Monthly Archives: March 2018

Edmonton addictions specialist wants stigma taken out of safe consumption sites

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Natasha Riebe · CBC News ·

As a first-of-its kind facility prepares to open in Edmonton, an outspoken addictions specialist is dismissing any opposition to supervised drug consumption sites.

On Monday, the Royal Alexandra Hospital will open Edmonton’s second supervised consumption site as a safe place for patients to do hard drugs while they’re in hospital. The site is a first in any acute-care hospital in North America.

In an interview Wednesday on CBC’s Edmonton AM, public health physician Dr. Hakique Virani dismissed the argument that safe consumption sites enable or encourage people to keep doing drugs.

He said Canada should take a cue from places that embrace harm reduction and “reject the idea that punishing people who use substances is effective, because it’s not.

“At the Royal Alex hospital, if you were to remove everybody who was there because they smoke cigarettes, drink alcohol, eat too much, drive too fast, don’t take their medications properly, don’t wash their hands, don’t get vaccinated, it would be a very, very quiet hospital.”

Supervised drug consumption sites remain controversial, with politicians like United Conservative Party Leader Jason Kenney saying he doesn’t believe in the approach and would not expand the program if elected Alberta’s next premier.

Many people living and working in the Boyle-McCauley area are opposed to safe injection sites opening in the neighbourhood. The Chinatown and Area Business Association has called for a judicial review of the safe injection sites.

“It’s interesting that you hear that from politicians but you don’t hear that from experts,” Virani told Edmonton AM host Mark Connolly.

“That’s not because of political differences, that’s because of a difference in understanding,” he said.

The Royal Alex facility will be the second supervised consumption site to open in Edmonton. A site at Boyle Street Community Services opened last week. Two more sites are to open in the city this spring.

Virani, other experts and front-line workers say the facilities are an effective way to prevent overdoses and deaths from opioids.

“The overdose crisis is top of mind for us,” said Marliss Taylor, a program manager at Boyle Street Community Services’ Streetworks.

Since the Boyle Street site opened on Friday, 97 people have used the service, with men outnumbering women three to one, Taylor said. Staff dealt with two overdoses in five days, saving emergency medical services from needing to respond.

Taylor said agencies in the city have been waiting for the sites for a long time.

“This is one way to be able to be with people at the time that they are most likely to overdose and be able to offer life-saving interventions if they require them,” she said.

Supervised consumption sites take addicts away from the dark alleys, where they face an “increased risk of overdose, increased risk of different infections,” Taylor added.

The program also takes needles off the street, as clients use and dispose of them in the supervised site.

“It makes far more sense to me to bring them indoors, into a place where they are safer.”

Taylor said a registered nurse is at hand at all times and users are encouraged to stay for 10 to 15 minutes so staff can make sure they’re OK.

Marliss Taylor, program manager at Boyle Street’s Streetworks, says safe sites get addicts out of dark alleys and keep needles off the streets. (CBC)

 

“This is one way to be able to be with people at the time that they are most likely to overdose and be able to offer life-saving interventions if they require them.”

They then can discuss counselling services, detox options and housing.

Taylor said Boyle Street will be part of an evaluation program, which all sites in the province will participate in.

Two more safe injection sites are set to open northeast of downtown this spring — a space in the George Spady Centre which will open evenings and weekends, and in the Boyle McCauley Health Centre.

Retrieved from http://www.cbc.ca/news/canada/edmonton/edmonton-safe-injection-site-opioid-1.4598086

Is FASD really 100% preventable?

 

A lot of progress has been made on effective FASD awareness and prevention strategies. Early efforts often used disrespectful tactics like unsettling pictures of women slugging down alcohol from a bottle while pregnant with a caption such as “Baby or the Bottle.” Those approaches have largely been abandoned. But one overly simple statement still pops up. And that is, “FASD is 100% Preventable.”

That statement is misleading because it suggests that FASD prevention is unidimensional and linked only to alcohol consumption. But alcohol use during pregnancy is linked to the social determinants of health, and its effects can be exacerbated by food insecurity, trauma, poverty and multi-substance use. It also suggests that stopping drinking is a simple choice. It puts the onus on the individual woman to make that choice and contributes to shame if they do not stop before they become pregnant. But in reality, there are many influences on women’s alcohol use, and real challenges to quitting before you know you are pregnant. Indeed, almost half of pregnancies are unplanned, so it is very challenging to be alcohol free before a pregnancy is confirmed.

In the case of other substances like tobacco or prescription painkillers, the public discourse extends beyond the individual user to corporate responsibilities, physicians and health authorities to provide harm reduction and treatment programs, and of governments to provide regulation and enforcement and policies that work toward social equity.

If we extend this perspective to alcohol use during pregnancy, we must speak about the responsibilities of the alcohol industry for targeting girls and women of childbearing age, and of health providers for providing comprehensive education and brief support during the preconception and prenatal periods. We must also consider the responsibilities of health services for providing integrated treatment programs for pregnant and parenting women; and of governments for ensuring gender equity and preventing violence against women.

Theoretically, stopping alcohol use in pregnancy, or ideally, before, sounds simple – just do it. But it takes a lot of individuals and sectors to do their part to make it realizable.  Simplifying it to statements like “FASD is 100% preventable” is not the best approach.

These previous blogs illustrate the full context of FASD and prevention approaches.

HOUSING IS KEY COMPONENT TO WOMEN’S RECOVERY, August 19, 2017

TARGETING STIGMA AND FASD IN MANITOBA, June 26, 2017

HEAVY DRINKING AMONG WOMEN: NORMALISING, MORALISING AND THE FACTS, Jan 24, 2017

FASD IS A PUBLIC SAFETY AND JUSTICE PRIORITY FOR ABORIGINAL GROUPS, October 23, 2016

HOW DO PARTNERS AFFECT WOMEN’S ALCOHOL USE DURING PREGNANCY? August 11, 2014

CanFASD Issue Paper: Cannabis Use During Pregnancy

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Kelly D. Harding, PhD and Nancy Poole, PhD
Canada Fetal Alcohol Spectrum Disorder Research Network

ISSUE:

In 2018, the Canadian government plans to introduce the Cannabis Act controlling the production, distribution, sale, and possession of cannabis in Canada. The proposed legislation would allow adults to legally possess and use cannabis. With the upcoming legalization, attention has been drawn to the potential effects of cannabis use in a number of domains, including the effects of cannabis use during pregnancy.

It is important to note that the legal use of cannabis does not necessarily make it safe. Unlike alcohol, the implications of cannabis use during pregnancy are not adequately researched or interpreted. The serious potential lifelong effects of alcohol exposure in pregnancy are known, yet a safe level of use cannot be established.

With cannabis, neither the potential effects nor a safe level of use in pregnancy are known. Thus, it is recommended that similar public health messaging be used: that it is safest not to use alcohol or cannabis in pregnancy.

Please click to download full issue paper: CanFASD-Cannabis-Use-During-Pregnancy-Issue-Paper-Final-March-2018

 

I AM A CAREGIVER! FOR A PERSON WITH FASD: Caregiver Resource Guide

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The Prevention Conversation project and Edmonton and area Fetal Alcohol Network Society previously posted this new Caregiver Resource Guide. But… it was not the final version!

Please delete your old downloads and enjoy the updated version thanks to Dr. Dorothy Badry and Jamie Hickey!

Caregiver-Resource Guide-FASD -CanFASD DBadry and JHickey March -2018

Maternal alcohol use early in pregnancy may be risk factor for infant abdominal malformation

180111_op1ak_rci-baby-foot_sn635Alcohol use early in the pregnancy by the mother may be a risk factor for a condition in which an infant’s intestines develop outside the abdomen, according to a study published in the Journal of Maternal-Fetal & Neonatal Medicine.

Loyola Medicine maternal-fetal medicine physician Jean Ricci Goodman, MD, medical director of obstetrical services, was first author of the study.

The national study was conducted with patients who were referred to a university-based tertiary level obstetric clinic for a routine mid-pregnancy ultrasound. The aim was to evaluate the impact of poor maternal nutrition, environmental exposure and vasoactive stimulants (drugs that can either raise or lower blood pressure) as potential risk factors for gastroschisis, a condition in which a baby’s intestines form outside the abdomen through a hole next to the belly button.

The study was conducted from September 2010 to June 2012, during which 38 cases of gastroschisis were diagnosed. Thirty cases were included in the analyses, with 76 control cases.

Among cases observed, there were no links found in either group between the use of illicit, prescription or over-the-counter drug use and gastroschisis. Diet and environmental exposures also did not seem to be risk factors.

However, the use of alcohol in mothers of gastroschisis cases one month prior and/or early in the pregnancy showed a significant increase in odds of the condition (36.7 percent in cases of gastroschisis versus 18.4 percent in the control group).

Babies born with gastroschisis are at risk for other anomalies in the gastrointestinal and other organ systems. Previous studies have indicated an increased rate in women from socially disadvantaged environments with nutritional deficits. While there has been an increase across all age groups and races, the largest increase (200 percent in the last decade) was among non-Hispanic African American women younger than 20 years.

“Cases of gastroschisis have been on the rise worldwide for 30 years,” Dr. Ricci Goodman said. “It’s important to understand why this trend is happening and develop measures to prevent it.”

Dr. Goodman is part of a multidisciplinary team at Loyola Medicine offering comprehensive, integrated maternal-fetal medicine care for women who have or may develop pregnancy complications.

NIH releases first dataset from unprecedented study of adolescent brain development

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The National Institutes of Health Tuesday released to the scientific community an unparalleled dataset from the Adolescent Brain Cognitive Development (ABCD) study. To date, more than 7,500 youth and their families have been recruited for the study, well over half the participant goal.  Approximately 30 terabytes of data (about three times the size of the Library of Congress collection), obtained from the first 4,500 participants, will be available to scientists worldwide to conduct research on the many factors that influence brain, cognitive, social, and emotional development. The ABCD study (link is external) is the largest long-term study of brain development and child health in the United States.

This interim release provides high-quality baseline data on a large sample of 9-and-10-year-old children, including basic participant demographics, assessments of physical and mental health, substance use, culture and environment, neurocognition, tabulated structural and functional neuroimaging data, and minimally processed brain images, as well as biological data such as pubertal hormone analyses. The data will be made available through the National Institute of Mental Health (NIMH) Data Archive, which can be accessed by researchers who obtain a free NIMH Data Archive account. All personally identifiable information is removed from the data to ensure participant confidentiality and anonymity.

“By sharing this interim baseline dataset with researchers now, the ABCD study is enabling scientists to begin analyzing and publishing novel research on the developing adolescent brain,” said Nora D. Volkow, M.D., director of the National Institute on Drug Abuse (NIDA). “As expected, drug use is minimal among this young cohort, which is critical because it will allow us to compare brain images before and after substance use begins within individuals who start using, providing needed insight into how experimentation with drugs, alcohol and nicotine affect developing brains.”

“Sharing ABCD data and other related datasets with the research community, in an infrastructure that allows easy query, data access, and cloud computation, will help us understand many aspects of health and human development.” said Joshua A. Gordon, M.D., Ph.D., director of NIMH. “These datasets provide extraordinary opportunities for computational neuroscientists to address problems with direct public health relevance.”

This comprehensive dataset, which will be disaggregated by sex, racial/ethnic group, and socioeconomic status, will allow researchers to address numerous questions related to adolescent brain development to help inform future prevention and treatment efforts, public health strategies and policy decisions, including, but not limited to:

  • How do sports injuries impact developmental outcomes?
  • What is the relationship between screen time and brain and social development?
  • How does the occasional versus regular use of substances (e.g., alcohol, nicotine, marijuana) affect learning and the developing brain?
  • What are some of the factors that contribute to achievement gaps?
  • How do sleep, nutrition, and physical activity affect learning, brain development and other health outcomes across racial/ethnic and socioeconomic groups?
  • What brain pathways are associated with the onset and progression of mental health disorders and do these pathways differ by sex?
  • What is the relationship between substance use and mental illness?
  • How do genetic and environmental factors contribute to brain development?

“The collection and release of this baseline data is a crucial step in ongoing efforts to sharpen our understanding of the link between adolescent alcohol use and long-term harmful effects on brain development and function,” said George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Recruitment of participants began in September 2016 through outreach to public, charter, and private schools, as well as twin registries in Colorado, Minnesota, Missouri and Virginia. The ABCD Study is designed to include a diverse population that reflects the demographics of the U.S., however these interim data may not fully capture that diversity as enrollment is not yet complete. So far, 7,637 youth have been enrolled, including 6,399 single participants and 1,238 twins/multiples, reaching a 66 percent recruitment milestone. The study aims to enroll a total of 11,500 children by the end of 2018. The next annual data release will include the full participant cohort.

Participants will be followed for 10 years, during which data are collected on a semi-annual and annual basis through interviews and behavioral testing. Neuroimaging data, including high resolution MRI, are collected every two years to measure changes in brain structure and function.

The ABCD Coordinating Center (link is external) and Data Analysis and Informatics Center are housed at the University of California, San Diego and recruitment is being conducted at 21 study sites (link is external) across the United States. For more information, please visit the ABCD website at www.ABCDStudy.org (link is external).

The ABCD study is supported by the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the National Cancer Institute, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute of Mental Health, the National Institute on Minority Health and Health Disparities, the National Institute of Neurological Disorders and Stroke, the NIH Office of Behavioral and Social Sciences Research, the NIH Office of Research on Women’s Health, and the Division of School Health at the Centers for Disease Control and Prevention (CDC), with additional partnerships with the National Institute of Justice, the CDC Division of Violence Prevention, the National Science Foundation, and the National Endowment for the Arts.

For more information about the adolescent brain, go to: https://www.drugabuse.gov/related-topics/adolescent-brain.

About the National Institute on Drug Abuse (NIDA): The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. Fact sheets on the health effects of drugs and information on NIDA research and other activities can be found at www.drugabuse.gov, which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA’s DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or email requests to drugpubs@nida.nih.gov(link sends e-mail). Online ordering is available at drugpubs.drugabuse.gov. NIDA’s media guide can be found at www.drugabuse.gov/publications/media-guide/dear-journalist, and its easy-to-read website can be found at www.easyread.drugabuse.gov. You can follow NIDA on Twitter(link is external) and Facebook(link is external).

About the National Institute of Mental Health (NIMH): The mission of the NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For more information, visit the NIMH website

About the National Institute on Alcohol Abuse and Alcoholism (NIAAA): The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, diagnosis, prevention, and treatment of alcohol use disorder. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at: https://www.niaaa.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Retrieved from https://www.nih.gov/news-events/news-releases/nih-releases-first-dataset-unprecedented-study-adolescent-brain-development

I AM A CAREGIVER! FOR A PERSON WITH FASD: Caregiver Resource Guide

Welcome to the “I am a Caregiver” resource guide for those providing care to a person with FASD. This guide was developed as a way for caregivers to access important information and resources relating to providing care for children and adults with FASD. FASD is a life-long disability and individuals impacted by FASD require a community of care and support. As a caregiver, you are a key part of the care team.

Within this book you will find general information and resources to help you in your caregiving role. However, as you go through this resource it is important to remember that each individual is unique and there is no one universal strategy or solution that will work for everyone. As always, it is important to consult regularly with the individual’s professional care team if you have questions or concerns.

For more information and resources on FASD please visit https://canfasd.ca/caregivers/information-for-caregivers/?platform=hootsuite

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