Monthly Archives: October 2017

Drugs and pregnancy — ‘tremendous stigma’ stops many women from coming forward


CBC News Posted: Oct 30, 2017 10:29 PM ET

About 30 pregnant or parenting women in Sudbury are trying to recover from drug addiction with the help of a special program.

But that number doesn’t seem to reflect what’s happening on the city’s maternity ward.

Last week, CBC Sudbury brought you a story about the number of opioid-addicted newborns being up at Health Sciences North. A doctor at the hospital says it now admits about one new case a week.

Monarch Recovery Services offers a pregnancy and parenting outreach program — but clients come to the program on their own, without a referral.

“You know what? We’re probably missing a large group of women that are pregnant and using opioids,” said spokesperson Jasmine Beange.

“Listening to the statistics at Health Sciences North, who are struggling with opioids, we’re not seeing those stats in our program.”

Beange says there is no shortage of work.

Currently, Monarch Recovery Services is serving about 30 women who are drug-dependent, and either pregnant or parenting young children. Beange says there’s tremendous stigma around drugs and pregnancy —  and that makes it very hard for people to come forward.

“There’s a lot of guilt and a lot of shame involved,” she said.

“And as a society I think we certainly don’t help. There needs to be more education out there around addiction. I haven’t met one client in the 13-14 years that I’ve been working in this field that woke up one day and said, ‘I want to be an addict for the rest of my life’.”

Beange says about 70 per cent of women in the program are struggling with addictions to, opioids as opposed to other drugs.

Who coined the term “mocktail” anyway?


Well, it just so happens that I bumped into an article from a 1983 issue of American Speech where the answer was to be found (please don’t ask how I seemed to be randomly browsing such an esoteric journal).

Philip Kolin says: The coinage mocktail appears for the first time, I believe, in an advertisement for Libbey Glass in Food Service Marketing (Feb. 1979, p. 76). According to that ad, mocktails “are a relatively new group of beverages prepared without any alcohol whatsoever.” Kolin comments that the ad was for a new line of mocktail glassware (I had no idea that glassware was so specialized – perhaps because most of mine was purchased at Ikea).

libbey-cocktail-glassHe further states, clearly with the air of someone who loves language: Mocktail is a clever invention. It humorously rhymes with cocktail, but has a semantically appropriate first syllable. Mocktails are literally mock cocktails, with the sense of mock in mock chicken or mock turtle soup. The -tail of the second syllable of mocktail, however, has acquired a new meaning-that of the unshortened (and unadulterated) cocktail.

If the term mocktail has only been around since the late 1970s, what about the term cocktail? Well according to a Wikipedia article, the term cocktail first appeared in print in 1806 where it was described as a ” stimulating liquor composed of spirits of any kind, sugar, water, and bitters — it is vulgarly called a bittered sling and is supposed to be an excellent electioneering potion, inasmuch as it renders the heart stout and bold, at the same time that it fuddles the head.”

Just a little etymology to start your week.


Kolin, P.C. (1983). Mocktails, Anyone? American Speech, 58(2): 190-191.

For more gems of knowledge please visit Girls, Women, Alcohol, and Pregnancy

Perspectives on FASD Prevention

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Are You In The Know, On Birth Control?

PMH-Birth_Cont_imgWhether you’re a man or woman, understanding your birth control options is important when you want to prevent pregnancy, start trying to become pregnant, or space your pregnancies. Choosing birth control that fits your life will give you the best protection because you’ll be more likely to use it correctly and consistently. Talk to your health care provider about the method of birth control that’s right for you.

There are many methods of birth control. Some prevent pregnancy by stopping the egg from being released (ovulation). Others act as a barrier to prevent sperm from reaching and entering the egg.

Using more than 1 birth control method—such as hormonal birth control and condoms—gives the best protection against pregnancy. Emergency contraceptive pills (EC) can be used with all methods of birth control if you think that your first method has failed. Keep reading to learn more about the different kinds of birth control options.

Condom (Male)

A male condom is a thin covering that fits over a hard (erect) penis. It decreases the risk of pregnancy by stopping sperm from getting to and entering the egg. It also decreases the risk of STIs and HIV by stopping semen, vaginal fluid, or blood from being passed between partners. Use a condom to prevent STIs and as a backup form of birth control.

There are many different types of condoms (styles, shapes, and sizes). Most condoms are latex, but there are non-latex ones. All condoms sold in Canada must meet government standards. To learn more about condoms and how to properly use them, go here.

Condom (Female)

A female condom is a soft, plastic (non-latex) sleeve with two flexible rings, one on each end. The closed, inner ring goes inside the vagina to cover the opening of the uterus. The outer ring stays outside the vagina to cover the genitals.

It decreases the risk of pregnancy by stopping the sperm from getting to or entering the egg. It reduces the risk of STIs by stopping semen, vaginal fluid, or blood from being passed between sexual partners. To learn more, go here.

Intrauterine device (IUD)

An intrauterine device (IUD) is a small, soft, T-shaped device with a nylon string attached to it. A health care provider has to put it in. There are 2 types of IUDs (copper and hormonal). Hormonal IUDs are sometimes called intrauterine systems (IUS). They work in different ways. Depending on the type of IUD, it can help prevent pregnancy for 3 to 10 years. New research suggests that long-acting methods of birth control such as IUDs work the best for preventing pregnancy over time. To learn more, go here.

Birth Control Pill (“The Pill”)

The pill is taken every day to prevent pregnancy. It contains hormones (estrogen and progestin) that are like a woman’s natural hormones. They stop the ovaries from releasing an egg. You can’t become pregnant if you don’t release an egg. To learn more, go here.

Birth Control Patch (“The Patch”)

The birth control patch is a thin, light brown patch that you wear on your skin. It has to be changed once a week. The sticky part contains hormones (estrogen and progestin) that are like a woman’s natural hormones. These hormones are absorbed through the skin. They stop the ovaries from releasing an egg. You can’t become pregnant if you don’t release an egg. To learn more, go here.

Vaginal Contraceptive Ring (NuvaRing®)

The vaginal contraceptive ring is a soft, 5.5 cm (2 inch), clear, plastic (non-latex) ring that you put in your vagina once a month. It contains hormones (estrogen and progestin) that are like a woman’s natural hormones. They stop the ovaries from releasing an egg. You can’t become pregnant if you don’t release an egg. To learn more, go here.

Hormonal Birth Control – Extended and Continuous Use

Extended use is when you take your birth control product for 2 or more cycles without stopping, then take a planned, hormone-free break. You’ll have your period during this break. This method means that you’ll have fewer periods.

Continuous use is when you take your birth control product without stopping (without taking planned hormone-free breaks). You’ll have fewer or no periods.

Talk to your health care provider for more information. You can also read Hormonal Birth Control for more information.

Progestin-Only Pill (POP)

Progestin-Only Pill (POP), also called the mini-pill, is a pill you take every day to prevent pregnancy. POP contains one hormone (progestin). It doesn’t contain estrogen. POP comes as a 28-day pack (there are hormones in all 28 pills). There are no hormone-free pills. POP prevents pregnancy by:

  • decreasing the cervical mucous and making it thicker
  • making the lining of the uterus thin
  • slowing down the egg in the fallopian tube
  • sometimes stopping an egg from being released

To learn more, go here.

Birth Control Injection (Depo-Provera® or “the Shot”)

The shot contains a hormone (progestin) that is like a woman’s natural hormone. It doesn’t contain estrogen. The hormone stops your body from releasing an egg, makes the lining of the uterus thin, and makes cervical mucous thick. You need a prescription for the injection. It needs to be given every 10 to 12 weeks. To learn more, go here.

Vaginal Spermicides

Vaginal spermicides are put in the vagina before sex to help prevent pregnancy. They contain an ingredient (nonoxynol 9) that kills sperm. When sperm comes in contact with a spermicide, the sperm dies and a woman can’t become pregnant. Spermicides come as film, foam, gel, cream, or suppositories. Some types of spermicides can be hard to find in Canada. To learn more about spermicides and how to use them, go here.


A diaphragm is disc-shaped, made of latex or silicone, and has a flexible rim. It’s inserted into the vagina before you have sex. It covers the cervix and stops sperm from entering the uterus. A diaphragm must be used with a special type of gel that kills sperm (spermicidal gel). To learn more, go here.

The Sponge

The sponge is a disposable piece of soft foam filled with a chemical that kills sperm (spermicide). It is inserted into the vagina to cover the cervix and helps prevent sperm from entering the uterus. To learn more, go here.

Fertility Awareness-Based (FAB) Methods

Fertility Awareness-Based (FAB) methods, sometimes called natural family planning, identifies the days of the month when the egg’s ready to be fertilized and becoming pregnant is most likely (fertile time). This can be used to:

  • prevent pregnancy—don’t have vaginal intercourse or use another method of birth control during a woman’s fertile time
  • become pregnant—have vaginal intercourse during a woman’s fertile time

To learn more, go here.

Lactation Amenorrhea Method (LAM) (used after the birth of a baby)

Lactation Amenorrhea Method (LAM) is a temporary method of birth control that can be used up to 6 months after the birth of a baby. Lactation means your body is making breastmilk and amenorrhea means you aren’t having a monthly period. It must be used correctly to work.

Exclusive breastfeeding (this means not feeding your baby anything other than your breastmilk) helps prevent an egg from being released each month. You can’t become pregnant if your body doesn’t release an egg. To learn more about how LAM is used when you are breastfeeding, go here.

Emergency Contraception (EC)

You can use emergency contraception (EC) if you aren’t sure if you’re protected from pregnancy (e.g., condom breaks, forgot birth control), or if you’ve had unprotected sex. EC doesn’t protect against STIs and HIV. It needs to be used right away, but can be used up to 5 days (120 hours) after unprotected sex. The two methods of EC are emergency contraception pills (ECPs), and the copper intrauterine device (IUD).

The two types of ECP’s are Levonorgesterol ECP (e.g. Plan B®, NorLevo®, Next Choice®, Option 2®) or Ulipristal Acetate ECP (e.g. Ella®).

The copper intrauterine device (IUD) requires a prescription and it is put in by your health care provider.

To learn more, go here.

Tubal Ligation

A tubal ligation is a permanent method of birth control. Surgery is done to close the fallopian tubes (the tubes that the egg travels through). This stops the egg and sperm from meeting. If the sperm can’t reach and enter the egg, you can’t become pregnant. To learn more, go here.


A vasectomy is a permanent form of birth control. The tubes (vas deferens) that carry the sperm from the testicles into the semen are cut and sealed. This means there’s no sperm in the semen, so no sperm to reach and enter the egg. To learn more, go here.

Withdrawal (Pulling Out)

Withdrawal is used during vaginal intercourse to reduce the risk of pregnancy. Withdrawal is when the penis is pulled out of the vagina before ejaculation. Ejaculation can’t happen near the partner’s vagina. If semen is near the opening of the vagina, sperm can reach and enter the egg. To learn more, go here.


Abstinence means different things to different people. Some people make the decision not to do these types of sexual activities. Abstinence to prevent STIs or pregnancy means that you don’t:

  • directly touch your partner’s genitals
  • have vaginal sex (penis to vagina)
  • have anal sex (penis to anus)
  • have oral sex (mouth to penis or mouth to vagina)

If you choose not to have sex, it means that you don’t need to use other forms of birth control and that you’re protected from STIs and HIV. To learn more, go here.

For more information please visit:


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There is no safe amount of alcohol during pregnancy, new study shows


Date: October 24, 2017

Source: Binghamton University

Summary: Any amount of alcohol exposure during pregnancy can cause extreme lasting effects on a child, according to new research.

Any amount of alcohol exposure during pregnancy can cause extreme lasting effects on a child, according to new research from Binghamton University, State University of New York.

A team of researchers led by Marvin Diaz, assistant professor of psychology at Binghamton University, determined that even a small to moderate amount of alcohol exposure produces significant amounts of anxiety in offspring, lasting through adolescence and into adulthood. This research differed in its use of only low levels of alcohol exposure, whereas prior studies used high levels of exposure to reach the same conclusion.

“There’s been a lot of media coverage on whether there’s a safe amount of alcohol to drink,” said Diaz. “This study shows that there isn’t.”

Pregnant rats were exposed to ethyl alcohol vapor for a six-hour period on their twelfth day of gestation; this was the only time the rats were exposed to alcohol. The offspring were then subjected to a series of anxiety tests. The researchers found that anxiety was most apparent in male rats during their adolescence. After entering adulthood, the effects were opposite, with ethanol-exposed male rats showing reduced anxiety, while the females still appear to be unaffected.

“The most important takeaway from this study is that the effects we studied on the rats only took one day of exposure to produce — just six hours,” said Diaz.

Diaz is interested in taking this research further, to determine exactly what changed in the brain to cause such increased levels of anxiety after alcohol exposure, and to see why the effects are apparent in male rats but not females.

Journal Reference:

  1. Siara K. Rouzer, Jesse M. Cole, Julia M. Johnson, Elena I. Varlinskaya, Marvin R. Diaz. Moderate Maternal Alcohol Exposure on Gestational Day 12 Impacts Anxiety-Like Behavior in Offspring. Frontiers in Behavioral Neuroscience, 2017; 11 DOI: 10.3389/fnbeh.2017.00183

Retrieved from:

Binghamton University. “There is no safe amount of alcohol during pregnancy, new study shows.” ScienceDaily. ScienceDaily, 24 October 2017. <>.

Developing and Testing Alcohol and Pregnancy Campaign Messages: Exploring What Works with Women


An article published by Kathryn E. France and colleagues in the journal Substance Use & Misuse looks at the development and testing of advertising concepts for a campaign to promote abstinence from alcohol during pregnancy in Western Australia.

France and colleagues conducted a series of nine focus groups with women on beliefs and attitudes on alcohol use during pregnancy and motivations for behavior change and gathered feedback on four television concepts that used different types of messaging.

Some of the key findings from the study include:

  • Women’s motivations for stopping alcohol use during pregnancy included, but were much broader than, a desire to protect their baby from harm
  • Messages could either aim to emphasize that the negative outcomes, experiences, or feelings could be reduced or avoided and/or that positiveoutcomes, experiences, or feelings could be obtained or maintained if women abstained from alcohol during pregnancy (e.g., wanting to minimize a generalized fear that something could go wrong or wanting to believe they were in control and doing the best that they could to support the health of the pregnancy and the baby)
  • In this particular study, the most effective message/tested ad concept was one that appealed to negative emotions, suggesting that fear appeals can be more effective than positive messages
  • It might be useful for campaigns to also include positive messages (e.g., a display of social support and acceptance for a pregnant women) abstaining from alcohol in conjunction with a threat-based message
  • Study participants also appreciated specific strategies for avoiding alcohol during social situations.

This study supports previous research showing that fear-based messaging can be effective if the behaviour that is being promoted is achievable by the viewer, i.e., women who drink alcohol in general. Fear or threat-based messaging promoting abstinence is not helpful for women with alcohol problems.

The authors also comment on the importance of being honest and factual about the limits of research on alcohol during pregnancy. Most women believed the public health guidelines that alcohol should be avoided during pregnancy, but questioned whether light drinking was a major concern.

“Credibility of the message was enhanced by acknowledging uncertainty about the risk to the fetus with low to moderate alcohol exposure. Rather than undermine an abstinence-based message, this information served as a clear rationale for the recommendation. An honest and scientific framing of the message and delivery by an expert source were also shown to minimize counterargument and strengthen the message’s persuasiveness.” (p. 8)

For more on this topic, see earlier posts:


France, K. (2011). Creating Persuasive Messages to Promote Abstinence from Alcohol During Pregnancy. Theses: Doctorates and Masters. Paper 413.

France, K., Donovan, R.J., Henley, N., Bower, C., Elliott, E.J. et al. (2013). Promoting Abstinence From Alcohol During Pregnancy: Implications From Formative Research. Substance Use & Misuse, Early Online:1–13.  DOI: 10.3109/10826084.2013.800118

FIFTH ESTATE: Motherisk hair test evidence tossed out of Colorado court 2 decades before questions raised in Canada


By Lisa Mayor, John Chipman, CBC News

A U.S. court laid out extensive problems with how hair-strand tests were being done at the Motherisk Drug Testing Lab at the Hospital for Sick Children in Toronto more than two decades before similar issues were uncovered in Canada.

A joint investigation by The Fifth Estate, CBC Radio’s The Current and the Toronto Star uncovered a capital murder trial in Colorado in which Motherisk’s tests were found to be “not competent evidence” and thrown out in 1993.

But the lab’s work continued to be used in Canadian courts and relied upon in thousands of child protection cases, including ones in which children were permanently removed from their parents.

From 1991 until 2015, Motherisk was performing what have now been determined to be unreliable and inadequate drug and alcohol tests on thousands of members of vulnerable families across Canada, with the results in some cases leading to child welfare decisions to separate children from their parents.

Child welfare agencies in five provinces across Canada paid for Motherisk’s hair-strand tests, believing they were hard scientific proof of substance abuse.

The Ontario government appointed retired Court of Appeal justice Susan Lang to investigate the lab’s procedures and protocols after a series of investigations by the Toronto Star revealed problems with the tests. Lang’s inquiry was completed in December 2015.

Through that investigation, it was determined that Motherisk’s results were unreliable and inadequate opinions from scientists who operated without any forensic training or oversight.

Colorado case

Two decades before the Ontario government launched its investigation into Motherisk’s hair-strand tests, Julia Klein, Motherisk’s de facto lab manager at the time, testified at an admissibility hearing in a 1993 death penalty case in Colorado.

Allen Thomas Jr. had been charged with raping and stabbing to death the grandmother of his ex-girlfriend. He faced the death penalty if convicted.

One of the defence strategies if Thomas Jr. was found guilty was to argue that he was so high on cocaine at the time he was incapable of committing intentional, premeditated murder, which was required for the death penalty in Colorado.

The defence would need to prove that he was taking cocaine at the time, and Motherisk was one of the few labs doing hair tests for drugs and alcohol in North America.

The Motherisk hair test results appeared to show Thomas Jr. was taking 55 grams of cocaine per month at the time of the killing.

Sick Kids hospital sign

Questions about the science of hair testing began after serious shortcomings were found at the Motherisk lab at the Hospital for Sick Children in Toronto. (CBC)


This case is the earliest known example of Motherisk’s hair tests being used in a criminal court.

The defence in the case wanted to introduce the hair test Motherisk had done on the defendant, but Justice Donald Marshall wouldn’t allow it. In his decision, the judge laid out many of the same deficiencies at the lab that would be uncovered in Ontario more than two decades later.

Marshall ruled Motherisk’s tests results were “not competent evidence.”

“He found that it was not reliable,” said Eva Wilson, district attorney on the case.

“I really appreciated his analogy: this reminded him of someone shooting at a target with a bow and arrow, and that Miss Klein shot the arrow, the arrow landed and she then drew the bulls eye around the arrow, a big round circle, to show it met its mark.”

Klein declined repeated requests for an interview and wouldn’t answer specific questions sent to her.

Red flags

The Colorado case arose in the joint investigation by The Fifth Estate, The Current and the Toronto Star during a review of a 2009 court case in Toronto. In that case, comments were made by Dr. Gideon Koren, the founder and longtime director of the Motherisk lab.

In that case in Ontario’s Superior Court of Justice, Tamara Broomfield was convicted of assault causing bodily harm, aggravated assault endangering life, failing to provide the necessities of life and administering a noxious substance with the intent to endanger life after allegedly feeding her two-year-old son near-lethal doses of cocaine.

Koren told the court the lab’s expertise and Motherisk’s tests had been “accepted by the courts in different jurisdictions,” including Canada and the U.S.

“About 10 years ago, Your Honour, we were asked by the Colorado court in a case of murder to test hair for cocaine in an individual who claimed to being addicted to the drug, and to the best of my knowledge, our results, not were just accepted, but had an impact on the judgment,” Koren testified.

Eva Wilson

Eva Wilson was the prosecutor in a 1993 Colorado murder trial where Motherisk lab tests were deemed inadmissible. (Jack Dempsey/Toronto Star)


The Fifth Estate, The Current and the Toronto Star scoured legal databases and contacted Colorado district attorneys and criminal defenders, but were unable to find any Colorado criminal proceeding in which Motherisk’s evidence was accepted.

Daniel Brown, a Toronto criminal lawyer who represented Broomfield in the early stages of her appeal, reviewed the Colorado hearing.

“Dr. Koren’s testimony in the Broomfield case appears to be a deliberate attempt to mislead the presiding judge about the widespread acceptance of Motherisk’s hair testing procedures in criminal courtrooms throughout the continent,” said Brown, who is a Toronto region director with the Criminal Lawyers’ Association.

“Dr. Koren wasn’t the doctor who testified in Colorado but you would have thought that he would have been keenly aware of what had happened,” Brown said.

“The fact that he would come to court 20 years later and suggest that that evidence was accepted in that Colorado courtroom was surprising. It seems to be misleading and it certainly warrants a perjury investigation if he deliberately tried to mislead the judge about the scope of the Motherisk evidence and how it’s been accepted across the continent.”

Koren did not respond to emails seeking comment for this story.

Broomfield was initially sentenced to seven years in prison.

In October 2014, after new evidence surfaced that questioned the accuracy of Motherisk’s results, Broomfield’s cocaine-related convictions were overturned.

Ontario investigation

Later that year, the Ontario government launched the investigation into Motherisk’s lab procedures and protocols headed by Lang.

“I considered it a tragedy that it’s not good for our justice system that we’re relying on forensic evidence that is unreliable and inadequate,” she said in an interview with The Fifth Estate.

“It’s a tragedy for the families, it’s a tragedy for the parents who may have lost temporarily or otherwise contact with their child, it’s really a tragedy for the children.”

Dr. Gideon Koren

Dr. Gideon Koren, seen in 1999, retired from SickKids in 2015 when the hospital closed the Motherisk lab. (Rick Madonik/Toronto Star)


In Klein’s testimony in the Colorado case, it appeared she didn’t understand what constituted forensic testing.

Wilson, the prosecutor, was shocked.

“She talked about forensic labs, [saying] their test samples come from dead people,” Wilson said.

“That’s not true. There’s a lot of living people whose blood and urine and semen, and body tissues and fluids, are being tested by forensic labs, thank goodness, otherwise we wouldn’t be able to charge people with driving under the influence of drugs unless they were dead.

“She was really off base with all of that.”

The Motherisk lab has always insisted its tests were meant to be only clinical in nature and not forensic.

Clinical tests are mainly meant for patient care — accuracy is important, but so is speed. Forensic labs do tests for legal purposes, such as DNA or fingerprints, and do this for more than just criminal matters.

Justice Susan Lang

The Ontario government appointed retired justice Susan Lang to investigate the procedures and protocols of the Motherisk hair test lab. (Bernard Weil/Toronto Star)


“They need to be right,” Lang said. “They don’t just need to be right in criminal law; they need to be right in family law. And a lot of people didn’t see family law as forensic work.… That isn’t good enough.

“Losing your child is the capital punishment of child protection law. You need to have these test results done right.”

Koren has been named in at least 11 lawsuits, including a proposed class action suit.

In his statement of defence in one of the lawsuits, Koren said Motherisk’s hair tests were “adequate and reliable for their intended purpose” and were meant to provide “information relevant to the medical care and safety of children.”

For its part, the Hospital for Sick Children has apologized for the Motherisk tests.

“We deeply regret that practices in and oversight of this particular program did not meet SickKids standards of excellence,” Dr. Michael Apkon, president and CEO of SickKids, said in a public statement on its website.

“We remain resolved in our efforts to ensure that we have effective oversight and the highest standards of quality and safety in all of our programs.”

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CBC: Wondering how to get involved in reconciliation? Start by asking yourself these 5 questions

Edmonton and area Fetal Alcohol Network Society

ry-moranRy Moran is the director of the National Centre for Truth and Reconciliation. (White Pine Pictures

In 2015, the National Centre for Truth and Reconciliation was created to preserve the memory of Canada’s residential school system and legacy.

Located in Winnipeg, it is home to the permanent collection of statements, documents and other materials gathered on residential schools.

The Centre also continues the work of making sure that reconciliation happens in Canada, and ensuring that as many Canadians as possible take part in the reconciliation movement.

“If you look at the logo of the centre it’s a flame … what that flame represents is that fire of reconciliation that we’ve lit in this country,” said Ry Moran, director of the National Centre for Truth and Reconciliation.

National Centre for Truth and Reconciliation Logo

“That flame represents is that fire of reconciliation that we’ve lit in this country,” said Ry Moran about the National Centre for Truth and Reconciliation’s…

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