Monthly Archives: May 2016

To Drink or Not to Drink

To Drink or Not to Drink

Pregnant Natacha talks about her decision to not drink while pregnant.  She says, ” I don’t think there is enough data to show there is no risk to consuming alcohol during pregnancy”. She would rather be cautious and not take the risk, so she chose to eliminate alcohol during her pregnancy.

What can Pavlov’s dogs tell us about drinking?

What can Pavlov’s dogs tell us about drinking?

Concordia researchers explain how fancy glassware and the sight of a liquor store can facilitate alcohol addiction
By: Cléa Desjardins
“Alcohol addiction is compounded by our ability to learn about predictive cues.” | Photo by Photholic (Flickr Creative Commons)
“Alcohol addiction is compounded by our ability to learn about predictive cues.” | Photo by Photholic (Flickr CC)
Humans aren’t much different from other animals. Just like Pavlov’s dogs, we can become conditioned to associate environmental cues with rewards. Innocent enough when the sight of your sneakers makes you want to go for a run, but not necessarily so when the sight of the liquor store prompts you to want a drink.Indeed, Pavlovian cues that predict alcohol can lead us toward addiction. And sometimes those cues can become desirable in and of themselves, as shown in a new study by Concordia researchers, published in Frontiers in Behavioral Neuroscience.

“Alcohol addiction is compounded by our ability to learn about predictive cues,” saysNadia Chaudhri, the study’s lead author and professor in the Department of Psychology.

“Conditioned reactions to those cues can trigger behaviours that result in drinking, like turning into the SAQ or reaching for a beer.”

The results of the study suggest that cues that predict alcohol can become highly desirable; therefore, people may keep drinking because of the pleasure derived from our interactions with them.

According to this research, drinkers wishing to make a change in their habits shouldn’t just focus on the booze itself, but on all the factors that surround alcohol consumption.

“Many people have specialized glassware for different kinds of drinks, and strong preferences for what they drink,” Chaudhri explains.

“These preferences could be driven by the sensory properties of alcohol, like its taste, smell and how it looks. It is important for people to realize that drinking alcohol is a complex behaviour, and in addition to what alcohol does to our brains, it also plays a role in regulating our behaviours.”

For the study, Chaudhri and her co-authors, former Concordia student Chandra Srey and postdoctoral researcher Jean-Marie Maddux, worked with 25 lab rats who were conditioned to associated a specific cue with the presence of ethanol — the main kind of alcohol found in alcoholic drinks.

The researchers paired a visual cue with the ethanol so that rats would come to expect alcohol every time they saw that cue. Eventually, when the cue was presented, rats approached the location where alcohol was about to be delivered. But after a time they stopped performing this behaviour and instead began approaching and interacting with the cue.

This happened even though the rats gained nothing by playing with the cue, and would actually have been better served by approaching the location where alcohol was about to be delivered.

The researchers also noted that the rats would work to earn presentations of a cue that was previously paired with alcohol, even when alcohol was not dispensed along with that cue. These results suggest that a cue that predicts alcohol can become highly desireable.

So how can rat behaviour help explain human addiction?

“Lots of our behaviours are governed by fundamental learning mechanisms that are also present in other animal species,” says Chaudhri. “By modelling these behaviours in rats we can better understand the factors that control how these behaviours are acquired and maintained in humans.”

She explains that we can use animal models to figure out ways to minimize unwanted behaviours like responding to cues that predict alcohol.

“This knowledge can then be brought back to the clinic, where we can test similar strategies in humans,” says Chaudhri.

“Rat models can also be used to inform us of the brain mechanisms that are important for behaviour. These basic science studies provide a critical foundation for the development of treatments for disorders like alcohol abuse and addiction.”

Chaudhri will soon present the results of this and other related studies at the upcomingSociety for Quantitative Analyses of Behavior annual symposium taking place May 27 to 28 in Chicago.

Partners in research:
This research was supported by the National Institute on Alcohol Abuse and Alcoholism, the Fonds de recherche du Québec – Santé and theNatural Sciences and Engineering Research Council of Canada.

Read the
cited study here, led by Nadia Chaudhri, professor in Concordia’s Department of Psychology

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South Africa’s FASD Problem

South Africa’s FASD Problem

Soaring rates of FASD in Eastern Cape’s Nelson Mandela Bay attributed to high alcohol consumption among pregnant women.  Bibi-Aisha of Al Jazeera reports that while the children display typical facial features of a child with FASD their mothers deny that they drank alcohol during pregnancy for fear they would be shamed, blamed, and stigmatised.

Why are rates of the condition, resulting from exposure to alcohol in the womb, so high in South Africa?


Eastern Cape’s Nelson Madela Bay mat have the highest rate of FASD in the World (Bibi-Aisha/Al Jazeera

Saldanha Bay, South Africa – On a weekday afternoon, the waiting room at Saldanha Clinic is filled mostly with women.

When seven-year-old Michelle Daniels* enters with her mother, a few stare. She has facial features typical of a child with Foetal Alcohol Syndrome (FAS) – small eyes, flattened cheeks, a short nose and a smooth philtrum above a thin upper lip.

It isn’t uncommon to see children like Michelle in the area. The Foundation For Alcohol Related Research (FARR) recently concluded a three-year study in the Saldanha Bay Municipality, which includes five small seaside towns on South Africa’s scenic West Coast.

It found a Foetal Alcohol Syndrome Disorder (FASD) – the umbrella term used to describe a spectrum of conditions of which FAS is the most extreme – prevalence rate of 6.42 percent (64 per 1,000) among children in Grade 1.

“This is not an insignificant number,” explains Leana Olivier, the CEO of FARR. “The prevalence rate of FASD in South Africa is several times higher than elsewhere in theworld.”

Education campaigns have made people more aware of the syndrome, which is linked to alcohol consumption during pregnancy.

One of the women who had stared at Michelle in the clinic murmured to her companion. “We never used to think these children looked different. We just said that’s how they were born, that’s how they look. Ya, we can see some of them are slow, but that’s how God made them. Now we know they’re like that because the mothers were drinking.”

Michelle’s mother denies that she drank alcohol during her pregnancies. “I have two sons, they’re 16 and 12. The oldest is a slow learner, and from what the nurses told us, I think he has the syndrome. But I don’t know how. My husband drank when I was pregnant, but not me. This one, she’s fine.”

Leana attributes this tendency towards denial to the social stigma sometimes attached to having a child with FASD. “There’s still a lot of labelling, a lot of blame placed on mothers,” she says.

Two kilometres away, at a clinic in the neighbourhood of Diazville, nurse Suzy Samuels has personal and professional experience of children with FASD. “We know the mothers are heavy drinkers. We work with these children; you can see they aren’t normal, but you can’t just tell the mother that. They don’t want to believe it, and they’ll say they didn’t consume alcohol when they were pregnant.”

Sixteen years ago, Suzy became a foster mother to Anna*. “She looked normal. But when she was three or four I saw something wasn’t right. She became hyperactive, she’d jump from high cupboards, and wasn’t afraid. She wouldn’t understand simple instructions. At school, she was bullied. Once, they put a rope around her neck, but she didn’t say anything. She just let them lead her around.”

Knowing that Anna’s biological mother was an alcoholic helped Suzy to understand the diagnosis. “I knew it was FAS. She doesn’t have the features, but her siblings do.”

Click here for the rest of the article


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.




New study uses technology to tackle Fetal Alcohol Spectrum Disorder


Jasmine Brown with Drs. Andrew Greenshaw and Egon Jonsson

Fetal Alcohol Spectrum Disorder (FASD) is a medical diagnosis for a range of physical, cognitive, and mental developmental disabilities that can affect a baby who was exposed to alcohol while in the womb.

“Alcohol can cause genetic defects, and a child with these defects does not grow to his or her full potential,” says University of Alberta researcher Dr. Andrew Greenshaw. “It is very difficult to diagnose, but FASD is associated with lots of problems. Kids with FASD find relationships difficult. They can’t follow rules effectively. They typically get into trouble with the justice system, and they can cause harm to themselves and others.”

It is estimated that between 40 and 80 thousand people currently live with FASD in Alberta, and about 700 babies are born each year with it. FASD cannot be cured, only managed.

The health consequences of FASD are enormous for those affected and their families. The economics of managing FASD is also a crippling burden on Alberta’s economy.

“The total cost of FASD in Alberta is approximately 1.2 billion dollars a year,” says Dr. Egon Jonsson, Executive Director and CEO of the Institute of Health Economics (IHE). “The biggest financial burden is on the legal system, specifically the police services since the majority of people with FASD come in conflict with the law. The health system is next, followed by social services and the education system.”

“Over the last two to three decades there have been a number of methods to prevent FASD. The most common have been campaigns to raise awareness,” says Dr. Jonsson. “However there is no evidence of change in behaviour. If anything has changed, it’s that the marketing of alcohol over the last 20-30 years has targeted women, which was not the case before, and research suggests that there is a substantial increase in the number of women drinking during pregnancy.”

A new way to help at-risk mothers

It is important to note that women who struggle with alcohol addiction cannot easily stop drinking despite understanding the potential harm to their baby. Life circumstances such as poverty, stress and other factors can lead to alcohol dependency.

Drs. Greenshaw and Jonsson are leading a unique study to see whether using technology called the SoberLink device could help at-risk pregnant women abstain from alcohol for the duration of their pregnancy and afterwards.

The goal is to have mothers-to-be self-monitor their drinking patterns. The hope is that they could then build on the periods of success where they abstained and perhaps demonstrate that for their loved ones. This sense of accomplishment could become a positive factor when they are most vulnerable to relapse. When combined with the standard care the women are already receiving, this approach should contribute to building knowledge in the health system to prevent FASD in a high risk population.

“We’ve already had women ask if they can keep the device once the study is done, so they can continue monitoring their sobriety afterwards because they want to give up drinking,” says Jasmine Brown, the study’s research coordinator. “They don’t want to relapse after their pregnancy because the support was taken away.”

Impact beyond FASD

If the device proves to be effective as a means to reinforce abstinence it could also be used in other areas of research and community support.

“We’re focusing on FASD prevention among pregnant women. But if it turns out to be an effective way for people with alcohol-use disorder to have a ‘win,’ to gain their community’s confidence and build their own confidence, then this tool may have implications for treating alcohol use disorder more broadly than among pregnant women,” says Dr. Greenshaw.

This study was funded by an Alberta Innovates – Health Solutions PRIHS grant.

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Linking diagnosis and prevention: building the next generation of policy responses


Linking diagnosis and prevention: building the next generation of policy responses


For many of those associated with Fetal Alcohol Spectrum Disorder (FASD) diagnosis, intervention, and prevention, there remains a mysterious aspect to the condition. When FASD was first identified in the 1970’s as the leading known cause of developmental delay, and the only disability of its type that might be called “100% preventable”, it was thought that the link between diagnostic and prevention work would be clear, uncomplicated, and achievable.


FASD, and the range of physical, cognitive, and daily living challenges linked to prenatal alcohol exposure could be prevented completely if women planning pregnancies quit drinking. Likewise, once the range of impairments and functional difficulties of people diagnosed with FASD were codified and elaborated, a road map for providing supports to individuals and families would also be achievable.

Although many promising practices have been developed and implemented, efforts to achieve and sustain prevention of FASD at a population level have been, and remain, elusive (Clarren and Salmon 2010). One reason that so much basic work still needs to be done seems to be related to a failure of FASD to be incorporated into the general cloth of medical work or easily addressed and accommodated in systems like education, social services, mental health, justice, and so on. We need to evaluate what we are doing, how it might be done better, and then to implement and disseminate change (Salmon and Clarren 2010).

The Canada Northwest FASD Research Network is committed to demystifying FASD diagnosis, intervention, and prevention through evidence-based research that promotes integrated approaches which link: compassionate and timely care for pregnant women and mothers with substance use problems; accurate and meaningful FASD diagnosis; and supportive care for people living with this disability. Any approaches need to be documented as they are implemented, so that the lessons learned from their efforts provide the evidence needed to drive the next stages of policy development.

A key to intervention and prevention

Accurate diagnosis of FASD is critical key for prevention and intervention. Proper diagnosis— which requires specialist multidisciplinary teams of professionals—requires capacity which is at present significantly lacking. Using data from the United States as a guide, conservative estimates suggest that the prevalence of FASD is approximately one in 100 people, and the prevalence of individuals with FAS is one in 1000. Using this estimate, the potential number of Canadians living with FAS is about 32,000, and the number of people with is FASD about 340,000.

At present, the number of evaluations that can be done annually in all of Canada is less than 2000. Such a discrepancy between the numbers of those who might require diagnosis and those who can actually get one is beyond comprehension. In addition to the benefits of having a proper diagnosis, population level diagnostic information is also needed to demonstrate to governments that there is a need for services. If efforts are not made to systematically collect information demonstrating the scope of need for support services, effective and responsive systems cannot be constructed. Systems will not be built for hypothetical clients.

No diagnosis—no problem. No problem —no need for a solution. Because FASD has been constructed as a consequence of maternal behaviour and often viewed as hedonistic, reckless or self indulgent, a diagnosis of this disability often generates a different response than other developmental disabilities that result by random chance or an undetected genetic variation. It has been (and in many instances remains) the case that the perspectives of birth mothers have been rendered invisible in diagnostic and support services for children with FASD. This has created conditions in which shame and mother-blaming have flourished, hindering opportunities for prevention within a broad range of systems. If done well, efforts to link policies and programs to enhance social supports and determinants of health, may also help to dismantle the shame and blame that underscore most contemporary prevention efforts.

Click to read full paper.

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Using culture to treat addictions

Using culture to treat addictions



Colleen Dell is exploring how indigenous culture helps people overcome addictions and the connection between human health and the health of animals and the environment.

“Linking animals, humans and the environment — in an indigenous world view, the three are never separated,” Dell said. “They have to be in equilibrium.

“Historically, indigenous people have lived with the land very well. From a western view right now, we couldn’t be doing worse. We are disconnected from the land, we don’t respect the land. We dominate the land and it’s the same thing with the animals.”

Dell, a sociology professor at the University of Saskatchewan, is the lead on a research project on indigenous health and animal-assisted interventions.

The keynote speaker at the Conference Board of Canada’s Indigenous Health Innovations Forum, held Wednesday in Regina, Dell spoke about her project: Honouring our Strengths: Culture as Intervention.

She told of an elder and indigenous researchers who travelled to 12 treatment centres across Canada. The elder spent three or four days at each location.

“He spent the first day and a half or so sharing the creation story, so that the project wasn’t just about, ‘Give me your information,’ ” Dell said.

Instead, the elder and members of the community led discussions about the role of culture in addictions treatment.

At White Buffalo Youth Lodge on Sturgeon Lake First Nation, horses are integral to treatment.

“A large majority of the girls coming through this residential treatment centre have experienced physical, sexual abuse,” Dell said.

But as a result of working with the horses, the young women learned what a healthy touch means.

“How else could you teach ‘healthy touch’?” Dell asked. “You get that feeling of trust and feeling of safety with a horse.”

Through the equine-assisted learning program, participants do a number of activities with a horse.

“For example, you have to lead a horse around some barriers or you have to get the horse to lie down,” Dell said. “To be able to do that with a horse, you have to connect. You cannot tell that horse what to do.

“Good luck if you’re going to try and drag a horse through some obstacles. Not until you respect that horse will that horse start to work with you.”

When indigenous people recapture their lost culture, they are on the road to discovering their identity and healing, she said.

“How can you be healthy in the world with your family if you don’t know who you are?” Dell said. “It is about respectful relationships — we need to build them between ourselves, the land and animals. But people also have to have good relationships with themselves.”

Her message resonated with Roger Francis, director of the Saskatchewan Institute for the Conference Board of Canada.

Francis co-chaired the conference, entitled Closing the Gap: Indigenous Health Innovations Forum.

“We’re talking about what is being led by indigenous organizations and indigenous people in this province to improve indigenous health care,” Francis said.

In consultation with the First Nations University of Canada, the Johnson-Shoyama Graduate School of Public Policy and the Indigenous Peoples’ Health Research Centre at the University of Regina, Francis developed the steering committee.

About 65 people from Toronto, Alberta and Saskatchewan attended the conference and included government policymakers, First Nations health delivery agents, health researchers and health consultants.

One session focused on health innovations in Saskatchewan’s north, another on innovations in the south.

“We talked about community-led innovations in HIV, in hepatitis C — and how, by letting the communities and the patients and the patients’ families provide the insight and intelligence in the solution for vision, you get better outcomes,” Francis said.

“In other words, culture becomes a real driver of positive health outcomes for people.”

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How To Convince Others That Your Normal-Looking Child Isn’t Normal

How To Convince Others That Your Normal-Looking Child Isn’t Normal.

4 action steps you can take to build a bridge

If we had a dollar for every time someone said, “Well, he doesn’t look like he has Fetal Alcohol Spectrum Disorder,” we’d be millionaires. The truth is, our child’s disorder makes it hard to see the forest for the trees.


I remember the first time my son stepped up to the plate the first year he played baseball. He held his bat like a pro. He not only looked like a miniature major league player, he acted and performed like one. With one swing, he sent a fastball up the middle of the diamond, straight into center field. When the center fielder bobbled the ball, my son had the wits about him to chug ahead, safely into second base. The crowd of parents, including us, went wild. One father turned to me and said, “You got yourself one heck of a ball player there!”

Fast forward to the end of the game. I stood by the second base bag, equipment bag slung over my shoulder, and waited for my son to make the choice to walk off the diamond by his own power. He scowled at me, with arms folded, not budging, just beyond the dirt of the infield. He had called me every name in the book, told me I was stupid, and shouted “Leave me alone” so loudly that the head coach walked over to see if everything was alright. I assured him it was.

“You played a good game buddy,” he said reassuringly to my son. “We just always like to switch it up and make sure everyone gets some playing time.” My son held his position. His upper lip was curled, there was snot dripping from his nose, and he glared as if he wanted to kill us both. The coach then turned to me and said, “This happens often with the boys when we first start the season. They’re disappointed when we move them from a position they love or get used to, to another one. He’ll get used to it though.” If only that were it, I thought to myself.

After weeks of my son behaving like this, and the good-hearted coach trying to reassure him unsuccessfully, I finally decided to sit down with him and explain Fetal Alcohol Spectrum Disorder. I shared that while my son looked normal, and even acted normal (most of the time), he suffered from a disorder that has caused damage to his brain, specifically the part where reason and logic exist. He looked at me cross-eyed.

“Well, he looks like a normal little boy,” he said. “I know,” I replied. “The diagnosis he has is Alcohol-Related-Neuro-developmental-Disorder which is under the umbrella of FASD.” He looked puzzled. I felt if I said, “He has autism,” or “He has Down Syndrome,” he would have nodded immediately. Unfortunately FASDs don’t have a voice like those special needs do.

Present but hard to see.

We learned a lot from that experience with the coach and many others like it- IEP meetings, church youth groups, football, you name it. We wish we could go and redo many encounters with folks who just didn’t understand how a kid that looked as normal as mine (charismatic, perfect smile, life of the party, eloquent) could not be normal. In retrospect, we’ve discovered 4 action steps that families like ours can take with coaches, teachers, neighbors, etc. to help them better understand our children…

  1. Share the facts. We can’t begin to count how many IEP meetings we’ve gone into with printed material on FASD’s. Our good friends over at and NTI Upstream do an amazing job of providing material, even a great documentary, on the facts of FASDs. Take this content with you, especially if it’s your first meeting with your child’s school, coach, or youth pastor.
  2. Honest conversation. Carve out time to sit down and speak honestly about your child’s disorder. Begin by saying something like this- “I need to share the reality of {Name} disorder with you. I know it’s hard to see, but he or she deals with Fetal Alcohol Spectrum Disorder. It happened when he or she was in their birth mother’s womb. It has caused {Name the behavior}. Here is some literature that is very helpful in understanding. The way you can help us is by {Name the helpful move the coach, teacher, or youth pastor can make}.” Obviously the conversation will be more 2-sided than this, and probably longer, but these are the critical points you need to make.
  3. Expert perspectives. Share some of the leading expert perspectives on FASD. One of our favorite FASD experts is Dr. Ira Chasnoff  from NTI Upstream. He’s a leading researcher and expert in the field of FASD. You can learn more here. If you have a doctor or therapists who gets it and can be a voice for you, by all means, use their perspective when communicating with people who do not understand.
  4. Move on. There’s a point when enough’s enough! You’ve shared the facts, had the conversations, even shared blog posts and articles from doctor’s, clinicians, and writers. But the person just won’t get it. At this, you can be sure that it’s time to move on. Pull your child from the team, stop dropping them off in that Sunday School class, request a different teacher,

Loving through the abnormal.

We love our son. It was hard at first to admit that he wasn’t normal, even harder to have those conversations with him. But in-spite of this, we love him and we want what’s best for him. But the same is true for the people surrounding him. His teachers, coaches, small group leader at church, even the parents of neighborhood kids he plays with. We want the best for them too. They’re not our enemies. They are friends and we will do everything in our power to bring them onto the same page with us, even if they aren’t in the same boat as us.

Our over-arching goal is always to build bridges and find ways to partner. Unless and until we are pushed to the absolute limit with continual misunderstanding, we will make this our goal.

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