Monthly Archives: January 2018

Attorney General: Big Horn County Crackdown On Pregnant Addicts ‘Counterproductive’

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Montana Attorney General Tim Fox says the Montana County attorney who has implemented an immediate ‘crackdown’ on pregnant women found to be using drugs or alcohol never consulted with him.

Tim Fox, Montana’s chief law enforcement officer, says he didn’t hear from Big Horn County Attorney Jay Harris.

“[He] Didn’t consult with my office about his approach in pushing for prosecution of mothers and pregnant women that might be abusing some substance. Frankly I think that kind of a blanket approach — using threats — is counterproductive,” Fox said.

Big Horn County Attorney Jay Harris says he will now seek restraining orders to prevent pregnant women from consuming alcohol or illegal drugs; particularly methamphetamine and opioids. If those orders are violated, his office would then seek to jail the women.

That caught the attention and condemnation of several statewide organizations including Planned Parenthood of Montana and the American Civil Liberties Union of Montana.

Caitlin Borgmann is ACLU’s Executive Director.

“It’s discriminatory to treat pregnant women differently from other people who are suffering from substance addiction. The more important point is that it is not only legally questionable, it’s wrong as a matter of public policy,” she said.

If Bighorn County Attorney Jay Harris attempts to enforce the policy, Borgmann says ACLU will immediately file a court challenge.

Harris declined Montana Public Radio’s request for a taped interview.

However, in emailed comments, he noted treatment should always be the preferred alternative to help expecting mothers overcome their addictions. But he adds a pregnant woman who persistently abuses drugs and/or alcohol is harming – potentially for a lifetime – a separate and innocent human being.

Referring to the treatment versus “crackdown” approaches, Harris’ email to MTPR reads: “Carrots and sticks are both needed — otherwise we are relying entirely on the good conscience of an individual stuck in the grip of chemical dependency. The integrity and value of human life cannot rest entirely upon such reliance.”

ACLU of Montana’s Caitlin Borgmann says pregnant women with addiction problems need more carrots in their lives and fewer sticks.

“It’s already very difficult for women to find treatment programs that will accept pregnant women. The last thing we want to do is make women afraid that they will be thrown in jail, that they might lose their existing children if they go and seek care because someone will then discover that they have been using drugs or alcohol,” Borgmann said.

Fourteen children in state protective custody died in 2017. Drug or alcohol use was a factor in most of those reports.

A Justice Department review of those deaths says the state could prevent many future deaths by offering more drug and alcohol treatment services for pregnant women.

It’s a concept that has the backing of Montana Attorney General Tim Fox.

“Individuals in crisis, particularly new mothers and pregnant women, aren’t looking to become criminals. More often than not, I would suspect that if we engage them and create an atmosphere where they will self-report and seek help we’ll probably get better outcomes,” Fox said.

In 2014, a Ravalli County prosecutor charged a woman who tested positive for drugs with criminal endangerment. A court later threw out those charges.

Big Horn County Attorney Jay Harris says he would initially seek civil, not criminal, interventions to protect unborn children.

Harris also encourages the public to report any known instances of pregnant women who are using drugs or alcohol to the local sheriff’s office.

ACLU’s Caitlin Borgmann describes that addition as particularly disturbing.

“This idea that we should be policing pregnant women is a frightening specter. We don’t want women to feel like everyone is out to get them rather than to help them,” she said.

Big Horn County Attorney Jay Harris says he will respond to any legal challenge to the new policy, as appropriate, in court. He adds he thinks most Big Horn County residents — and most Montanans — will agree with his new policy approach.

Retrieved from http://mtpr.org/post/attorney-general-big-horn-county-crackdown-pregnant-addicts-counterproductive

Montana Attorney Moves to Prosecute Women Who Use Drugs and Alcohol During Pregnancy

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Resources for treating addiction are scarce in Montana, especially for pregnant women. According to government data, from 2000 to 2013, the state’s incidence of neonatal abstinence syndrome — essentially a form of withdrawal in newborns who are suddenly cut off from the drugs they became dependent on while developing in an addicted mother’s womb — rose at twice the rate of the national average. And with budget cuts digging into funding for Big Sky Country’s already overburdened foster homes and drug treatment programs, pregnant women are often pushed to the back of the line.

But one local official has a solution that has drawn fierce criticism for its lack of scientific justification and regressive social implications. The American Civil Liberties Union has promised to challenge the new measure in court.

Last Thursday, Gerald “Jay” Harris, the Attorney for Big Horn County in the south of the state, announced a “crackdown” on pregnant women who use non-prescribed drugs or alcohol, promising to slap them with a restraining order to compel them to comply. If mothers-to-be violate the order of protection, Harris’s order decrees, they could find themselves in jail. “I regret not taking a more proactive approach until recently,” Harris told Undark. “You’ve got a potential generation of young folks that are going to have disability because of the prevalence of meth addiction, alcoholism, and other types of drug addiction. I don’t think it’s worth the risk.”

Harris has urged other prosecutors nationwide to implement similar measures and has called on the public to report any pregnant women who use drugs or alcohol to the sheriff’s office. He says he is also exploring the legal issues involved in involuntary committing women to treatment centers. But most of all, pregnant drug users are told they need to turn themselves in. “Expecting mothers acknowledging their own drug or alcohol addiction problems should immediately self-report to the Department of Public Health and Human Services and enroll in voluntary daily substance abuse monitoring in order to avoid prosecution,” the January 11 notice reads.

Denunciations of the measure have been swift. The National Advocates for Pregnant Women, a New York-based nonprofit, condemned the move in a statement last Friday, saying it “irresponsibly promotes medical and scientific misinformation, promotes an environment of fear, and reflects a shocking disregard for the rights and well-being of women and families.”

“There’s zero evidence that punitive approaches work,” says Lynn Paltrow, NAPW’s executive director, “and in fact, lots of indication that it’s completely counterproductive.”

Dr. Sheryl Ryan of the American Academy of Pediatrics expressed similar concerns.

Last March, AAP’s Committee on Substance Use and Prevention, which she chairs, published a policy statement urging a public health response, rather than a punitive approach, to pregnant women who use narcotics.

“Women who abruptly stop using substances, there’s an increased rate of fetal demise, early onset of labor, and poor pregnancy outcomes for the mother as well,” Ryan says. “If we’re a country that is so interested in a welfare of our children, then we really need to put our money where our mouth is.”

As I reported in November, forcing a pregnant woman to suddenly stop using opioids can put the mother and baby at greater risk than the drugs themselves. The withdrawals a mother experiences will also be experienced by the fetus, often leading to premature birth or miscarriage.

Harris claims his statement is about the rights of the unborn — what he calls “Natural Law” — but according to Ryan, Paltrow, and others, this crackdown could have the unintended effect of encouraging abortions, both spontaneous and clinical. A now-scrapped law in Tennessee that allowed mothers who used drugs to be charged with “fetal assault” drove some women to terminate their pregnancies.

Harris warned in his public notice that if a drug-using woman aborts to avoid jail time, the state’s attorney general should prosecute them. Though Big Horn County has a population of just over 13,000, Harris wrote in the notice that he would be reaching out to surrounding tribal prosecutors in the hopes that they — along with other communities across Montana and the country — adopt similar policies.

“A drug- or alcohol-addicted expecting mother doesn’t have the full mental capacity to exercise the ‘right to abortion,’ as set forth in case law, that a non-drug or alcohol-addicted expecting mother would,” Harris says.

In response to the ACLU’s pledge to challenge any attempt to enforce his proposed policy, Harris said he would respond to any legal arguments in court.

Retrieved from: https://undark.org/2018/01/19/montana-jay-harris-pregnant-drug-crackdown/

Edmonton: Pregnancy Pathways Program

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Background

  • Every year in Edmonton, approximately 100 women are pregnant while experiencing homelessness, and are in desperate need of housing, health and social supports.
  • These vulnerable women often do not access health care and other supports consistently due to their mental health and addictions, precarious housing situation, lack of knowledge about services and/or fears that their babies may be apprehended by Child and Family Services.
  • Women may come to hospital just before giving birth without adequate prenatal care, which often results in undernourished mothers and underweight and unhealthy babies who need neonatal intensive care.
  •  Early childhood experiences have a significant impact on physical and mental health later in life.

Pregnancy Pathways Program

  • A unique partnership of some 25 stakeholders from acute health care, addictions, mental health, government and non-profit sectors, collaborating to address the unmet housing and support service needs of pregnant women experiencing homelessness, many of whom are also struggling with addictions or mental health issues.
  • Boyle McCauley Health Centre will be the Lead Agency managing and staffing Pregnancy Pathways.
  • Our vision: a dedicated apartment building with 24-7, on-site supports and a gathering space to build community and foster peer support.
  • Work is ongoing to secure a dedicated apartment building; in the meantime, we are starting with a scattered site model, with the intention of providing those supports on an outreach basis.
  • Our Team will be lead by our Wellness Coordinator, who will work with Participants to identify achievable goals, and along with our Client Support Workers, will link women to the health care, treatment and other supports they need, and help them build life and parenting skills.
  • Boyle McCauley Health Centre has holistic health and wellness services, including pre-natal care. They will work closely with Alberta Health Services, one of our partners, to supplement their services and coordinate access to needed physical, mental health and addiction support services.
  • All supports will be provided from a harm reduction, strengths-based and trauma informed perspective.
  • For many women, reconnecting with their culture will be important to building wellness. We expect a large majority of our Participants will be Indigenous, and we will ensure they have access to cultural ceremonies and teachings from Elders and traditional knowledge keepers. We will similarly work to ensure women from other culture can explore and practice their cultural traditions.
  • After 6-18 months, each woman will transition away from Pregnancy Pathways, with a plan in place for affordable housing and access to the supports she needs to continue to work toward her goals.

Participants

  • All women joining the Pregnancy Pathways program will be:
  • currently homeless;
  • able to live independently with supports that are available;
  • currently engaged with the HER Program., BMHC, E4C, Catholic Social Services or Metis Child and Family Services, with a frontline worker who can provide background knowledge;
  • interested in the program, and willing to engage with the Team.
  • We will also make sure that the housing location is appropriate for a particular woman, and that any risks of violence can be mitigated to ensure the residence is safe for the woman and the other participants.
  • We know that there will be more pregnant women experiencing homelessness than Pregnancy Pathways will be able to assist, so the following will be considered when deciding on priority for Intake will include the women’s age, substance use history, work in the sex trade, medical complications during pregnancy or otherwise, and access to prenatal care.
  • Over a three year project phase, we expect to work with 30-36 women. Our objective is to help women and their babies be healthy, with a better chance for everyone to meet their potential. Through the program, mothers will also be better able to make a decision about raising their baby, finding other ways to become involved in their child’s life or choosing adoption or foster care for their newborn. We will also empower women to make decisions about their future fertility.

Evaluation

Stakeholder feedback will be sought throughout the project phase, and robust evaluation will be undertaken to help refine the program design for Pregnancy Pathways, and to support sustainable long-term funding.

For More Information contact:
Nancy Peekeekoot, Wellness Coordinator
Phone: 780 249 7002
Email: npeekeekoot@bmhc.net
Wendy Bouwman Oake, Program Director
Phone: 780 497 7146 ext 102
Email:wendyb@bmhc.net

Pregnancy Pathways Steering Committee: Alberta Health Services, Bent Arrow Traditional Healing Society, Boyle McCauley Health Centre, Catholic Social Services, City of Edmonton, E4C, Homeward Trust, Metis Child and Family Services, Royal Alexandra Hospital, Streetworks, University of Alberta, YMCA of Northern Alberta, and YWCA of Edmonton

FREE WEBINAR – EFFECTS OF DRUGS AND ALCOHOL AFTER BRIAN INJURY

Register now for the January 25, 2018, Alberta Brain Injury Initiative (ABII) Webcast

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Photo Source: Flood Modeller
Join (ABII) for this free webinar titled Effects of Drugs and Alcohol After Brain Injury.

Continued drug and alcohol use can impact persons who have been affected by a brain injury. In this webinar, a panel of experts will discuss:

  • Neurobiology of substance use disorders
  • The significance between traumatic brain injury and substance use disorders
  • Case examples of approaches used to manage substance use disorders

This webinar will be of interest to caregivers or anyone supporting individuals with brain injury who wish to learn more about these issues.

AGENDA:
Date: Thursday, January 25, 2018
Time: 2:00 p.m. – 3:15 p.m. MST
Register Here
Speakers: Dr. Rajpal Thiara, Dr. Reno Gandhi and Amanda Nickerson
Format: Presenters with PowerPoint Presentation
Cost: FREE! Please share with your networks
Q&A: You can pose questions to the speakers through the live chat functionality

SPEAKER BIOS:
Dr. Raj Thiara is medical lead of the Brain Injury Rehab Program for Edmonton.

Dr. Reno Gandhi is a neuropsychologist and registered psychologist at Glenrose Rehabilitation Hospital.

Amanda Nickerson is a social worker for Alberta Health Services.

A healthy eating guide to pregnancy

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Folic Acid (Folate)

Choose foods high in folate and take a multivitamin with folic acid in it to help prevent neural tube defects (e.g., spina bifida—in which the spine doesn’t form as it should) in your baby. Choose a multivitamin that has 0.4–1.0 mg of folic acid.

Some women may need higher levels of folic acid. Talk to your health care provider about your folic acid needs before you get pregnant if:

  • you’ve had an earlier pregnancy affected by a neural tube defect
  • you have a close relative with a neural tube defect
  • you have diabetes, epilepsy or are obese
  • you take medicine on a regular basis

Talk to your health care provider before taking more than 1 mg of folic acid a day.

Foods high in folate or fortified with folic acid:

  • whole grain breads, leafy green vegetables, beans and lentils, citrus fruits and juices and most cereals.

    Multivitamins with folic acid

    Healthy eating and taking a daily multivitamin with folic acid helps you prepare for a healthy pregnancy. Make sure your multivitamin with folic acid (0.4–1.0 mg) also contains iron, vitamin B12 and vitamin D. Talk to your health care provider about the supplement that is right for you.

  • If you are not already taking a multivitamin, begin now and take it throughout your pregnancy.

Iron

Your iron needs are very high during pregnancy. Your body makes about an extra 2 kg (4 lbs.) of blood during pregnancy. You need higher amounts of iron to make this extra blood.

Choose foods high in iron and take a multivitamin containing folic acid and iron. Your body absorbs the iron from meat, poultry and fish better than iron from other foods. In your third trimester, your baby is storing up iron to use for the first 6 months after birth.

For your body to absorb more iron, eat a food containing vitamin C (e.g., oranges or strawberries) and a food containing iron at the same time. For example, have vegetables with meat, or an orange with a bowl of cereal and milk. Tea and coffee can interfere with iron absorption, so limit these drinks and have them between meals rather than at meals. Some women may need more supplemental iron than others. Talk to your healthcare provider to find out how much is right for you.

Best sources of iron:

  • beef, pork, chicken, lamb, fish, sardines, shrimp, oysters and mussels

Other foods with iron:

  • legumes (lentils, beans, chickpeas), tofu, whole grain and enriched cereals

    Anemia

    When you’re pregnant, it’s hard to get the amount of iron you need just from the foods you eat. Health care providers recommend all pregnant women take a multivitamin with folic acid and iron (16–20 mg) during pregnancy. Anemia during pregnancy has been linked to decreased weight gain, preterm birth, and babies with a low birth weight.

  • A common sign of anemia is feeling tired. However, since most women feel tired during their pregnancy anyway, blood tests are an important way your health care provider can make sure you’re getting enough iron.
  • If you follow the nutrition recommendations provided and take your multivitamin with folic acid and iron every day, you should get the amount of iron you need. Only take an extra iron supplement if your healthcare provider tells you to. Iron supplements can make you constipated, so be sure to increase your intake of fiber and fluids.

Calcium

Calcium helps keep your bones strong. It also helps your muscles and nerves work properly. During pregnancy, calcium helps your baby build strong bones and teeth too.

Drink at least 500 ml (2 cups) of milk or fortified soy beverage each day.

Foods high in calcium:

  • milk and yogurt
  • calcium-fortified beverages, such as soy, rice or orange juice—the label must say calcium fortified

Other sources of calcium:

  • cheese, canned salmon or sardines with bones, and tofu made with calcium

Vitamin D

Vitamin D is important during pregnancy. It helps keep your bones strong and builds strong bones in your baby. It also helps your baby store up her own vitamin D to use during her first few months.

Many Canadians don’t get enough vitamin D. Be sure to follow Canada’s Food Guide: drink at least 500 ml (2 cups) of milk or fortified soy beverage daily and eat at least 2 servings of fish per week. You also need to take a supplement with vitamin D (400 IU) every day. Check your multivitamin to see how much vitamin D you’re getting from it. You may need to add an extra vitamin D supplement if the multivitamin has less than 400 IU.

Foods high in vitamin D:

  • milk, fortified soy beverages, fish (e.g., salmon, trout, herring, Atlantic mackerel and sardines) and vitamin D-fortified orange juice

Note: Not all milk products are high in vitamin D. In Canada, milk, margarine and some yogurts have vitamin D added to them.

‘Perpetually potentially pregnant’ project nets $56K grant

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By Ashleigh Mattern, CBC News Posted: Jan 14, 2018 8:31 AM

The Zika virus inspired Alana Cattapan’s research.

Cattapan had a trip planned to the Dominican Republic and people in her life told her she shouldn’t go because she’s in her 30s and it had been recommended that “women of childbearing age” avoid affected areas.

“This was strange to me because I was not pregnant, not planning on being pregnant, and the concerns were really about fetal health, not about women,” said Cattapan, who is an assistant professor at the Johnson Shoyama Graduate School of Public Policy at the University of Saskatchewan.

“I was really interested in how people were thinking about, not me, but a child that I hadn’t yet conceived and wasn’t interested in conceiving.”

Her research project called “Perpetually potentially pregnant” has been awarded a grant totalling $56,000 from the Canadian Institutes for Health Research, the Saskatchewan Health Research Foundation, and the U of S.

Alana Cattapan

Professor Alana Cattapan will be conducting her research via documentary analysis and interviews. (Submitted by Alana Cattapan)

The goal is to change the interaction between health care providers and women of childbearing age; to challenge the assumption that women will get pregnant just because they are of a certain age.

For example, she spoke to one woman who said her doctor had been insisting she take folic acid daily in case she someday gets pregnant.

“Folic acid really is important for fetal health, but the doctor has never, ever identified any of the reasons it might be useful for her to take folic acid,” Cattapan said.

“The guidelines for women’s care focus more on the potential future fetus than it does sometimes on women’s health.”

Effects of drugs on women unknown

These assumptions can also lead to gaps in knowledge about the effectiveness of drugs for women. In clinical trials, when the effects of drugs are still unknown, women of childbearing age are sometimes left out of the trials.

“We don’t know a lot about the effects of certain drugs on women because they’ve only ever been tested on men.”

Men’s reproductive functions are also often left out of the discussions of health prior to conception, even though sperm can be affected by exposure to chemicals, pollutants, stress, and alcohol and drug use.

“We focus on women’s reproductive bodies, but we don’t talk about men, whose bodies are really important to reproduction.”

Part of her research will include developing tools for public health agencies that will educate them about the topic.

Overall, she wants to broaden the way health care is provided to women in their 20s, 30s and 40s.

“Women who are planning on being pregnant or women who are already pregnant have fetal health in mind. Women are interested in recommendations that will ensure that when they have babies, they will have healthy babies.

“But it’s important to remember that women in their 20s and 30s who are not planning on having children, or who are far from being ready to have children, shouldn’t be thought of as just reproductive subjects, and we need to pay more attention to that.”

OPINION: Social workers often face impossible tasks (not just in Nova Scotia…across Canada)

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ALEC STRATFORD
January 12, 2018 – 5:30pm

The Chronicle Herald printed a front-page story on Jan. 4 about a Family Court judge who dismissed the province’s request to take a 20-month-old girl into permanent custody, ruling the child’s safety won’t be jeopardized by staying with her troubled family.

In her decision, Justice Elizabeth Jollimore writes: “There is a difference between parents who are poor, and poor parents. Ms. C and Mr. S are parents who are poor.”

This is an extraordinarily important distinction to make.

The Canadian Centre for Policy Alternatives-Nova Scotia (CCPA-NS) recently released the 2017 Report Card on Child and Family Poverty in Nova Scotia. The report states that one in five Nova Scotian children lives in poverty. Our province has done a poor job of achieving the goal of eradicating poverty for children by the year 2000.

In addition, the auditor general’s report on the state of mental health care services in Nova Scotia states that one in five Canadians will have a mental health care issue, and then it goes on to identify many crucial problems within the current system.

Both sources highlight that our province’s social structures do not meet the needs of the people. Our systems continue to penalize those who are the most vulnerable to the shortcomings of these systems.

The recent Child and Family Service Act changes expanded the definition of neglect. The former minister of Community Services, Joanne Bernard, stated at the time that she was bringing the amendments through the legislature, as these changes were needed to keep children in their homes and to provide support before the family is in a crisis.

The assumption was made that families have timely access to relevant and quality resources to address child protection concerns like neglect, when in fact, as the CCPA-NS Child and the auditor general’s report points out, these services are too often unavailable.

Social workers engage with the most vulnerable in our society. They have the knowledge and skills to competently perform assessments, interventions, negotiations, mediations, advocacy and evaluations. They are trained in inter-professional practice, community collaboration and teamwork. They can tell the difference between intrapersonal issues and structural issues. Social workers labour in solidarity with vulnerable populations to address intrapersonal issues and to empathetically connect with clients on the impacts of structural issues affecting their lives.

But even the most ethical, empathic and altruistic social worker cannot begin to keep children safe in Nova Scotia without the fundamental tools to do so. Without these tools, social workers often find themselves facing the seemingly impossible scenarios of trying to keep children safe.

It is no wonder so many social workers face record levels of burnout. This is the equivalent of asking a doctor to perform a surgery without the proper surgical tools, medical supports or hospital infrastructure, or asking a highway worker to build a highway without bulldozers and shovels.

We need to address the deep structural inequities that exist in our province and reimagine our current political economy to keep children safe.

To do this, we must have meaningful debate and advocate for structural change to address the following:

The culture of affluence that allows the top 100 CEOs in Canada to make more money by 10:57 a.m. on Jan. 2 than most Nova Scotian workers will make this year. When the culture of affluence is left unchecked and the concerns of the oppressed go unnoticed, there is eroded trust and increased anxiety and illness, which have a lasting impact on a range of social issues.

The need to work towards the public good. We must make real and sustainable investments in areas such as housing, mental health, food security and domestic violence.

The legacies of colonialism and racism. We must work in solidarity towards liberation from the effects of oppressive behavioural patterns and work to “unlearn” oppressive attitudes and assumptions.

Work towards greater democratic participation, building structures that allow Nova Scotians to hold their government accountable, increase meaningful participation in government policy creation to advance the common good. We believe this province is in desperate need of a Child Youth Advocate Office that could facilitate this process in child protection matters.

Ultimately, Justice Jollimore’s decision reinforces that we cannot continue to penalize those who are oppressed by a system that we are collectively responsible for. Her decision again reminds us that the cycle of abuse, poverty and neglect are ours as Nova Scotians to change.

Alec Stratford is registrar / executive director of the Nova Scotia College of Social Workers.

Retrieved from http://thechronicleherald.ca/opinion/1536261-opinion-social-workers-often-face-impossible-tasks

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