Category Archives: News

BBC: Why alcohol affects women more than men

OOEC6SBKLVEDNKIPQMHWPMWZQQIt used to be that men were the outsized alcohol drinkers in Western society – perhaps best depicted in popular culture by Don Draper’s Mad Men cronies, who swilled from office stashes of brown liquor, knocked back three-martini lunches and imbibed Old Fashioneds in an after-work pub culture where few women dared tread.

But epidemiologists have noted that the rise of marketing alcohol to women and the changing of gender roles have gradually shifted the booze imbalance. Overall, men are still almost twice as likely as women to binge drink. But that isn’t true for younger people, specifically. In fact, women born between 1991 and 2000 now drink just as much as their male counterparts – and their drinking rates could eventually surpass them.

Women’s bodies are affected differently by alcohol than men’s bodies – for reasons that go beyond mere size

Women are increasingly suffering from the ill effects of alcohol, too. National data show that the cirrhosis death rate shot up by 57% among women aged 45-64 from 2000-2015 in the US, compared to 21% among men. And it rose 18% in women aged 25-44, despite decreasing by 10% among their male peers. Adult women’s visits to hospital emergency departments for overdosing on alcohol also are rising sharply. And risky drinking patterns are escalating among women in particular.

But the problem isn’t just that women are drinking more. Researchers are finding that women’s bodies are affected differently by alcohol than men’s bodies – for reasons that go beyond mere size.

Scientists have discovered that women produce smaller quantities of an enzyme called alcohol dehydrogenase (ADH), which is released in the liver and breaks down alcohol in the body.

Meanwhile, fat retains alcohol, while water helps disperse it. So thanks to their naturally higher levels of body fat and lower levels of body water, women experience an even more dramatic physiological response to alcohol.

“That vulnerability is why we see increases in medical problems in women with alcohol-use disorders, compared to men,” says Dawn Sugarman, a psychology professor at Harvard Medical School and addiction psychologist at McLean Hospital in Belmont, Massachusetts. (Find out more about how different bodies react to alcohol differently in our recent story Why do only some people get blackout drunk?)

Women who drink excessively also tend to develop addiction and other medical issues more quickly than men. It’s a phenomenon called ‘telescoping’: women with alcohol struggles tend to start drinking later in life than men, but it takes them much less time to develop alcohol addiction. Women are also faster to experience liver disease and damage to their hearts and nerves.

Many of these gender-based differences in alcohol’s effects on the body weren’t discovered until recent decades. The earliest study on gender-based differences in ADH, for example, was published in 1990.

In fact, almost all clinical studies on alcohol were done entirely on men until the 1990s. This was partly because scientists were encouraged to eliminate as many variables as possible that might influence an experiment’s results – one of which was gender. And because alcoholism was assumed to be a mostly male problem, no-one wondered what not studying women and alcoholism might miss.

That changed when government institutions like the US National Institutes of Health mandated that women and minorities had to be included as clinical research subjects, and critical gender gaps in medical research began to be addressed.

Scientists just assumed, well, you could study men and it could apply to women – Sharon Wilsnack

“People just didn’t think about women,” says Sharon Wilsnack, a psychiatry and behavioural science professor at the University of North Dakota’s School of Medicine and Health Sciences. “To the extent that they did, they just assumed, well, you could study men and it could apply to women.”

For her PhD at Harvard University in the early 1970s, Wilsnack wrote her graduate dissertation about women and alcohol; her literature review then yielded only seven studies at Harvard’s Widener Library. With her husband, a sociologist, Wilsnack went on to lead the first long-term national study on women’s drinking habits. Among their many findings was the discovery that women who abuse alcohol often have been sexually abused as children, a gender difference that has since been deemed as crucial in helping women with addiction.

Gender-based alcohol research since then has turned up a variety of other sex-specific results.

Click to read full article by Marisa Taylor 

Retrieved from http://www.bbc.com/future/story/20180618-why-alcohol-affects-women-more-than-men

 

The Globe and Mail: What Canada’s doctors are concerned about with marijuana legalization

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 HEALTH REPORTER

As Justin Trudeau’s Liberal government tables its long-awaited marijuana legislation, Canada’s doctors have a message about pot: Just because it will eventually be legal, doesn’t mean it’s safe.

The Canadian Medical Association, the Canadian Psychiatric Association, the Canadian Paediatric Society and other organizations representing front-line health-care providers have been busy broadcasting their concerns about the ill effects of cannabis, especially for chronic smokers under the age of 25.

“We’re saying, ‘please keep the public-health focus front of mind as this legislation is unrolled,’ ” said Gail Beck, the clinical director of youth psychiatry at The Royal, a psychiatric hospital in Ottawa. “Lots of people think this is harmless.”

 

Explainer: Legal marijuana is coming but what does it mean for you?

The medical profession in this country has long had misgivings about medicinal marijuana – namely, that there is not enough solid evidence of pot’s efficacy in treating chronic pain and other ailments to warrant a doctor’s endorsement. But with the advent of legal recreational marijuana, doctors have a different set of worries.

 

Addiction

One top-of-mind concern: The potential for addiction to marijuana, especially among teens and young adults. “We know that 1 in 7 teenagers who start using cannabis will develop cannabis-use disorder, which is significant,” said Christina Grant, a professor of pediatrics at McMaster University in Hamilton.

Cannabis use crosses over into disorder territory when it begins to cause dysfunction in users’ day-to-day lives, derailing their commitment to school or work and sowing conflict in their families, said Dr. Grant, the lead author of the Canadian Paediatric Society’s position statement on marijuana, released last fall.

Mental illness

Cannabis has also been linked to certain mental illnesses. The drug’s relationship to depression and anxiety is still up in the air; the science has not established a causal relationship between the two. In other words, it’s not clear if people smoke pot because they are depressed and anxious or are depressed and anxious because they smoke pot.

There is stronger evidence that heavy use of cannabis can lead to psychosis, especially among people who have a family history of mental illness, Dr. Beck said. However, the vast majority of the research involved people who use cannabis daily. The scientific literature is virtually silent on the mental-health effects of smoking pot now and then.

“We don’t know the lower limit that’s safe,” Dr. Grant cautioned. “There’s no evidence to say, yeah, use it once, use it twice and nothing will happen.”

Please click to read full article https://www.theglobeandmail.com/news/national/what-canadas-doctors-are-concerned-about-ahead-of-marijuana-legalization/article34694165/?_cldee=bGlzYUByb2dvemluc2t5Lm9yZw%3d%3d&recipientid=contact-e551c9199c4ce8118147480fcff4b171-c6baefc24156457881db2feb4cfd508c

Report: Alcohol-related deaths in Canada increasing faster for women than men

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Amanda Colleta, CTVNews.ca
Published Thursday, May 31, 2018 10:00AM EDT

Alcohol-related deaths and hospitalizations in Canada are increasing at a faster rate for women than men, according to data released by the Canadian Institute for Health Information on Thursday.

The non-profit group found that from 2001 to 2017, the rate of women who died from causes linked directly to alcohol jumped a whopping 26 per cent. For men during that same period, the rate increased roughly 5 per cent.

Kathleen Morris, vice president of research and analysis at the CIHI, said in a statement that “it is troubling to see the rates for women increase so much faster than those for men.”

Historically, men have been far more likely to be hospitalized for alcohol-related reasons than women, but women “are catching up,” said Joseph Amuah, a senior researcher with the health system performance branch of the CIHI and an adjunct professor at the University of Ottawa.

Researchers with the CIHI don’t have a definitive explanation for what is driving the trend, but they note that Canada is not an outlier.

“One key thing to remember is that the hospitalizations entirely caused by alcohol indicator is only one indicator and that we just started looking at it in the past two years,” Amuah told CTVNews.ca.

“But if we look at this trend from the long-term side of things, this is part of a pattern that we are seeing globally.”

Girls aged 10 to 19 have already closed the gap with boys. While the rate of hospitalizations entirely caused by alcohol from 2016 to 2017 was 44 boys per 100,000, for girls of the same age, it was 69 per 100,000.

The research also found that the rate of hospitalizations caused by alcohol for females grew 3 per cent from 2016 to 2017 when compared to the previous year. For males, the year-by-year increase was less than 1 per cent.

Amuah said greater gender equality around the world, as seen in the workplace, may be extending to alcohol consumption. Women are drinking more heavily than in the past, he said, which means they’re also more exposed to health risks.

And because women’s bodies metabolize and process alcohol differently than men, they suffer a more pronounced response to heavy drinking and binge drinking than men, he added.

The CIHI’s data also found that for the second consecutive year, there were more hospital admissions in Canada for alcohol-related conditions than for heart attacks.

Nearly 80,000 Canadians were admitted for alcohol-linked conditions from 2016 to 2017, compared to 77,000 hospital stays for heart attacks during that same period.

Mental health and addiction-related conditions were responsible for early 75 percent of those alcohol-related hospital stays.

Amuah said policymakers should consider tighter rules on alcohol advertising. He argues that a comprehensive strategy similar to the one that targeted tobacco consumption is needed here, particularly to prevent the normalization of alcohol consumption among Canadian youth.

“It’s important not to rest on our laurels,” he said.

The CIHI’s data comes from an indicator called “hospitalizations entirely caused by alcohol,” which measures hospital stays linked to conditions such as alcohol poisoning, chronic alcohol abuse, liver disease, alcohol withdrawal, hepatitis and liver failure.

A study released by the group in 2017 cautioned that this indicator represents only “the tip of the iceberg of alcohol harm” because it excludes hospitalizations partially related to alcohol consumption such as heart disease or injuries stemming from drinking and driving.

Retrieved from https://www.ctvnews.ca/health/alcohol-related-deaths-in-canada-increasing-faster-for-women-than-men-report-1.3953066

In The News: CBC, IUD most effective birth control method, Canadian pediatricians declare

Intrauterine contraception is easily the most effective method of contraception, the Canadian Paediatric Society says. (Jay Directo/AFP/Getty)

 

Teen girls who are sexually active should be offered long-acting birth control such as an intrauterine device (IUD) as a first line of defence, the Canadian Paediatric Society says in a new position statement.

Pediatricians reviewed the benefits and risks of each method of birth control, which they will continue to do with patients.

“We’re saying that intrauterine contraception is easily the most effective method of contraception and so you should be talking about it,” said Dr. Giosi Di Meglio, an author of the statement and a member of the society’s adolescent health committee.

An IUD is a small, often T-shaped device placed inside the uterus by a doctor, nurse practitioner or nurse to prevent pregnancy. An intrauterine system (IUS) also has a hormone component. Both work continuously over years and can be removed at any time by a health-care provider.

In the late 1970s, concerns arose because it was thought that the IUD’s string, which comes out through cervix, could help bacteria get into the uterus and increase the risk of an infection.

A copper IUD costs about $60 to $100. (Craig Chivers/CBC)

 

“However, when they went back and analyzed the data again, they realized in fact that the string was not acting that way at all,” Di Meglio said an interview from Quebec City. “You’re just as likely to get a pelvic infection if you’re not using any form of birth control than if you’re using the IUD.”

A small risk of tissue perforation exists during insertion and there can be intense cramps immediately after the procedure and up to a few days after.

Putting the IUD or IUS front and centre in the list of effectiveness is an important change in practice, the society said. Members will continue to tell young people about the pros and cons of birth control options as part of the collaboration with patients.

The devices themselves cost the Quebec government’s prescription plan about $325 for the hormone-releasing system that lasts five years. People can buy copper-based IUDs for about $60 to $100.

An intrauterine system (IUS), which contains a hormone, lasts about five years and costs about $325. (Craig Chivers/CBC)

 

Many young women who are sexually active use birth control pills. Di Meglio said the pill works fairly well in studies with ideal conditions, but in real life, the number of failures is much higher.

About nine in 100 women who use contraceptive pills, a skin patch or intravaginal ring will have an unintended pregnancy, which Di Meglio called a lot for teens and their parents. Using a condom reduces the failure rate to two in 100.

Condoms are still the best protection against sexually transmitted infections and all youth are encouraged to always use them for that purpose.

For parents, the society suggests talking about sex and the emotional side of sexuality early and in small steps to encourage youth to ask questions.

Retrieved from http://www.cbc.ca/news/health/birth-control-iud-1.4684855

In The News: We’re separating babies from their teenage mothers in care, perpetuating a never-ending cycle

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Elizabeth Wall-Wieler – for CBC News

There is a well-known connection between teen pregnancy and child protection services. Girls who spend time in the care of child protection services have higher rates of teenage pregnancy, and teenage mothers are more likely to have their child taken into care.

Teenage mothers who give birth when they are in out-of-home care (e.g. foster care, kinship care) are also more likely to have their children taken into care.

Until recently, we didn’t know how often this happens. It turns out, it is all too common.

In a recently published study in Pediatrics, my colleagues and I followed the children of 5,942 teenage mothers in Manitoba up to their second birthday to see how many were placed into care. We found that among teenage mothers who were themselves in care when they gave birth, 49 per cent of their children were placed into care before their second birthday, with 25 per cent being placed in care in their first week of life.

For teenage mothers who were not in care when they gave birth, 10 per cent of their children were placed in care before age two (2.5 per cent were placed in their first week of life).

This means that teenage mothers who were in care when they gave birth were more than 11 times more likely to have their child placed in care in their first week of life, and more than seven times more likely to have their child placed in care at any point before their child’s second birthday.

Even though all teenage mothers are at high risk of having their child placed in care, why are teenage mothers who give birth while in care at a significantly higher risk?

Young women in foster care face many challenges and often lack the financial and parenting supports provided to teenage mothers by their families. Although becoming a mother can be a joyful time and can give young women an opportunity to create a family that they may not have had, parenting while in care comes with additional challenges. These young mothers often feel like they are under constant scrutiny by their social workers and are always needing to prove to everyone that they are able to parent.

Keeping mothers with babies

Placement in care within the first week of life is sometimes associated with substance use by the birth mothers, which is more prevalent among adolescents in care. However, evidence shows that treatment for substance use disorder is less successful when women are separated from their children.

Programs such as Portage’s Mother and Child Program in Montreal have found success by providing accommodations for mothers and their children in their rehabilitation program. More such facilities should be made available across Canada.

When a child is placed in care, the government takes on the role of surrogate parent to that child. But by separating a quarter of young mothers from their infant within the first week of life, and almost half before the child turns two, the government is failing in its role of surrogate parent, and in these cases, surrogate grandparents.

A much greater emphasis needs to be put on dual placements – whenever possible, mothers and children should be placed together. This ensures that mothers and children have the chance to bond. This should be supplemented with specific supports to mothers (e.g., financial, housing, child care and education) to assist young mothers in their transition to motherhood.

In general, we know that most children are placed in care due to neglect, not due to abuse. Dedicated funds for prevention, as well as support workers committed to working with mothers and their children in this period of transition, can help to address that.

Our study used data from Manitoba, which has the highest rate of children in care among the provinces. However, this is not an issue that is limited to Manitoba. Canadian provinces with relatively low rates compared to other provinces still have higher rates of children in care than many other countries, and Indigenous children are hugely overrepresented in the child welfare system across the country.

The tireless work of many children’s advocates has resulted in a renewed effort to address challenges in the Canadian child welfare system, specifically in Indigenous communities. Failing to support young mothers who are in care is contributing to what has become known as “the millennial scoop,” sadly analogous to the systematic removal of children in the Sixties Scoop.

To prevent this cycle of involvement in care from continuing, the child welfare system needs to put in place dedicated resources (money and support workers) to help families stay together. Let’s make sure that these families get the support they need to ensure they are the last generation with this experience.

This column is part of CBC’s Opinion section.

Retrieved from https://www.cbc.ca/amp/1.4681539

In The News: Township trauma: the terrible cost of drinking during pregnancy (The Guardian)

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Mentors helped Veronic Blom stop using alcohol and crystal meth when she was pregnant with her youngest son. Photograph: Kate Hodal for the Guardian

In a dusty township in South Africa’s sun-drenched wine country, Charay Afrika says only one thing helped numb her through a turbulent relationship and two pregnancies: alcohol.

She drank all day, every day, throughout her full-term pregnancies – unaware of the effect alcohol could have on her children.

Afrika was still at school when she met her first boyfriend, a man who would go on to beat her and rob her at gunpoint multiple times before she finally escaped him. “He’d beat me and lock me in the house with no food and then disappear for days,” Afrika, 28, says quietly. “I once had to drug him with sleeping pills so that I could call the neighbours and beg for help to sneak out. But he found me again and robbed me at gunpoint, and the whole thing started all over again. I drank as a way of escaping it all. I drank the whole time. I didn’t stop.”

Now eight years old and at school in Roodewal township, her eldest child has learning difficulties and behavioural problems – telltale signs of foetal alcohol syndrome (FAS), a condition under the broader umbrella of foetal alcohol spectrum disorder (FASD), which can manifest in birth defects such as brain damage, physical and mental impairments and stunted growth. It is directly caused by the mother’s drinking during pregnancy.

FAS affects more children in South Africa than anywhere else in the world: prevalent in 111 per 1,000 children, a rate 14 times higher than the global average of 7.7 per 1,000, according to the American Medical Association journal JAMA Pediatrics. But even this estimate may be lower than the true figure, say social workers in the Western Cape, as FAS is often a “hidden disability” that can affect a child in a number of ways, not all immediately obvious to parents or doctors.

“It’s a development issue,” says Sudene Jeftha, a social worker with FASfacts, an NGO based in Worcester. “You can’t necessarily see it when the child is born, only later when the child isn’t talking or crawling or walking like other children.”

The condition is endemic in the Western and Northern Cape, where high levels of unemployment, alcohol and substance abuse and teen pregnancies are intrinsic to daily life. In high-risk rural areas, up to 72% of school-age children are believed to suffer from FAS. Experts point to the 200-year-old dop system, in which Afrikaner farmers pay black and mixed-race workers in wine, or dop, as the primary cause of the regions’ high prevalence of alcoholism. Although the system was outlawed long ago, as many as 20% of vineyards are estimated to still pay their workers in wine, and binge-drinking in the Western Cape is a major health concern.

There is no concerted national health effort to tackle the issue, nor have there been any government studies to measure the socioeconomic impacts. But in a country where as many as six million people are thought to be affected by FASD and an additional three million are thought to have had foetal alcohol exposure, comparisons with other nations come in handy. In the UK, research has shown that it costs £2.9m to raise a child with FASacross their lifespan, while a Canadian study found that FAS youths were 19 times more likely to end up in jail than their peers.

A number of NGOs, including FASfacts, now run courses in at-risk communities to spread awareness of the condition, as well as “mentor mother” programmes, which rely on local mothers going door-to-door to speak to pregnant women about drinking. FASfacts, founded in 2002 by François Grobbelaar (an Afrikaner whose father used to pay his farmworkers in dop), claims this approach has helped reduce the number of pregnant women who drink by as much as 84%.

Veronic Blom, 33, drank and used tik (crystal meth) throughout her first two pregnancies. She was approached by one of FASfacts’ mentor mothers and stopped using both during her third pregnancy. Blom is now a mentor mother herself. “I smoked heavily – heavily – for the whole nine months of the pregnancy,” she says of her second child, now aged two. Making a rectangle with her thumb and forefinger, she indicates the size of a full gram of meth. “I’d smoke the full packet and smoke the whole day. I can only thank God he wasn’t born with any problems with his face.”

From the corrugated-iron shack in the Esselen Park township she shares with her two youngest children, Blom says the programme has changed her for the better. “I’m very talkative and I like to give back and speak to other mothers,” she says. “I usually tell them my own story so they know they don’t have to use their stories as an excuse: they can do better. The women are mostly keen to do better, but teenage pregnancy here is very common, you know, women selling their bodies to buy drugs or food.”

Please click to read full article https://www.theguardian.com/global-development/2018/may/27/mothers-children-foetal-alcohol-syndrome-south-africa?CMP=share_btn_tw

In the News: CBC, Pregnant women asked to avoid cannabis in face of poor research

Nurse, doctor worry use of the soon-to-be-legal drug will exacerbate existing problems

The Society of Obstetricians and Gynaecologists issued a warning this month to people of child-bearing age, or who are pregnant or breastfeeding, stating that THC can enter the placenta and breast milk. (Frederic J. Brown/AFP/Getty Images)

 

Alberta medical professionals are warning that the upcoming legalization of cannabis may exacerbate the province’s problem of premature and low-weight infants.

Alberta has the highest rate of premature infants, as well as low-weight births, in the country, according to new data from the Canadian Institute for Health Information.

The stubborn statistic has barely budged, despite medical professionals trying to improve infant and maternal health, said Dr. Duncan McCubbin, an obstetrician based in Medicine Hat, Alta.

He said the upcoming legalization of cannabis is being touted as safe and may lead to more women using it during pregnancy.

“I’m extremely worried about the babies and the next generation of premature babies that are going to come in the next five to 10 years in the province in Alberta,” he said.

At issue is the research surrounding the medical safety of cannabis for pregnant women and infants, which has not met the “gold standard” of randomized studies of the effects.

And ethically, he said, such tests are hard to run while avoiding harm to participants or their fetuses.

‘Just don’t have the evidence’

A lack of evidence to the contrary does not mean that cannabis is safe. Early studies suggest carrying parents and their infants could potentially be harmed.

“We really have still not been able to solve the problem of premature babies, and we do know the risk factors, including smoking, lower socioeconomic class,” he said. “We just don’t have the evidence that cannabis use is not going to make that worse.”

The Society of Obstetricians and Gynaecologists issued a warning this month to people of child-bearing age, or who are pregnant or breastfeeding.

It said most people believe no harm could come from consuming cannabis while pregnant, but the organization warns the psychoactive component, THC, can get into the placenta and breast milk, which nurture fetuses and infants.

Click to continue reading article http://www.cbc.ca/news/canada/calgary/pregnant-women-alberta-cannabis-1.4643013

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