Author Archives: edmontonfetalalcoholnetwork

Drinktank: Alcohol and pregnancy – Why doesn’t it worry us?


Following a call for submissions to the Food Regulation Standing Committee (FRSC) Pregnancy warning labels on alcoholic beverages public consultation, Australian governments will shortly decide whether to mandate alcohol pregnancy warning labels on all products sold in Australia.

Currently in Australia, alcohol companies are not legally required to include pregnancy warning labels on their products, and instead choose whether or not to include any information about the harm of alcohol and pregnancy on their labels.

New market research undertaken by Hall & Partners found that the alcohol industry’s current voluntary approach to warning of the dangers of drinking during pregnancy is misleading, confusing and fails to adequately raise awareness about the risks to the unborn child.

Off the back of this research, the Foundation for Alcohol Research and Education (FARE) has commenced campaigning for a new mandatory labelling system to complement its FRSC submission.

Today on Drink Tank, Louise Gray, Executive Officer of the National Organisation for Fetal Alcohol Spectrum Disorders (NOFASD) Australia, asks: Alcohol and pregnancy – Why doesn’t it worry us?

We worry about bagged lettuce, we are fearsomely opposed to smoking during pregnancy; we gladly take soft cheese off the menu and share information about the dangers of listeria.

Yet – Consider……

Summer 2017, Sydney, Australia. A group of upwardly mobile 30-somethings gather for a Christmas party. Plans to celebrate a year of campaigns, social media successes, work portfolio growth, and the benefits of quality education and living in a country like Australia.

The food on offer is the best that Australia can provide in this season – quality seafood, fruit, cheeses and meats – a wide variety with lots of alternatives. After all, some of the party attendees are pregnant and they need alternatives so that they can avoid raw seafood, camembert and the host of other items highlighted so that women who are pregnant won’t consume them. Even lettuce needs to be sourced and the origin identified to make sure that it didn’t come from a dreaded bag. Smokers, of course, won’t even make an appearance at this gathering and will be huddled outside in furtive groups.

Enter Nicole, a slight and well-exercised woman, five months into her long-awaited pregnancy. Nicole is brimming with health and vitality, perhaps with the glow that pregnant women are often reported to have, as she awaits this much-anticipated birth. Nicole has private health insurance and access to the best medical care in Australia.

She did not receive any advice about alcohol and pregnancy until she was five months pregnant and this was received in a package of information from her hospital. Finally, at this point, she was clearly told that no alcohol is the recommended health advice for pregnant women supported by the Australian government health guidelines, the World Health Organization, and most global health advisories.

Nicole heeded this advice from the moment she began planning her conception and pregnancy and has confidence that she has given her tiny baby the best chance to develop and create the complex systems which are required to keep a human body going.

Nicole, at five months, is visibly pregnant and her series of Christmas parties was a series of opportunities to refuse alcohol. Everyone offered alcohol, at every event and when she declined she was encouraged to “have just one”. Sometimes comments bordered on ridicule for her choices, while others offered ‘researched’ advice that a small amount of alcohol is good for you.

We don’t force cigarettes on people, we don’t encourage people to ignore risks with soft cheese, we don’t try to convince someone to eat just one piece of sushi – so why do we encourage and support alcohol in pregnancy?

Why don’t we think of interesting alcohol-free choices?

Why do we make alcohol-free the exception rather than the rule?

Does it matter if people don’t understand what happens when a pregnancy is exposed to alcohol?

Does it matter that there is no known safe limit of alcohol which can be consumed during pregnancy?

Does it matter that children risk a lifetime of disability and challenges?

It does matter because Fetal Alcohol Spectrum Disorder (FASD) is the most prevalent, preventable disability in the world.

Studies in mainstream populations in the US and Canada point to conservative estimates that between 2 – 5 % of the population is affected by FASD with higher numbers evident in at-risk communities.

We don’t know how much FASD there is present in mainstream Australia – it hasn’t been researched. However, newspaper headlines document increased incidence of serious behaviour issues in schools, increased incidence of emergency room incidents, unacceptable growth in prison populations, falling education standards and increases in disability numbers.

Australia needs to undertake effective FASD screening or we will never prevent FASD and we will never know the role which FASD has in these figures.

Finally, Australia needs to be serious about pregnancy warning labels on packaged alcoholic beverages. It would be impossible to find another product which causes such harm and is sold so widely and freely without a clear warning and reminder.

Mandatory labels are needed. It is negligent and irresponsible for Australia to remain complicit in a situation which exposes unborn children to unacceptable risk.

Postscript – Nicole (not her real name) gave birth to a healthy baby girl and was grateful she understood that alcohol should not consumed when planning a pregnancy and during pregnancy.

8th International Research Conference on Adolescents and Adults with FASD: Presentations


Although there have been thousands of published articles on FASD, there remains to be limited research specifically on adolescents and adults with FASD. As individuals diagnosed with FASD continue to age, the “need to know” across a broad spectrum of areas continues to be critically important for identifying clinically relevant research questions and directions.

Continuing on the work of seven previous conferences, there remains a clear need to examine relevant global research, programs and policies. What does existing or emerging research tell us? Are the results transferable from country to country and/or from laboratory to real life? Are there clinical implications of results from any of these areas of which we should be aware? What are the changes in our thinking, practice and directions that will be required to improve outcomes? What are the implications for the future?

This interactive 2018 conference provided an opportunity to be at the forefront of addressing these relevant global issues.

To see the conference presentations and webcasts please click here


Who proved alcohol is a teratagen?

Pioneer contributions of Dr. Sulik!

Red Shoes Rock

Red Shoes Rock honors the FASD pioneer – Dr. Kathleen K. Sulik – Thank you!

The FASD community is grateful that Kathleen K. Sulik, Ph.D. is a scientist who studies birth defects.

Her discipline is called teratology or developmental toxicology. Much of her research has involved studying the various types of birth defects that result from exposure of an embryo to alcohol at very specific times during development.

Suliklabfigure1Dr. Sulik designed experiments to demonstrate that alcohol can cause major birth defects and the brain damage as early as the first three weeks of fetal development.

One of the major findings from her laboratory’s studies is that alcohol can cause permanent brain damage if exposure occurs at very early stages of embryonic development — stages that occur prior to the time that most women would even realize that they are pregnant.

Dr. Sulik began her career with plans of becoming a…

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CCSA releases new policy brief: Decriminalization, Options and Evidence


Decriminalization: Options and Evidence

Rebecca Jesseman, M.A., and Doris Payer, Ph.D.

Executive Summary

A growing body of evidence suggests that decriminalization is an effective way to mitigate the harms of substance use and the policies and practices used to deal with it, especially those harms associated with criminal justice prosecution for simple possession. This policy brief reviews the various ways in which decriminalization of controlled substances is being interpreted and implemented internationally and in Canada.

Decriminalization is a policy strategy in which non-criminal penalties, such as fines, are available for designated activities, such as possession of small quantities of a controlled substance. It has been proposed as a way to reduce the harms associated with the opioid crisis. An understanding of decriminalization starts by recognizing that it is not a single approach, but a range of policies and practices.

This brief will inform policy makers, decision makers, analysts and advisors in the health, social and criminal justice sectors by:

Defining key concepts;

 Illustrating examples of informal (de facto) and formal (de jure) applications of decriminalization, including harm reduction services, police diversion and national policy approaches;

 Identifying considerations for evaluation and monitoring of applied decriminalization approaches;

 Summarizing lessons learned from international and Canadian experience; and

 Proposing decriminalization options for application to the current Canadian context.

Key Findings

Recognizing that substance use is a complex health issue with social, economic and public safety impacts is fundamental to developing comprehensive and effective responses.

 Decriminalization encompasses a range of policies and practices that can be tailored and combined to respond to particular contexts and to address specific objectives.

 The growing body of evidence on various approaches to decriminalization provides a valuable source of lessons learned to inform the development of policy and practice.

 Gaps in knowledge about the impact of decriminalization approaches need to be filled by conducting rigorous evaluations and making data and results accessible.

The Issue

Substance use patterns and prevalence, and its associated harms evolve over time. To address changing contexts, strategies to deal with substance use must change as well. The current Canadian context is marked by an opioid crisis, with deaths due to opioid overdose reaching unprecedented levels. The crisis highlights the need for agile and innovative responses informed by evidence.

Decriminalization is an evidence-based policy strategy to reduce the harms associated with the criminalization of illicit drugs. For those who use illicit drugs, these harms include criminal records, stigma, high-risk consumption patterns, overdose and the transmission of blood-borne disease.

Decriminalization aims to decrease harm by removing mandatory criminal sanctions, often replacing them with responses that promote access to education and to harm reduction and treatment services. It is not a single approach or intervention; rather it describes a range of principles, policies and practices that can be implemented in various ways.


Over the past few decades, various decriminalization strategies have been implemented both in Canada and in other countries, including Australia, the United States, Portugal and the Czech Republic. Decriminalization is receiving increased attention in Canada as a possible substance use strategy. Decriminalization measures are being considered to help address the opioid crisis, including the contamination of illicit drugs with fentanyl, and were earlier proposed as alternatives to legalizing non-medical cannabis.

Click image to download the full report!


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Risky Drinking By Either Sex Can Affect Future Offspring Interview with:

Toni Pak, Ph.D. Professor and Department Chair Department of Cell and Molecular Physiology Loyola University Chicago Maywood, Ill 

Toni Pak, Ph.D.
Professor and Department Chair
Department of Cell and Molecular Physiology
Loyola University Chicago
Maywood, Ill What is the background for this study?

Response: We have known for many years that drinking alcohol during pregnancy can lead to developmental delays and birth defects in offspring. However, our data demonstrate that drinking large quantities of alcohol in a “binge” fashion before pregnancy can also impact future offspring and importantly, this is true for drinking behaviors of both parents, not just the mother.

Our previous data support the idea that alcohol is affecting the parental sperm and eggs to induce these modifications in the offspring, but this most recent work shows the extent of those effects on social behavior, pubertal maturation, and stress hormones as the offspring grow to adulthood.

This means that the risky behaviors of young people, such as the extremely popular practice of binge drinking, have potentially far-reaching consequences for generations to come. What are the main findings?

Response: Our data also address an important debate in the growing field of “epigenetics”, which refers to environmental or experiential factors in one generation that can impart rapid trait changes in future generations in a manner that does not actually affect the genetic code.

The debate is whether the experiences of one generation can confer some adaptation for the next that would be beneficial. For example, if one generation was exposed to chronic food shortage that could alter the metabolism in the next generation such that they would better tolerate a decreased food supply. However, our data demonstrated that there were no adaptive traits conferred to the offspring that allowed them to better tolerate alcohol when the offspring were themselves exposed. This suggests that certain environmental toxicants, such as drugs of abuse, do not follow this beneficial adaptation argument for epigenetic processes. What should readers take away from your report?

Response: We have shown evidence that alcohol exposure of parents during pubertal development, preconception, can influence future offspring social behavior, pubertal maturation of hormone profiles, and body weight. In addition, there do not seem to be any advantages in these offspring, such as decreased stress activation by alcohol exposure themselves. Teenage binge drinking, therefore, has the ability to cause multigenerational changes in offspring development, with or without future generations exposing themselves to alcohol. What recommendations do you have for future research as a result of this work?

Response: Recent advances in genomics research have revealed that preconception behaviors and experiences of mothers and fathers, including diet, environmental toxicants, and drug abuse, can impact future offspring through epigenetic mechanisms. The results of our study suggest that parental binge alcohol exposure, before conception, alters phenotypic traits in first generation offspring. Future research should focus on which parental experiences can be transmitted to offspring, and of those, which represent the biggest concern for the health of those offspring. 


AnnaDorothea Asimes, Chun K Kim, Amelia Cuarenta, Anthony P Auger, Toni R Pak. Binge drinking and intergenerational implications: parental preconception alcohol impacts offspring development in rats. Journal of the Endocrine Society, 2018; DOI: 10.1210/js.2018-00051

Resource: Here Come Baby Videos

Here Comes Baby, is a video series for new and soon-to-be parents. The videos include:


The videos will bring together local parents, health professionals, experts to discuss the realities of life with a new baby. Expect to see some familiar faces!

Bathing Baby

This video demonstrates how to give a new baby a bath. It includes tips and tricks on how to turn bath time into an enjoyable experience for both baby and the parent or caregiver.


This video shares answers to common questions about jaundice.

Postpartum Recovery

This video shares answers to common questions about recovery in the postpartum period.  

Diaper Change Demonstration 

This video demonstrates how to change a new baby’s diaper.  It includes suggestions/tips that may make diapering safer, easier and more enjoyable for parent and baby.

Postpartum Mental Health

This video shares some of the emotional changes after giving birth and some tips on what you can do about it.


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In a new study by the Canadian Centre on Substance Use and Addiction and the Canadian Institute for Substance Use Research, it is estimated that the overall cost of substance use in Canada was $38.4 billion in 2014. That amounts to approximately $1,100 for every Canadian regardless of age.

Substance use is a significant cost to the Canadian economy.

It has a direct impact on the healthcare and criminal justice systems as well as an indirect economic impact through lost productivity illness, injury and premature death.


With a better understanding of the economic, health and social costs of substance use in Canada — supported by comparable, valid and up-to-date data — federal and provincial/territorial public health experts will be able to:

Lost Productivity

Prioritize and target relevant public policies

Create initiatives to target the harms caused by substance use
Criminal Justice

Identify information gaps, research needs and refinements to be made to national data reporting systems
Other Direct Costs

Establish a baseline for measuring changes in policy and determining the effectiveness of harm-reduction programs

Objectives of This Project

The Canadian Centre on Substance Use and Addiction (CCSA) and the Canadian Institute for Substance Use Research (CISUR)had two main objectives for the Canadian Substance Use Costs and Harms project:

Provide updated data on the costs of substance use in Canada

The Canadian Substance Use Costs and Harms report provides estimates of the costs of substance use in Canada from 2007 to 2014.


Launch an interactive data visualization tool (Coming Fall 2018).

The Tool allows for ongoing monitoring and in-depth exploration of the harms and costs of substance use over time. The methods behind this tool build on the work of CISUR’s alcohol and other drug AOD monitoring project.


Snapshot of Findings

In 2014,

  • The overall cost of substance use was $38.4 billion, which amounts to approximately $1,100 for every Canadian regardless of age.
  • Almost 70% of the total costs were due to alcohol and tobacco.
  • The four substances associated with the largest costs were:

Alcohol ($14.6 billion or 38.1% of the total cost)

Tobacco ($12.0 billion or 31.2% of the total cost)

Opioids ($3.5 billion or 9.1% of the total cost)

Cannabis ($2.8 billion or 7.3% of the total cost)
  • The distribution by cost type was as follows:
Lost Productivity

Lost productivity ($15.7 billion or 40.8% of the total cost)

Healthcare costs ($11.1 billion or 29.0% of the total cost)
Criminal Justice

Criminal justice costs ($9.0 billion or 23.3% of the total cost)
Other Direct Costs

Other Direct Costs ($2.7 billion or 7.0% of the total cost)
  • Per-person costs were highest in the three territories

Northwest TerritoriesNorthwest Territories


Between 2007 and 2014,

  • The per-person costs associated with SU increased 5.5% from $1,025 per person in 2007 to approximately $1,081 in 2014
  • The per-person costs associated with alcohol use increased by 11.6% from $369 per person to $412 per person
  • Per-person costs increased by 19.1% for cannabis ($67 to $79) and 6.8% for tobacco ($315 to $337)
  • Per-person costs decreased by 24.6% for cocaine ($84 to $63) and by 17.9% for other substances ($20 to $16)

Please click image to download full report:

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