from one generation to the next, along with social conditions that induce further hopelessness. The source of that multi-generational trauma is this country’s colonial past and its residue in the present. The march of the history and progressCanada celebrates, from which we derive much pride and national identity, meant catastrophe for natives: the loss of lands and livelihood and of freedom of movement, the mockery and invalidation of their spiritual ways, the near-extirpation of their culture, the corruption of their intra-familial and intra-communal relationships, and finally, for nearly a hundred years, the state-sanctioned abduction, rape, physical abuse and mental torture of their children.

The questions we must ask ourselves nationally are very simple. How do we as a country move to heal the trauma that drives the misery of many native communities? What can be done to undo the dynamics our past has dictated? Some may balk at such inquiry, fearing the discomfort that comes with guilt. However, this is not a matter of communal guilt, but of communal responsibility. It is not about the past. It is about the present. And it is about all of us: When some among us suffer, ultimately we all do.

To begin, native history must be taught fully and in unsparing detail in our schools. All Canadians should know, for example, that 50 years ago it was not unheard of for a four-year-old girl to have a pin stuck in her tongue for the crime of speaking her mother language and later endure serial rape by teachers, religious mentors. Such were the antecedents of today’s drug use and suicidal anguish. The resonant values, brilliant art, stories and wisdom culture of First Nations people should be introduced in Canadian schools. Canadians must be helped to see their First Nations peers in their fullness, which includes their humanity, grandeur, unspeakable suffering and strength.

We must renounce any political, economic or social policy that reinforces the colonial trauma of disempowerment, loss and dispossession. Not another square centimetre of native land must be disturbed, not a blade of grass cut, not one more drop of water diverted, not a millimetre of pipeline laid without First Nations agreement.

Institutions and individuals interacting with native people must become deeply trauma-informed. Judges, teachers, law-enforcement personnel, nurses, doctors, psychiatrists, social workers, public employees, policy-makers all must understand what trauma is, its multiple impacts on human mentality and behavior, and how to address it. Without such information, as I have witnessed repeatedly, the best-meaning people can unwittingly re-traumatize those who can least bear further pain and loss. Practices that devastate families must be stopped, such as the frequent apprehension of children without restorative and compassionate family-building support.

Alternative forms of justice must be developed, aligned with native traditions and in consultation with First Nations. The implicit racism in our law-enforcement institutions must be openly acknowledged and cleansed. Powerfully beneficial traditional healing practices must be researched, taught, encouraged. We need to celebrate the First Nations cultural renaissance, a tribute to human resilience, now taking place.

Economic and social conditions that engender despair must be addressed, with the utmost urgency. If we could spend more than $15-billion on our self-declared mission to help the people of Afghanistan, surely we can find the resources in our rich land to help redeem people whom our history continues to victimize.

(Gabor Maté is a retired B.C. physician who specializes in addiction.)

Retrieved from: http://www.nsweekly.com/news/2016-04-20/Voices_of_the_People/How_do_we_heal_trauma_suffered_by_Native_communiti.html

Scotland: Newborn babies tested for alcohol after shock research shows 42 per cent of mums drink while pregnant

Newborn babies tested for alcohol after shock research shows 42 per cent of mums drink while pregnant

Newborn babies tested for alcohol while in hospital

Newborn babies tested for alcohol while in hospital

8 hrs ago / Helen Puttick

NEWBORN babies in Scotland are being tested for alcohol after researchers found signs that pregnant mothers from all walks of life are drinking regularly.

Hundreds of infants at the Princess Royal Maternity Hospital (PRM) in Glasgow are having samples collected and then analysed for molecules which stay inside unborn children when their mothers drink.

Early results suggest up to 42 per cent of mothers consume some alcohol while pregnant, with around 15 per cent drinking more than one or two small glasses of wine a week.

Official advice across the UK is for expectant mothers to avoid alcohol entirely, with the Scottish Government warning: “The effects of alcohol on the developing foetus can be many and varied, and potentially devastating.”

The new research, funded by Glasgow Children’s Hospital Charity, was inspired by a separate project in the city looking at eye movements in babies with mothers who had a history of drug abuse.

It found evidence of significant alcohol use in 44 per cent of the mothers who had used other substances as well as 23 per cent of a control group who had no addiction history, although the number of participants was small. When completing questionnaires all denied alcohol misuse in pregnancy.

Consultant neonatologist Dr Helen Mactier, who is leading the research, said: “There is an assumption that all problem drinking in pregnancy is associated with poverty and there is no evidence to confirm that.”

“It is much easier to conceal problem drinking if you are affluent and if you are clever.”

After a feasibility study, supported by the Scottish Government, the team at PRM are now collecting 750 samples of meconium – the thick dark substance which babies pass shortly after birth containing matter they ingested in the womb.

Dr Mactier said: “Alcohol is a small molecule so it crosses the placenta easily. It can be in the amniotic fluid, it can be in the blood. The foetus metabolises alcohol the same as it gets sugar and protein.”

However, she said the by-products of metabolising alcohol are large molecules which cannot leave the placenta. Dr Mactier said: “The molecules are then stuck in the baby. They get laid down in the meconium.”

The meconium samples now being collected at PRM are being frozen and sent to forensic toxicology experts in Italy for analysis.

Dr Mactier said almost 600 samples had been gathered so far thanks to “huge cooperation from mums as well as staff” at the hospital. The mothers are also asked to complete a questionnaire about their background and lifestyle.

The researchers are looking for high levels of the alcohol by-products, so they say the occasional drink will not be highlighted.

By identifying the scale of alcohol consumption in pregnancy and the groups most likely to drink, they hope to be able to target messages and interventions to address the problem.

Dr Mactier said: “Alcohol consumption in pregnancy is almost certainly contributing to a lot of learning disability in Scotland, which is not fully recognised, and learning disability is associated with poor school performance and criminality in the long term.”

Fetal Alcohol Spectrum Disorder, the umbrella term for a group of problems caused by exposure to booze in the womb, is considered the most common non-genetic cause of learning disability in the UK. The symptoms include short height, low body weight, poor co-ordination, learning issues, behaviour problems as well as issues with hearing and sight.

It can, however, be difficult to diagnose and Dr Mactier’s research team is also investigating whether a spot of blood could be taken at birth and analysed for signs of significant alcohol exposure in the womb. This could then be used to help diagnose FASD in children exhibiting symptoms as they grow-up.

Glasgow Children’s Hospital Charity – formerly Yorkhill Children’s Charity – is funding the £65,000 project.

Shona Cardle, chief executive of Glasgow Children’s Hospital Charity, said: “This particular study highlights the importance of research to the health of children today and for future generations.

“The ability to identify fetal alcohol syndrome in babies gives medical practitioners the opportunity to intervene and help mothers at an earlier stage than was previously possible, with clear benefits for the long term health of further children born to affected mothers.”

Dr Peter Rice, chairman of Scottish Health Action on Alcohol Problems (SHAAP), said Dr Mactier’s work was very important for increasing understanding of the affects of alcohol on the foetus.

He added that World Health Organisation research showed high levels of awareness regarding the risks of drinking during pregnancy in the UK compared to Eastern Europe.

Dr Rice also said alcohol could damage babies during the early months of pregnancy. “There needs to be a whole population approach,” he said. “Just simply giving women information once they are pregnant, although important, for some types of harm will be too late.”

Retrieved from: http://www.heraldscotland.com/news/14460210.Newborn_babies_tested_for_alcohol_after_shock_research_shows_42_per_cent_of_mums_drink_while_pregnant/?ref=mr&lp=7

Thunder Bay plans services for pregnant women, new moms with addictions

Thunder Bay plans services for pregnant women, new moms with addictions

18 per cent of women who deliver babies at Thunder Bay hospital report substance use

By Jody Porter, CBC News

cynthia-olsen

Pregnant women and new mothers struggling with addictions are the focus of a new strategy being developed by health and social service providers in Thunder Bay, Ont.

Statistics from 2014 show that 18 per cent of women who delivered a baby at Thunder Bay Regional Health Sciences Centre reported “substance use,” according to the city’s drug strategy coordinator, Cynthia Olsen.

The complex problem of serving both mothers and children requires a multi-pronged approach to care, she said.

“Women need unique services,” Olsen said. “We need to be able to provide appropriate services that are holistic and we need to better support the children of the families.”

Dr. Naana Jumah, a clinician and researcher at the Thunder Bay hospital, studied the concerns of pregnant women in the region outside the city and found that traveling to give birth presents its own set of problems.

Dr. Naana Jumah, Margaret Leslie, Cynthia Olson

“Women who have addictions issues, substance use issues, who come from more complicated social situation — the effect of removing them from their communities and their supports is that much more magnified,”  Jumah said.

Jumah said the shortage of mental health services across the region also presents problems, particularly in small communities where women may be stigmatized while seeking help.

“Women being pregnant and being identified as substance-using can often cause that woman feel a lot of shame, can cause her to be identified in the community, can cause her to be targeted,” she said.

Thunder Bay is looking towards Mothercraft – Breaking the Cycle program as a successful model. The program has been operating in Toronto for 20 years.

“We see decreased rates of children going into care [of child welfare agencies] because their moms have received the care that they needed during pregnancy and have been able to make changes for themselves and their children,” said Margaret Leslie, the director of early intervention programs with Breaking the Cycle.

No time-line has been set for Thunder Bay to develop its own model for serving pregnant women and new mothers who use substances, Olsen said.

Retrieved from: http://www.cbc.ca/news/canada/thunder-bay/addicted-moms-thunder-bay-1.3552257

Yukon FASD study prompts calls for ‘system-wide change’

Yukon FASD study prompts calls for ‘system-wide change’

Seen in about 1% of overall population, FASD diagnosed in 17.5% involved in Yukon justice system

By Philippe Morin, CBC News

wenda-bradley

A study in Yukon is showing the prevalence of Fetal Alcohol Spectrum Disorder (FASD) within the criminal justice system.

The condition affects an estimated 1 per cent of children in Canada, but new research shows the percentage of people within Yukon’s justice system with FASD is 17.5 per cent, or about one in six.

A Yukon government study examined people at the Whitehorse Correctional Centre either serving sentences or on remand as well as people under Community Supervision Orders.

Dr. Kaitlyn McLachlan was the study’s lead investigator. She works with the Department of Psychiatry and Behavioural Neurosciences at McMaster University.

Kaitlyn McLachlan

The new research ‘puts Yukon in a position to consider system-wide change,’ said lead investigator Kaitlyn McLachan of McMaster University. (McMaster University)

“That tells us, a sizeable proportion of people in criminal justice are experiencing difficulties in their day-to-day functioning,” she said.

McLachlan says Yukon’s research is unique in Canada and illustrates the intersection of criminal justice and mental health care.

“It puts Yukon in a position to consider system-wide change,” she said.

‘Not appropriate’ care say critics

One advocate for change is Dr. Larry Burd, who serves as director of North Dakota’s Fetal Alcohol Syndrome Center and is an associate professor in the department of pediatrics at the University of North Dakota School of Medicine. He’s been researching FASD for 30 years.

He says incarceration is “not appropriate” for people with FASD as the “impairment focuses on this issue of thinking, evaluating before you act. That’s quite impaired by FASD. We end up with people that are in the correction system because of brain damage.”

Burd adds that governments in the U.S. and Canada are “just using the corrective system because that’s all that’s available.”

In 2003, Burd attempted to get voluntary estimates from Canadian provinces and territories.

At the time, Yukon’s correctional system estimated that only 2.6% of offenders had FASD.

The new findings are almost seven times higher.

“I think it’s a huge step forward in addressing a much under-considered problem with very serious consequences,” he said.

FASD linked to poor impulse control

FASD is linked to poor impulse control, mood swings and difficulty in understanding consequences.

Wenda Bradley works with FASD Yukon. She says she’s seen how its effects can lead to repeated incarceration.

“I know a fellow who has 18 years of time served, but only two or three months at a time. That’s not healthy for him. And it’s not useful for anybody because it’s always this turnaround,” she said.

One example Bradley mentioned is that clients often miss appointments with a parole officers.

“People can be in (the criminal justice system) for a long amount of time because they can’t understand the rules or can’t follow through with the rules and keep circling in and out of the system,” she said.

Bradley says she hopes the justice system will change and ensure there are “supports in place, before people start getting into trouble.”

Yukon MP calls for change in law

Yukon MP Larry Bagnell has brought forward a private members’ bill, calling for more treatment and less incarceration in cases of FASD.

“I’m excited the study’s done, because it gives the  government impetus for action,” Bagnell said.

Larry Bagnell

“Sentencing doesn’t make any sense if you don’t understand the purpose as a deterrent,” says Yukon MP Larry Bagnell. He says people with FASD ” need direction, they need guidance and they need to be treated differently by the correction and justice system.” (Philippe Morin/CBC)

“[People with FASD] need support to make sure they integrate properly in society. Their  brain is malfunctioning through no fault of their  own. They need direction, they need guidance and they need to be treated differently by the correction and justice system.”

Bagnell adds that “sentencing doesn’t make any sense if you don’t understand the purpose as a deterrent.”

The FASD study is part of a larger project involving Yukon’s departments of Justice, and Health and Social Services.

In 2014, when the project had been recently announced, then-federal Justice Minister Peter MacKay visited Whitehorse and said the research was leading the country.

Part of the challenge is that FASD is hard to diagnose. A Canadian medical standard for diagnosis was only approved in 2005, with revisions in 2015.

Yukon, meanwhile, is working to create a FASD assessment and diagnostics team which will help the justice system identify people with FASD.

Retrieved from: http://www.cbc.ca/news/canada/north/yukon-fasd-study-prompts-calls-for-system-wide-change-1.3552362

Pregnancy and Policy: Who Decides? Time to Stop Focusing on Fear and Shame

pregnant1019a

Fetal alcohol spectrum disorders (FASDs) are completely preventable. FASDs are caused when alcohol, consumed during pregnancy, crosses the placenta and can result in effects that range in severity. The exact prevalence is unknown, but it is estimated that at least 10 out of 1,000 children have FASD (May & Gossage, 2001). This estimate, though high, may still fall short of the actual cases due to the window in which a diagnosis occurs. While the most severe cases of FASD are obvious at birth, less subtle effects of FASD, such as developmental, cognitive, and physical disabilities, may not be obvious until the child ages, delaying diagnosis and treatment. FASD is a public health issue where prevention is our best approach. The questions remains: How do we prevent FASD while preserving a person’s autonomy before and during a pregnancy?

With 1 in 10 people drinking during pregnancy (CDC, 2015), the solution is more complicated than simply asking people to abstain from alcohol use while pregnant. Almost 50 percent of all pregnancies in the US are unplanned, which can delay pregnancy awareness (Guttmacher, 2016). Unplanned pregnancies can result from a lack of knowledge about or access to birth control. Many people are unaware of their pregnancy for eight weeks or more and drink during this window of time. Consuming alcohol during this window unknowingly and unintentionally exposes the fetus to alcohol’s potentially damaging effects. People who become pregnant may be unaware of the effects of alcohol exposure on the developing fetus, or may need support to minimize or abstain from alcohol use. Furthermore, those who suffer from serious addiction or mental health issues require a network of support to address their drinking. In order to address the complexity of FASD, we must understand the very important intersections between access to contraception and education about alcohol’s effects on the fetus.

This is an issue that has not gone unaddressed. The CDC recommends that reproductive-age women, not using birth control, should abstain from drinking any alcohol (CDC, 2016). Abstinence is the safest approach, but provides no educational information about why one should abstain or how one can access health care, counseling, or birth control. This abstinence-based approach does not address underlying trauma, mental health issues, or access for treatment of alcoholism. Given that a large portion of the population enjoys responsible drinking, suggesting abstinence from alcohol is an unrealistic expectation. This approach comes off as paternalistic and infers that women’s participation in the world is solely to produce offspring. Another strategy that has been used is point of sale warning posters and labeling on alcohol-containing products. While these strategies demonstrated a small decrease in FASD, the effect has waned as people have tuned out these familiar messages. While some providers screen for alcohol use, there is no universal screening for alcohol use in the obstetric setting. These prevention initiatives have failed as they do not address the multifactorial nature of FASD.

As former methods are proving ineffective, it is time to address FASD through a reproductive justice framework. Society must recognize that women deserve to be viewed as more than just reproductive vessels and consider the larger contextual issues. Education and access to healthcare are two extremely complex, yet undeniably critical factors necessary to address FASD. Women who have access to family planning information and care will have more control over their fertility and pregnancy planning. This strategy may significantly decrease the number of children born with FASDs caused by late pregnancy recognition.

The CDC asks women who are sexually active and do not use birth control, “Why take the risk?” when it comes to alcohol. This sets the precedent that women live and act with malicious intent for a theoretical pregnancy, thus promoting societal shame. Shame occurs through the lack of conversation and screening for alcohol use during prenatal visits, and is a major contributing factor to the under-diagnosis of FASD. A reproductive justice lens avoids shaming women and avoids fear-based tactics. Instead, it asks women about their alcohol use and provides information, resources, and the necessary support to help women make informed and un-coerced choices. This includes ensuring that women are provided with accurate education about alcohol consumption during pregnancy that reflects the complexity of this subject.

FASDs will not be resolved with any one simple intervention. A paradigm shift has the strongest potential to move towards healthier outcomes for pregnant people and their children. It is time to move away from the current focus on fear and shame. FASDs are completely preventable, and their incidence can be reduced in the US by adopting a reproductive justice lens.

Your voice can make a difference on this issue. Join the National Organization for Fetal Alcohol Syndrome’s campaign to end FASD and pledge to Stamp Out Stigma! Use your voice and help us move away from the current focus on fear and shame, and move towards a more empowering approach to preventing FASD. Go to http://www.nofas.org/stigma and take the pledge today! It will take all of us to make the paradigm shift necessary to lower FASDs and move towards healthier pregnancy outcomes and healthier babies.

 

References:

 

Authors Full Name(s): Shannon Durst, Fatima Malik, Annie Richardson, Annie Song, EB Troast, Peg Walden

Retrieved from: http://www.huffingtonpost.com/san-jose-state-university-mph-student-cohort-2014/pregnancy-and-policy-who-_b_9754856.html

White Americans Are Dying Younger as Drug and Alcohol Abuse Rises

Quitting Drinking

White Americans Are Dying Younger as Drug and Alcohol Abuse Rises

WASHINGTON — Life expectancy declined slightly for white Americans in 2014, according to new federal data, a troubling sign that distress among younger and middle-age whites who are dying at ever-higher rates from drug overdoses is lowering average life spans for the white population as a whole.

The new federal data, drawn from all deaths recorded in the country in 2014, showed that life expectancy for whites dropped to 78.8 years in 2014 from 78.9 in 2013. Men and women had declines, but because of statistical rounding, the decline did not appear as sharp among men.

Life expectancy for women fell to 81.1 in 2014 from 81.2 in 2013. The average life span for men also fell, but not enough to sink below 76.5 years, their life expectancy in 2013.

“The increase in death in this segment of the population was great enough to affect life expectancy at birth for the whole group,” said Elizabeth Arias, the statistician at the National Center for Health Statistics who analyzed the data, referring to whites from their mid-20s to their mid-50s. “That is very unusual.”

Dr. Arias, who is preparing a larger study of mortality trends over the past 15 years, said drug overdoses, liver disease and suicide were the main drivers of the gloomy trends among whites in recent years, a pattern also found by other researchers.

Life expectancy for whites had been rising for decades, but it has stagnated in recent years. It inched up in 2010 and 2011, and was flat in 2012 and 2013.

Recent research has documented surprising increases in death rates among less educated whites. Last year, a paper by Anne Case and Angus Deaton documented rising death rates among middle-age white Americans, particularly those with no more than a high school education. Other research has found rising rates among younger whites.

The pattern had puzzled demographers, but the recent analyses have pointed to suffering and anxiety among working-class whites.

In contrast, life expectancy for blacks rose to 75.6 in 2014 from 75.5 in the previous year. Blacks have gained more than a year of life expectancy since 2008. Black men had the biggest increase of all the groups in 2014, rising to 72.2 from 71.8.

For Hispanics, life expectancy jumped to 81.8 in 2014 from 81.6 in 2013. Hispanic women had even more pronounced gains, with life expectancy rising to 84 years from 83.8 in 2013. Overall, Hispanics, like blacks, have gained one year of life expectancy since 2008.

The overall life expectancy for Americans, 78.8, remained unchanged.

The last time life expectancy for whites dropped was in 2005, around the time of a particularly severe flu season, though it is not clear that flu caused the decline.

The most recent dip before that was in 1993, around the time of the AIDSepidemic, when there was a decline in life expectancy for the entire United States population. The drop was steepest among blacks, whose life expectancy dropped to 69.2 from 69.6 in one year.

Typically, most of the deaths in the country occur among people in their 60s or older. Deaths in people who are younger or middle age are relatively rare and do not usually affect overall life expectancy. A surge in death rates at those ages is sometimes analogous to a generation of men going to war or a wave of mothers’ deaths in childbirth.

“There is the expectation that life expectancy will go up every year, and that has been realized just about every year over the past century,” said Samuel Preston, a demographer at the University of Pennsylvania.

Retrieved from: http://www.nytimes.com/2016/04/20/health/life-expectancy-decline-mortality.html?_r=0

hope through nature

One woman’s journey to bring hope to the women of the Downtown Eastside. Discussing topics such as FASD and how Jaime uses nature to bring hope.

For more information about Forest and the Femme, visit:
http://www.forestandthefemme.org

« Older Entries