Category Archives: Resources

Licit and Illicit Drug Use during Pregnancy: Maternal, Neonatal and Early Childhood Consequences

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Non-medical abuse of drugs can occur at any stage of life. When such exposure occurs during pregnancy and in the postnatal phase, it raises understandable concern about the impact on the health of the mother and child, as well as possible longterm consequences for brain development in the new infant. As individuals our concerns are immediate and heartfelt, and yet as a society we have in many respects turned a blind eye to this tragic state of affairs. Women in the greatest need, arising in part from a dependency on illicit drugs, often have limited options for the long-term care they require.

We can hope that publications such as this Substance Abuse in Canada report, which summarizes new and sophisticated research and clinical developments concerning maternal, neonatal and early childhood consequences of drug use during pregnancy, indicate that the tide is turning. Thanks to the efforts of a new cohort of researchers who appreciate the complex biological and social factors that give rise to addiction, there are real prospects for a much better scientific understanding of addiction as a chronic disorder that requires new and integrated treatment strategies for it to be addressed effectively.



Planning for Change, Facilitator Guide: Workshop for First Nations Women about FASD Prevention and Skills for Change – Booklet


Click to download

This resource was developed to guide facilitators in planning and presenting a workshop about Fetal Alcohol Spectrum Disorder (FASD) prevention and skills for change for First Nations women.

The workshop includes information about: • Alcohol use during pregnancy and FASD. • Self-care. • Ways to improve health. • Supports for health changes.

Prenatal alcohol exposure is the leading preventable cause of brain damage and developmental disability. Alcohol use during pregnancy may result from lack of awareness of the risks, unplanned pregnancies, social norms around alcohol use, addiction, inter-generational trauma, sexual abuse, as well as other interacting factors such as mental health concerns, substance use, poverty, and lack of resources.

Awareness is growing in Canada about First Nations health issues such as high levels of poverty, stress, chronic disease, disability, sexual abuse, suicide, homelessness, family violence, etc. Loss of traditional values, language, and family/community kinship due to colonization, residential schools, and other historical events have seriously affected the physical, emotional, mental, and spiritual health of First Nations in Canada. There are ongoing impacts on reproductive health and parenting, for example FASD.

Pregnancy and motherhood can be times of renewed hope and strength to make important health changes for women and for the future generations.


2nd Floor Women’s Recovery Centre


The 2nd Floor Women’s Recovery Centre is operated by the Lakeland Centre for Fetal Alcohol Spectrum Disorder in Cold Lake, AB. This is a unique long term residential alcohol/drug treatment program exclusively for women. Our mission at the 2nd Floor is to help women break the cycle of addiction and to reduce the number of babies born prenatally exposed to alcohol and other drugs.

The program is available to women who are 15 years of age and up from anywhere across Canada. Our target group is women who are pregnant or at risk of getting pregnant and have alcohol or substance use issues.

Women who are interested in attending the 2nd Floor for treatment do not need to have a FASD diagnosis. A woman may make an application anytime, and may be asked to attend detox prior to admission to the program. Prospective clients on a methadone or suboxone program are accepted on a case-by-case basis.

The minimum stay is 28 days to a maximum duration of 6 – 7 months. The program offers each woman a private room with shared washroom facilities and common rooms. At the 2nd floor, each woman will have regular access to the Addiction Counsellor, a Case Coordinator, a Career & Life Readiness Programmer, a Registered Nurse, a Physician, and other community service providers.

We are unable to provide support or accommodations for the women’s partner or children. Anyone can make a referral to the program. The Minister of Human Services has added the 2nd Floor Women’s Recovery Centre to the list of addiction treatment programs in Alberta that is eligible for funding. There is a $40 daily rate that can be covered by a variety of funders, please talk to us about the options. The program can also accommodate women who are mandated by the courts.

For more information, contact us at: 780.594.9903

or visit our website at: 

Thank you, Paula Dewan, BSW, RSW Residential Supervisor 780-594-9903

Honouring Our Strengths: Culture as Intervention in Addictions Treatment

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Drug addiction among Indigenous peoples is a serious health concern in Canada. A group of researchers and addiction treatment service providers through the University of Saskatchewan are involved in a project to evaluate the effectiveness of First Nations culture as a health intervention in alcohol and drug treatment.

The research team is working with 12 National Native Alcohol and Drug Abuse Program (NNADAP) and Youth Solvent Addiction Program (YSAP) treatment centres across the country.

The research questions are:

1. What are the indicators of healthy client wellness as an outcome of participation in traditional Indigenous cultural interventions while in treatment for problematic substance use?
2. Drawing on this understanding, what is the validity of a culturally competent instrument developed to measure change in wellness among clients in treatment for problematic substance use?

Take a look at a brief video clip introducing the project here.

The project team is using a ‘Two-Eyed Seeing’ lens to guide the course of evidence gathering and assessment. The use of Two-Eyed Seeing originated with Mi’kmaq Elders Murdena and Albert Marshall. Two-Eyed Seeing involves a weaving back and forth to integrate and connect the best of Indigenous and Western knowledge systems with the purpose of co-learning, generating, understanding, and finding solutions to urgent problems (see an article on this topic here).

You can take a look at a powerpoint presentation called “Culture as Intervention in Addictions  Treatment: Appreciating the Evidence within Indigenous Knowledge” that the team did recently at the Chiefs of Ontario Health forum here (the list of cultural interventions below is from this presentation).

Pages from NAT CasI 2014

Another (fun) outcome from the project is a series of 12 recipe cards. Traditional foods are an important way to connect with culture and the team wanted to showcase some of the food knowledge that has been shared with them across the country.


Visit the project website here.

For more on culture and healing from addiction, see earlier posts:

Retrieved from:

Thunder Bay’s Family Health Program publishes research report for preventing alcohol-exposed pregnancy

thunder-bay-report-coverAs part of the work of the Family Health Program, the Thunder Bay District Health Unit has published results from a research project on best practices to preventing alcohol-exposed pregnancy. Alongside reviewing literature, they looked at practices both in their health unit and among local community programs and services, and at provincial public health standards.

Seven over-arching themes were identified for a multi-pronged approach to preventing FASD:

1.  Population Health Surveillance
2. Public Awareness
3. Public Programs
4. Education for Health Care and Social Service Providers
5. Screening and Intervention by Health Care and Social Services Providers
6. Partnerships
7. Policy/Government Directives (1)

The report targets gaps to be addressed within each of these themes. As an example, within “Public Programs” there is a call to expand or develop programming that is culturally based and that includes women’s partners, and within “Education” to replace generalized training and education with approaches that target specific provider needs.

The authors caution readers not to “dilute the alcohol and pregnancy focus” when incorporating recommendations into existing service structures, and stress that additional research and evidence of programming, policy, and partnerships is needed.

Download the full report here to read more about their research methods, findings and recommendations, and to explore linkages with the Ontario Public Health Standards for reproductive health.

  1. Thunder Bay District Health Unit, Family Health Program. (2016). Effective interventions and strategies to prevent alcohol-exposed pregnancies. Thunder Bay, ON.

Retrieved from:

Alberta’s DrinkSense

Alberta’s DrinkSense

In Alberta, alcohol is so much a part of social events that it is not usually thought of as a drug. However, alcohol is a drug and it is the drug used the most in Alberta. 76% of Albertans drink alcohol. However, the good news is the large majority drink responsibly. The proportion that drink harmfully varies by age group.


For more information take a peak at the Alcohol and Health, Alcohol and Alberta booklet, click to download!


New Curriculum for FASD Informed Practice

New Curriculum for FASD Informed Practice

The College of New Caledonia (CNC) has developed a FASD-informed training curriculum to support their FASD informed guide and in response to the expressed needs of three national programs supported by the Public Health Agency of Canada (PHAC) that focus on healthy birth outcomes and healthy outcomes for children.

FASD Trauma Informed guide“Facilitating a Collaborative, Strength-based Approach to FASD Informed Practice:  Western Region BC” was developed following consultations with workers in The Community Action Program for Children (CAPC), the Canada Prenatal Nutrition Program (CPNP), and Aboriginal Head Start (AHS in BC). Workers and administrators wanted help in adjusting their practice of working with women, children and families to include FASD-informed approaches.

These trainings were delivered on-site to approximately 350 people during 2014-2016. Developed by Anne Guarasci and Barb Durban with funding from PHAC, the curriculum, in the form of PowerPoint presentations, has been refined for distribution and consists of three separate presentations each with a particular focus, but all include a primer on FASD including current diagnostic terminology.

1. “Supporting Marginalized Parents who may have FASD” — This presentation focuses on what causes FASD, how it is diagnosed, and who is at risk; the complex nature of prevention and why a holistic, relational approach is required; behavioural and cognitive cues that may indicate FASD; and, the fundamentals of an FASD-informed practice.

Empower guide2. “Strategies and Structures for Supporting Marginalized Women and Families who may have FASD” — Participants explore practices and communication skills that empower and support clients and build relationships; examine individual and agency perceptions, policies and structures in order to reduce barriers to relationship and services for clients; and, develop FASD-specific communication strategies. Client “compliance” issues are re-examined within the context of brain functioning. FASD diagnostic terminology and pathways to access assessment and diagnosis are reviewed.

3. “FASD Prevention” — Using a FASD-informed approach as described in CNC guides (1,2) and the work of Deb Rutman (3), this training builds on the 4 levels of prevention of FASD in Canada (4): awareness and health promotion; brief counseling with women and girls of childbearing age; specialized prenatal support; and postpartum support.  How FASD-informed and trauma-informed approaches overlap is explored along with many strategies for working with women, including those who may have FASD, such as building relationships and reducing barriers through reflective practice, Motivational Interviewing, harm reduction, and individualized services.

The FASD-informed practice training curricula is intended for training of program coordinators and administrators, new frontline workers and seasoned workers who may benefit from a refresher. A year-long evaluation of the training was conducted by Deborah Rutman, and the results will be available for presentation in this blog space, in the next few months.

Retrieved from:

For more about FASD-informed work, see earlier posts:


  1. Guarasci, Anne (2013). FASD Informed Practice for Community Based Programs. Burns Lake, BC: College of New Caledonia – Lakes District Campus.
  2. Guarasci, Anne (2011). Empowering Front-Line Staff and Families Through a Collection of Lived Experiences: Supporting Women Who Have Fetal Alcohol Spectrum Disorder (FASD) Behaviours and Characteristics and/or Other Related Disabilities. Burns Lake, BC: College of New Caledonia – Lake District Campus.
  3. Rutman, D. (2011). Substance using women with FASD and FASD prevention: Voices of women with FASD: Promising approaches in substance use treatment and care for women with FASD. Victoria, BC: University of Victoria.
  4. Poole, Nancy A. (2008). Fetal Alcohol Spectrum Disorder (FASD) Prevention: Canadian Perspectives. Public Health Agency of Canada: Ottawa, ON.
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