Monthly Archives: August 2017

Housing is a key component to women’s recovery

1cyrqyw0ccktv906f9sp_400x400Sheway is well-known in Canada for its success in providing wrap-around services for pregnant and newly parenting women who are dealing with complex personal and social circumstances. It is trauma-informed, women-centred, culturally responsive and uses a harm reduction approach with a focus on connection with self and others. Women and their children can remain in the program up to 18 months post-partum. Last December, Lenora Marcellus, University of Victoria, and Sheway published findings to their study on how women make the transition from Sheway to living on their own – Supporting Families at Sheway and Beyond. Additionally, Dr. Marcellus has published a journal article:

Marcellus, L. (2017). A grounded theory of mothering in the early years for women recovering from substance use. Journal of Family Nursing. E-print ahead of press. 

In order to learn what elements of a positive transition could be identified and built upon, they followed 18 women for 3 years after leaving Sheway. These women faced multiple obstacles in this transition process with the overarching theme being “holding it together.” Their daily efforts are explored in these 3 ways:

Restoring Self: gaining recovery and taking care of self, reconnecting with self and others, and rebuilding trust and credibility.

Centering Family: parenting their children, preserving a routine, dealing with partners, and handling custody issues.

Creating  Home: “chasing housing”, having to take whatever housing is available even if inadequate, and maintaining not only a physical space but a feeling of home for the family

While acknowledging the value for pregnancy and postpartum support as most often provided in maternity programs, their findings underscore that secure housing is a key component to a successful transition for women and their families. Yet, although housing is important to the overall health of women and their families, the choices they must make often result in a double bind. For example, women often are faced with choosing between affordable housing that is far from supports versus more expensive housing that is near supports. Some women must choose between staying in an unsafe relationship or losing housing. As well, some women must accept inadequate housing because of their substance use history, which serves to undermine their recovery and their maintaining custody of their children.

“Poor housing was identified by women as a potential trigger to relapse in their recovery.” – [1] p. 39

Complete findings are detailed within the report and recommendations are framed within the Levels of Prevention model developed by this prevention network.  Among the research team recommendations is to extend the time women can stay in the program in order to solidify recovery, supports and resources. As well, they stress that housing needs to be a core component of intensive, integrated maternity programs.

For more on these topics, see earlier posts:


  1. Marcellus, L., Supporting families at Sheway and beyond: Self, recovery, family home. 2016, Sheway: Vancouver, BC.

Retrieved from:

The Best Alcoholism Apps of the Year

Healthline has selected these apps based on their quality, user reviews, and overall reliability as a source of support for people living with alcoholism. If you want to nominate an app for this list, email Healthline at

According to the National Institute on Alcohol Abuse and Alcoholism, about 15.1 million adults ages 18 and older have alcoholism.

Staying sober requires a tremendous amount of personal strength, psychological treatment, and reliable support along the way. Addiction is a complex disease and affects people in different ways. While not a substitute for treatment, these apps can serve as tools for additional positive reinforcement and accountability.

Stop Drinking with Andrew Johnson

iPhone rating:

4 stars$2.99

Android rating:

4.5 stars$2.99

Andrew Johnson’s app is designed for heavy drinkers who are trying to either cut back or stop drinking altogether. It uses hypnotherapy, positive suggestions, and visualization to help you achieve your goal. You can set reminders throughout the day for times when you may need some help relaxing and refocusing.

Twenty-Four Hours a Day

iPhone rating:

5 stars$5.99

Android rating:

5 stars$5.99

This app is based on the best-selling book of the same name. It’s been helping people with sobriety for years. The app offers 366 daily meditations from the book at your fingertips, making it easier for people to have help between meetings or anytime it’s needed. Many of the meditations include prayer and religious teachings. The newest update gives phone users the ability to share its daily messages by text.

AlcoDroid Alcohol Tracker

Android rating:

4.5 starsFree

AlcoDroid tracks your alcohol consumption, making it a good possible starting point if you suspect you misuse alcohol. Use it to log your drinks and see how often you’re drinking. The app will also give an estimated blood alcohol content based on your log. It can be set to track how much you spend on drinks as well.

12 Steps AA Companion

iPhone rating:

3.5 stars$2.99

Android rating:

4.5 stars$1.99

This app is based on the 12-step program from Alcoholics Anonymous (AA). Each step represents part of the healing and recovery process. You get the Big Book of AA at your fingertips, with prayers, promises, and the ability to highlight and share text. A sobriety calculator keeps track of how many years, months, days, and hours you’ve been sober.

I Am Sober

iPhone rating:

4 stars$1.99

Every day of sobriety is a victory. Reminding yourself of how much you’ve accomplished can help you stay on track. This app keeps track of these victories, including how long you’ve been sober and how much money you’ve saved by not buying alcohol. It notifies you when you reach new milestones and lets you set times to get daily notifications on your progress.


iPhone rating:

4 starsFree

Anxiety and depression are often closely linked to alcoholism. Happify is designed to help you learn positive ways to cope with these moods instead of engaging in unhealthy behaviors. The app includes over 30 audio recordings. They’ll guide you toward positive thoughts. The recordings use evidence-based techniques shown to work in positive psychology, mindfulness, and cognitive behavioral therapy.

iPhone rating:

4 starsFree

Android rating:

3.5 starsFree

This app wasn’t specifically designed for addiction, but it’s made to help you set a goal and work toward it. You can use it to help limit or quit drinking, track sober days, or as a way to practice new healthy habits, like getting regular exercise. uses the power of positive reinforcement to help you achieve your goals and feel good about it.


iPhone rating:

4 starsFree

SoberTool is designed specifically for people with alcoholism. It combines several features seen in the other apps we’ve mentioned. It tracks both days sober and money saved. There’s also a community forum where you can share messages as well as daily motivational messages and reminders to read them. One of its most unique tools is the ability to help you develop the best personalized relapse prevention based on a few questions in the app.

nomo – Sobriety Clocks

iPhone rating:

4.5 starsFree

Android rating:

4.5 starsFree

This app was actually created by someone in recovery to help himself keep on track and motivated. Set sobriety clocks to track how long it’s been since your last drink in this app. You can also find accountability partners and share your information with them. Earn chips for recovery milestones, too. The app even has little distraction exercises to help your mind refocus during intense cravings.


iPhone rating:

3.5 starsFree

Android rating:

4 starsFree

Whether you’re stopping drinking altogether or trying to cut back, a good support system can be a big help. Daybreak is designed to help you connect with a supportive community as well as health and well-being coaches. You can track your progress with weekly check-ins or set notifications for when you think you’ll need check-ins.

Sober Grid

iPhone rating:

5 starsFree

Android rating:

4 starsFree

Making new connections during recovery can be important. Sober Grid is a social network for sobriety. In addition to tracking your days sober, the app helps you find other sober people both near you and around the world to share and chat with. Choose to remain anonymous and share as much or as little as you like.


Android rating:

4 starsFree

Flipd is another app that’s not made specifically for addiction, but it does help you focus and practice productivity. Use it to block distractions and help yourself refocus on important tasks. The app primarily focuses on stepping away from your phone to unwind, engaging in other activities, and avoiding procrastination. It actually locks you out of your phone during designated times, except for making outbound emergency calls and receiving incoming calls.


iPhone rating:

4.5 stars$1.99

There isn’t just one approach to recovery. It often requires several tools to keep you on course. This app is designed to keep you accountable for your own behavior by logging your “lights” — red for “acting out,” yellow for “warning,” and green for “way to go.” The idea behind this is that you can’t change your behavior until you recognize it. This app aims to help you do both.

Field Guide to Life

iPhone rating:

4 stars$7.99

Android rating:

4 stars$7.99

The first steps are often the hardest. While Field Guide was designed for people new to addiction recovery, it can be used at any stage. The app focuses on taking things one day at a time with daily inspiring messages and activities, a sobriety counter that can be seen every time you open the app, and videos featuring recovery experts. You can also store up to five images of people or things that keep you motivated to stay sober.



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Training: Understanding Addiction


Promoting Healthy Relationships and Supportive Environments


Understanding Addiction is an online learning program that seeks to equip non-specialist workers and volunteers with the knowledge, skills, and attitudes to confidently help people who face challenges with substance use and addiction. The goal of this course is to ensure that anyone in a “helping role” will be able to foster healthy relationships and build supportive environments.

Participants will engage in eight interactive online lessons that feature opportunities for personal reflection, downloadable resources, and a facilitated forum. They will learn about topics such as: the factors behind addiction and control, the dynamics involved in helping people change their behaviour, and what to do in difficult situations. Participants will also have opportunities to practice skills that enhance client engagement while promoting safety.

This program has been developed by the Canadian Mental Health Association BC Division (CMHA BC) in partnership with BC Non-Profit Housing Association, BC Government and Service Employees’ Union, Centre for Addictions Research BC (University of Victoria), 7th Floor Media (Simon Fraser University) and Walden Media Group. CMHA BC exists to promote the mental health of British Columbians and support the resilience and recovery of people experiencing mental illness.

Course Registration

Understanding Addiction is available twice throughout the year and the cost per person is $100. To sign up for the course, please follow these three steps:

1. Register for the training until September 30, 2017

2. Create an account

Once your payment has been processed, you will be re-directed to create an account.  Create a unique username and password to sign in.

*Please note: Your account will only be activated once your payment is received and the course begins.

3. Login and begin the course

The Course Facilitator will grant you access to the course once your cohort becomes available. On the first day of the learning cohort you registered for, you will be able to log into the course and start the first lesson. You will have a four-month period from the first day of the learning cohort to complete it.

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For more information please visit:

Partnership aims to reduce alcohol harms on Canadian campuses


Thirty-six universities and colleges have teamed up with the Canadian Centre on Substance Use and Addiction and Universities Canada in an effort to curb high-risk drinking. The Postsecondary Partnership – Alcohol Harms (PEP-AH), as it’s called, is connecting students and administrators with health experts to create campus programs to reduce harms related to binge drinking.

While Canadian universities have individually been grappling with the issue for decades, this partnership represents a more collaborative approach, said Scott Duguay, co-chair of PEP-AH and associate vice-president, enrolment management, at St. Thomas University. “We’re offering resources and ideas and best practices but allowing a lot of space for individual members to build their own plans,” Mr. Duguay said. “We strongly encourage institutions that are partners to have a campus team that oversees alcohol harm reduction programming.”

A 2016 survey of 43,780 students from 41 Canadian campuses affirmed the challenges institutions face with the prevalence of binge drinking. More than a third of students surveyed reported having five or more drinks the last time they partied or socialized, and many reported physically injuring themselves (18 percent), having unprotected sex (24 percent), forgetting where they were or what they did (29 percent) and doing something they later regretted (38 percent) due to alcohol.

“PEP-AH is not concerned with the drinking per se, but the harms associated with it,” said Catherine Paradis, co-chair of PEP-AH and senior research and policy analyst with the Canadian Centre on Substance Use and Addiction, which has received funding from Health Canada for this initiative. Ms. Paradis led the creation of a framework for campus programs to reduce alcohol harms. She recommends that institutions adopt at least one recommendation in each of five strategic areas, depending on the needs and structure of their campus. “Drinking is a social behaviour that happens in a larger context,” she said. “Each university or college has its own history and its own culture and policies.”

PEP-AH grew out of discussions since 2013, when former Acadia University president Ray Ivany rallied the support of university presidents to look at campus drinking culture. Mr. Ivany became passionate about the issue after having to deliver news of 19-year-old Acadia student Jonathan Andrews’ death following a night of binge drinking in residence. It was an event after which “our campus changed forever,” Mr. Ivany had said.

This past June, student affairs staff, administrators and students met for a one-day conference during CACUSS, the national conference of student affairs professionals across Canada, to share best practices and challenges. The dialogue will continue into 2018 and includes four student symposia in Western Canada, Ontario, Quebec and Atlantic Canada in advance of the national meeting. It was recognized that “students were at the heart of this if it was going to work, but we needed presidential level approval and support,” Mr. Duguay said. “At the end of the day, students are the experts in the experience itself.”

Cam Yung, PEP-AH’s student representative for Ontario and rector at Queen’s University, echoed that sentiment (the rector position at Queen’s is held by a student and is elected by students). Queen’s has had an alcohol working group for almost 20 years and recently hosted PEP-AH’s Ontario student symposium. “Students react better when they have peers there to lead and provide guidance,” Mr. Yung said. “When we have students educating students, and not a top-down approach of administration trying to educate students about alcohol harms, that is a way more effective solution.”

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HEALTH REPORT: Concurrent mental and substance use disorders in Canada

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Individuals who have both a mental and substance use disorder at the same time are more likely to experience poor psychological health, use more health services and report unmet needs than a person with only one type of disorder.

These findings are from a new study on the prevalence of concurrent disorders in Canada, released in today’s Health Reports. The study is the first to use the 2012 Canadian Community Health Survey—Mental Health to examine the demographic and socioeconomic characteristics, health status and health care service use of people with concurrent disorders. The study estimates that 282,000, or 1.2% of Canadians aged 15 to 64, experienced mental and substance use disorders concurrently in the previous year, that is, at least one mood/anxiety disorder and at least one substance use disorder.

Almost all (91%) of those with concurrent disorders reported high psychological distress, significantly more than those with a mood/anxiety (79%) or a substance use (34%) disorder alone.

Overall, individuals with concurrent disorders were more likely (76%) to use health services, such as care for mental health or substance use, compared with those who had a mood/anxiety (67%) or substance use (21%) disorder alone. Despite higher use, these individuals had greater odds of reporting unmet or partially met needs for mental health care after controlling for demographic and socio-economic factors and number of chronic conditions.

For more information please visit:

Concurrent mental and substance use disorders in Canada” is now available in the August 2017 online issue of Health Reports, Vol. 28, no. 8 (Catalogue number82-003-X).

This issue of Health Reports also contains the article, “Needs for mobility devices, home modifications and personal assistance among Canadians with disabilities.”

Fathers and alcohol consumption during pregnancy


Alcohol consumption during preconception and pregnancy is generally considered to be the prospective mother’s responsibility, with many current international alcohol policy guidelines recommending the reduction or non-use of alcohol by pregnant women. However, research suggests that decisions about alcohol use can often be influenced by others, in particular the prospective father.

The National Drug Research Institute did research on the father’s involvement in alcohol exposed pregnancies. This study was initiated due to factors such as; the Australian Alcohol Guidelines, and ‘mothers guilt’. Interestingly, over the past decade the guidelines have changed the recommendations for women’s alcohol consumption during pregnancy from 2 standard drinks per day to no consumption being the safest option. The responsibility has been solely pressed on women and have not focused heavily enough on the social determinants that support the consumption of alcohol during pregnancy.

The findings of the research identified that 75% of women who do drink during pregnancy are consuming alcohol together with a partner. Of these women, 40% of drinking episodes are initiated by male partners. The fact that male partners are social facilitators of alcohol consumption nearly half the time is concerning.

The key message this research is trying to convey is that decisions about alcohol use during preconception and pregnancy are not the sole responsibility of women but occur within the context of the home and the broader social environment. More complex policy is required to assist in reducing alcohol-exposed pregnancies and increasing the potential for healthy pregnancies, and fetal and infant outcomes.

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FASD Justice and Reconciliation: Tough Questions, New Collaborations

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Final Report- FASD Justice & Reconciliation (final 07-17)

Fetal Alcohol Spectrum Disorder (FASD) is an umbrella term used to describe a spectrum of physical, neurological, cognitive, socio-emotional, and behavioural impairments that may result from prenatal exposure to alcohol. In addition to these impairments, secondary challenges (such as involvement with the criminal justice system) may be experienced in the absence of appropriate supports and services. FASD is often discussed in the context of the criminal justice system, as individuals with FASD are understood to be overrepresented in the justice system.

In 2015, the Truth and Reconciliation Commission of Canada released 94 Calls to Action, directed at various levels of government and to all Canadians. TRC Calls to Action 33 and 34 specifically address FASD. The Calls to Action provided an opportunity to bring together policy makers, front-line workers, parents/caregivers, and students to discuss how the TRC can be considered in justice practices. The Symposium took a holistic look at how justice programs at the local and national level may incorporate culturally-appropriate programming. This included discussions on how individuals and families can be best supported in the community and, when necessary, in the justice system.

Moreover, the Symposium drew attention to the need for programs that are attentive to the broader contexts that impact Indigenous peoples with FASD, particularly when in contact with the justice system. Indigenous voices and programs were at the centre of the discussion. Justice programs that have solidly incorporated Indigenous perspectives were also explored—from smaller community-based projects to larger programs embedded in province-wide judicial initiatives. The goal was for participants to be exposed to programs from across Canada, to gain a broader understanding of the complexity of issues when discussing FASD in the justice system and to be introduced to new tools and networks to respond to the TRC Calls to Action.

The Symposium featured six presenters who led an exploration of how justice system programming supports people with FASD, focusing on the experiences of Indigenous individuals. This included the perspectives of parents, front-line community workers, and diagnosticians. Participants engaged in discussions focused on current practices, future directions, and the path forward. From the feedback collected throughout the event, Dr. Stewart’s research team has produced 6 key findings and 18 recommendations for moving forward.

Key Findings and Recommendations

1 Culturally and Historically-Informed Practices

Participants noted that there is often a lack of culturally and historically-informed programming for individuals with FASD across systems.

Recommendation 1: Develop relationships between agencies and Indigenous communities.

Recommendation 2: Develop training focused on the TRC and the history of residential schools and colonialism in Canada for agencies.

Recommendation 3: Explore the potential for culturally and historically-informed practices within the health system.

2 Trauma

Participants recognized the role of trauma in the lived-experience of individuals with FASD, particularly in relation to the potential for re-traumatization within the justice system.

Recommendation 4: Develop and distribute training on trauma-informed practices.

Recommendation 5: Establish the capacity for trauma to be incorporated as a mitigating factor in sentencing.

Recommendation 6: Develop outreach and training material for frontline health professionals about practices surrounding diagnosis and care.

3 Advocacy

Participants discussed the ways in which individuals with FASD, families, and support agencies can advocate for greater awareness of FASD and confront the stigma surrounding FASD.

Recommendation 7: Facilitate collaborative spaces that are inclusive and welcoming of candid discussions.

Recommendation 8: Create spaces for individuals with FASD and caregivers to engage directly with policy-makers and program managers.

Recommendation 9: Facilitate spaces for individuals with FASD and families to access training.

Recommendation 10: Implement and integrate changes to programs and practices that honour Indigenous perspectives.

Recommendation 11: Establish keeping families together as a top priority informed by Indigenous perspectives.

4 Resources

Participants expressed that, while some jurisdictions have demonstrated success in establishing supports for individuals with FASD and their families, there are substantial gaps in services particularly in rural or remote communities.

Recommendation 12: Identify wise practices that best support individuals with FASD across the lifespan informed by Indigenous perspectives.

Recommendation 13: Prioritize community driven requests for supports and services with an emphasis on sustained funding.

Recommendation 14: Fund culturally appropriate diagnoses, mentorship, and respite for families, lifeskills and mentoring for individuals, and ongoing support that changes across the lifespan.

5 Interagency Collaboration

Participants noted that a primary challenge to the provision of appropriate supports and services to individuals with FASD is the “silo effect” (agencies working in isolation) which prohibits effective collaboration.

Recommendation 15: Facilitate regular opportunities for interdisciplinary teams to come together to share resources.

Recommendation 16: Strike working groups comprised of federal, provincial/territorial stakeholders, and policy-makers in collaboration with Indigenous communities to implement TRC Calls 33 and 34.

6 Challenging Systems and Policy

Participants noted many barriers to individuals with FASD accessing services, including the need for maternal confirmation and justice-specific concerns (such as conditions of release and use of legal jargon).

Recommendation 17: Complete a program and policy review through a TRC lens to make appropriate modifications to programs, practices, and protocols.

Recommendation 18: Undertake a review of culturally modified/culturally appropriate diagnostic practices to modify or enhance current diagnostic practices.




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