Standards for Preventing Problematic Substance Use: Youth

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Effective prevention does not necessarily mean working harder, but can be achieved through focusing resources on community needs and evidence-informed practices, and linking with other initiatives in the community.

In partnership with the Canadian Standards Task Force, CCSA developed a Portfolio of Canadian Standards for Youth Substance Abuse Prevention. The Canadian Standards provide teams with guidance — based on the best available evidence — on how best to plan, select, implement and evaluate their prevention efforts. The Canadian Standards were a foundational piece used by the United Nations Office on Drugs and Crime to develop the International Standards, released in March 2013.

The Canadian Standards are designed to support prevention teams in planning, implementing and evaluating their initiatives. They provide:

  • A common benchmark for excellence;
  • Support and guidance to pursue continuous improvement;
  • Flexibility to adapt to different regional contexts or populations; and
  • Practical resources and examples to support change.

The rationale behind standards for youth drug use prevention

  • Youth are more likely than adults to engage in risky substance use and to experience greater harms from that use.
  • Applying the Standards helps ensure that prevention initiatives are successful and informed by the latest quality evidence.
  • Drug use prevention works. Read A Case for Investing in Youth Substance Abuse Prevention.

The Canadian Standards Portfolio

Developing the Canadian Standards

These resources were developed by a task force of experts following extensive cross-Canada consultations with prevention and education specialists, drug awareness police officers, clinicians, community outreach workers, researchers, policy analysts, senior managers in addiction agencies and health departments, teachers, school administrators and other key stakeholders.

Discover how some of our partners use the Canadian Standards.

Contact us at youth-jeunes@ccsa.ca to let us know how the Canadian Standards are working for you and if you have suggestions for new tools or resources

DRINKAWARE: Mocktails Made Easy

Creating alcohol-free drinks with party appeal is easy. Choose a delicious mocktail from the tutorial videos below and let an expert mixologist walk you through how to prepare it.

If you’re heading out rather than staying in, many pubs, restaurants, and bars should offer a mocktail menu. And if they don’t, try ordering a ‘virgin’ version of your favourite cocktail from the bartender – one without alcohol.

Lime Rickey

Legend has it that this kissing cousin to the mojito was invented by Colonel Rickey, a nineteenth-century English officer posted in Washington. For a seasonal twist, try making with crushed ice. Either buy some ready made from your local off licence, or take a rolling pin to a bag of ice in the kitchen.

The Real Shirley Temple

For a spot of film star glamour at your annual drinks do, try this Hollywood classic. Apparently, it was first served to the young starlet by a barman in Beverley Hills when she first hit the big-time. If you’re not a fan of ginger ale, try it with lemonade instead.

Virgin Mary

This non-alcoholic version of the classic Bloody Mary is a tomato juice drink that you can sip all day and night. For best results, use top quality tomato juice for a rich and authentic taste. It’s also a healthy choice for breakfast.

Sparkling Pom Collins

The Tom Collins is honoured by mixologists around the world as the granddaddy of all modern cocktails. The recipe was first written down in 1876, but this contemporary non-alcoholic version puts a new twist on an old favourite.

Ginger Limeade

Ginger limeade is a deliciously sweet ‘n citrusy mocktail and its sophisticated bite makes it a great choice to keep your guests warm and cosy when the temperature is dropping outside. For best results, cut the ginger as fine as you can so that its natural warmth infuses the whole drink.

Retrieved from https://www.drinkaware.co.uk/advice/how-to-reduce-your-drinking/how-to-cut-down/mocktails/

 

Fetal Alcohol Disorder May Be More Common Than Previously Thought

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By AMANDA MACMILLAN

For more, visit TIME Health.

 

In a new JAMA study of more than 6,000 first-graders, researchers estimate that between 1.1% and 9.8% of American children have developmental or neurological problems caused by fetal alcohol spectrum disorders (FASDs)—a significantly higher number than previous studies have reported. And out of the hundreds of children determined in the study to have FASD, only two had been previously diagnosed.

The estimate comes from school-based assessments, family interviews and in-person evaluations of 6- and 7-year-olds in four communities across the country: one in the Midwest, one in the Rocky Mountains, one in the Southeast and one in the Pacific Southwest. Previous studies, which have estimated the rate of FASD to affect just 1% of children, involved smaller groups of people from single communities or from people in doctors’ offices, say the authors of the new study.

FASD is an umbrella term for health abnormalities caused by exposure to alcohol in the womb; it includes fetal alcohol syndrome, partial fetal alcohol syndrome and alcohol-related neurodevelopmental disorder. FASDs are a leading cause of developmental disabilities around the world, and people with these conditions can experience growth deficiencies, facial abnormalities and organ damage. They often have physical, cognitive and social challenges throughout life, and have an increased risk of premature death.

Before the current study began, researchers established standardized classification criteria for FASD based on facial features, growth, and neurodevelopmental performance. Using that criteria, they then screened a random sampling of first-graders in public and private schools in the four chosen regions, and interviewed the children’s mothers and other close relatives.

Based on their findings, the authors determined that FASD affected between 11 and 50 out of every 1,000 children they examined. That translates to between 1.1 and 5%, which they say is a conservative estimate: It assumes that no additional FASD cases would be found in children in those communities that hadn’t participated in the study.

When the researchers used a statistical technique assuming that the rate of FASD in children who were evaluated would be the same in all first-graders in those communities (more than 13,000 children total), the estimated FASD rate was even higher—ranging from 3.1% in the Southeastern group to 9.8% in the Rocky Mountain group.

TO READ MORE VISIT: http://time.com/5134900/fetal-alcohol-syndrome/

‘Pinking’ of alcohol marketing spurs culture of ‘wine moms,’ says author Ann Dowsett Johnston

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When it comes to women and drinking, sometimes a glass of wine isn’t just a glass of wine, says journalist and author Ann Dowsett Johnston.

“Wine has become the code for ‘I deserve it, parenting is hard, I need to decompress,'” says the Toronto-based author of Drink: The Intimate Relationship Between Women and Alcohol.

That’s also led to the concerning rise of the culture of “wine moms,” Johnston says, with wines featuring names like “Girl’s Night Out” or wine glasses with “Mom Juice” written on them.

“You see mommy wine festivals … you see moms and yoga and wine [events], you see painting and wine, you see mani-pedis and wine.… I would argue that most women see wine as a food group and as a decompression tool,” she said.

“There’s an enormous sense of self-medication.… The fastest thing you can do at the cutting board is open a bottle of wine, pour yourself a glass. It’s faster than going to your doctor to say ‘I’m suffering from burnout,’ it’s faster than going to a yoga class and relaxing in a different way.”

It was more than 10 years ago when Johnston finally realized that she herself had a drinking problem.

“I got into trouble with alcohol in my 50s when I was over-performing at a job and used alcohol for self-medication,” she said.

Even though Johnston knew she was getting into trouble with her drinking, “it took two family members and a sweetheart who confronted me, and luckily I took a sledgehammer and went to rehab and I’m in my 10th year of sobriety,” she said in an interview with CBC’s Information Radio.

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‘In Canada, we’ve seen a statistically sturdy increase’ in women’s drinking since the early 2000s, says Johnston. (anndowsettjohnston.com)

Johnston’s experience not only led her to rehab and sobriety, it also gave her insight into the connections between women and alcohol, which she discusses in Drink.

Men still consume more alcohol than women, according to the Liquor and Gaming Authority of Manitoba, but Johnston said there has been a recent rise in how much women are drinking.

“Women are drinking far more than they used to.… In Canada, we’ve seen a statistically sturdy increase” in women’s drinking since the early 2000s, said Johnston.

‘Mom can’t cope unless she’s drunk’

She believes that one of the biggest contributing factors to the rise of drinking among women has been marketing.

There’s been a “pinking” of the market since the mid-1990s, Johnston said, with the invention of “alcopop,” drinks like Mike’s Hard Lemonade and Smirnoff Ice that are typically marketed to women — “what I like to call ‘chick beer’ or ‘cocktails with training wheels,’ an attempt to get the female gender to keep up with men.”

But that kind of marketing hasn’t focused only on fruity-tasting drinks for women, said Sheri Fandrey, who heads up the Addictions Foundation Manitoba’s knowledge exchange services. Many other products besides alcohol are marketed to women by using their own insecurities, she said.

‘[Children] are picking up on the fact that their parents, especially their moms, have to be anaesthetized to deal with them, and I think that sends a subtle but dangerous message to our young people.’– Sheri Fandrey, Addictions Foundation Manitoba

“We’re being influenced and manipulated in such subtle ways that we see it more as fun and a joke, and don’t realize that it is actually shifting people’s behaviour,” she said.

But there are some unintended consequences that come with marketing wine to mothers, says Fandrey — while the marketing might be intended for them, the parents aren’t the only people who see it.

Children also see and hear those messages, and get the impression that their mothers have to drink to deal with them, she says.

“[Children] are picking up on the fact that their parents, especially their moms, have to be anaesthetized to deal with them, and I think that sends a subtle but dangerous message to our young people — ‘Mom can’t cope unless she’s drunk,'” Fandrey said.

“It’s giving adults the sense that we can’t possibly cope with the stress and certainly can’t cope with child-related stress without alcohol, and for the kids, they’re picking up on it,” says Fandrey.

Binge drinking

Using alcohol as a nightly coping mechanism is not the only drinking habit that is on the rise, she says — there’s also been a rise in risky drinking behaviour, like binge drinking.

“It used to be the realm of men to get stupid drunk and to do really foolish things under the influence,” but now women are starting to engage in that kind of dangerous drinking, Fandrey said.

Heavy or binge drinking is defined as having several drinks in one sitting: five or more drinks for a male, and four or more for a female, at least once a month in the past year.

According to Statistics Canada, in 2013, nearly 25 per cent of Canadians males and 13 per cent of females over age 12 reported heavy drinking.

Fandrey believes this type of drinking is still a way to cope with a stressful life, but with a “save it for the weekend” mentality.

‘If you want to know if you’re getting into trouble, ask yourself … are you drinking to numb? To numb feelings, to numb stress, to numb depression or anxiety?’– Ann Dowsett Johnston

“When people tell me what their reasons are for using substances like alcohol, you know, it makes sense in the short term for someone who’s feeling anxious and stressed to have that slight sense of numbness. There is a short term anti-anxiety effect from alcohol,” she said.

In the long term, though, alcohol contributes to depression, she said.

“It all seems OK, and there seems to be benefits and you don’t really look beyond that into what it might add up to in the weeks and months and years.”

There are very real dangers to physical health as well, says Johnston.

“We pay a lot of attention to the opioid crisis in Canada, and so we should, but the truth of the matter is more people are dying of alcohol every year than any drug overdose.”

Johnston also says not everyone who has a drinking problem will be able to see it.

“If you want to know if you’re getting into trouble, ask yourself two things: are you drinking to numb? To numb feelings, to numb stress, to numb depression or anxiety?” she said.

“And secondly, if you kept a drinking diary and said ‘tonight I’m only going to have one or I’m going to have zero,’ could you keep your promise? If you can’t you should really talk to your doctor and have a hard look at your drinking.”

CBC News Retrieved from http://www.cbc.ca/news/canada/manitoba/ann-johnston-women-wine-moms-1.4517510

Alcohol Use Disorder

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Health experts are drawing attention to women reaching for a drink to take the edge off after analysis shows they may be consuming more alcohol.

The National Institutes of Health highlights a trend that has women closing in on the gender drinking gap.

“Men drink more than women, but the gap is shrinking,” said Dr. George Koob, Director of the National Institutes of Alcohol Abuse and Alcoholism.

The NIAAA cited a 2015 study led by Aaron White, Ph.D., NIAAA’s senior scientific advisor to the Director. The organization said longstanding differences between men and women in alcohol consumption and alcohol-related harms might be narrowing within the nation.

The analysis reviewed data including current drinking, number of drinking days per month, reaching criteria for Alcohol Use Disorder”, or AUD, and driving under the influence of alcohol over the past year.

The NIAAA says the data shows a narrowing gap for females and males between 2002 and 2012. The data shows the percentage of people who drank alcohol in the previous 30 days increased for females from 44.9 percent to 48.3 percent, but decreased for males from 57.4 percent to 56.1 percent.

The NIH indicated more than 5 million women live with AUD. Doctors say the line can be murky between the health benefits of a nightly glass of wine and the amount that could catalyze habits with consequences. While many women in central Ohio may not be diagnosed with AUD, they may say ‘yes’ to an evening treat of “mommy juice”.

“That’s meant to describe alcohol, but in a way that it fuels you,” explains Columbus resident Shelby Fulton. “Coffee is your morning ‘mommy juice’ and in the evening you have a glass of wine to decompress. And if you’re stressed out you’re not going to be the best version of the mom you want to be. It helps you relax. There’s nothing wrong with that.”

Dr. Koob agrees that one glass may not be a problem, but calls for women to take note of the quantity of consumption.

Alcohol Use Disorder includes people who find it difficult to stop or control alcohol use. Doctors say women sipping more than either three drinks per day or seven drinks per week are at risk.

“When you start exceeding those levels you’re pushing the envelope for problems associated with alcohol,” said Koob.

To assess whether you or loved one may have AUD, here are some questions to ask. If you answer yes to any of these, doctors suggest you speak to a professional.

In the past year, have you:

  • Had times when you ended up drinking more, or longer than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking? Or being sick or getting over the aftereffects?
  • Experienced craving — a strong need, or urge, to drink?
  • Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  • Continued to drink even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
  • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
  • Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

Resources:

Researchers found women may have to consume more alcohol than men to trigger the reward center in the brain. To learn more about this study, click here.

To learn more about AUD and growing trends, click here.

Retrieved from https://www.10tv.com/article/alcohol-use-disorder-new-diagnosis

28 FASD Facts for Health Professionals

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http://www.nofasd.org.au/announcements/28-fasd-facts-for-health-professionals

28 FASD Facts for Health Professionals

1. Alcohol is a teratogen that readily crosses the placenta and damages the central nervous system and other organs and may impair prenatal and postnatal growth (Fitzpatrick & Pestell, 2016)

2. When a mother consumes alcohol during pregnancy, the blood alcohol of the fetus is the same or higher than the mothers (Bower & Elliott, 2016)

3. In the absence of facial dysmorphology, FASD is commonly underdiagnosed and mis-diagnosed as Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder and Conduct Disorder (Stevens, S., Nash, Koren, & Rove, 2013).

4. Only 41% of allied health and medical professionals are confident in asking about alcohol use during pregnancy which contributes to the under-diagnosis of FASD (Payne, Elliott, Bower et al., 2005).

5. FASD is recognised as the leading preventable cause of birth defects and developmental and learning disability worldwide (Mather, Wiles & O’Brien, 2015).

6. 92% of individuals living with FASD will have a co-occurring mental illness, with depression and suicidal ideation being the most common (Thanh & Jonsson, 2016)

7. 50% of Australian women will experience an unplanned pregnancy, leaving the chance of alcohol exposed pregnancies very high (Australian Medical Association, 2016)

8. The ‘spectrum’ of birth defects is due to the quantity of alcohol consumed, how frequently it was consumed and the timing during the gestation of the pregnancy it was consumed (May & Gossage, 2011).

9. Rates of alcohol use, binge drinking and drinking during pregnancy are increasing in young Australian women (Elliott, Payne, Morris, Haan & Bower, 2008).

10. The National Health and Medical Research Council and World Health Organisation advise to abstain from drinking alcohol during pregnancy and breastfeeding (NHRMC, 2009; World Health Organization, 2014)

11. The 3 sentinel facial features for FASD (thin upper lip, smooth philtrum, short palpebral fissure length) are specific to alcohol exposure and do not vary by race, age or gender (Moore et al., 2007).

12. Women have articulated that peer pressure & not wanting others to know they are pregnant, insufficient education and the enjoyment of alcohol as reasons they felt giving up alcohol during pregnancy would be hard (Tsang & Elliott, 2017).

13. Life expectancy at birth for people with FAS is 34 years old with the leading cause of death being suicide (Thank & Jonsson, 2016).

14. 83% of individuals living with FASD do not display facial features (Aros., et al, 2012)

15. 1/3 women are unaware of the dangerous effects alcohol has on a developing fetus (Paedon, Payne, Bower, Elliott et al., 2008)

16. Problems that emerge in childhood do not disappear with age, but rather form the development of additional and possibly more severe disorders later in life (Pei, Denys, Hughs & Rasmussen, 2011)

17. The risk of developing early onset (13-17 years) alcohol abuse disorder was two times higher in those exposed to 3 or more standard drinks in early pregnancy (Alati et al., 2006)

18. Facial dysmorphology only occurs when alcohol is consumed during the first trimester (Feldman et al., 2012)

19.  81% of individuals living with FASD will have a language disorder (Popova et al., 2016)

20.  Children living with FASD are three times more likely to experience gross motor impairment than those without FASD. The most common gross motor deficits children experience is balance, coordination and ball skills (Lucas et al., 2014)

21.  FASD occurs in all cross-sections of society, wherever there is alcohol there is FASD (Fitzpatrick & Pestell, 2016).

22. High socio-economic status is a strong predictor for alcohol use (McCormack, Hutchinson, Burns, Wilson, Elliott, Allsop, Najman, Jacobs, Rossen, Olsson & Mattick, 2017).

23.  There is no threshold for prenatal alcohol exposure required for diagnosis of FASD (Bower & Elliott, 2016)

24. 1 in 4 pregnant women continue drinking during pregnancy, & of these, 96% report drinking 1 or 2 standard drinks (defined as 10g of ethanol) in a typical drinking session (2013 National Drug Strategy Household Survey, 2014)

25.  61% of pregnant women drank between conception and pregnancy recognition. Binge and heavy drinking the most common (McCormack, Hutchinson, Burns, Wilson, Elliott, Allsop, Najman, Jacobs, Rossen, Olsson & Mattick, 2017)

26. Global prevalence is conservatively estimated at 7.7 per 1000 population (95% CI, 4.9-11.7 per 1000 population) and is much higher in populations with risky levels of drinking(Lange, Probst, Gmel, Rehm, Burd & Popova, 2017).

27. Without intervention individuals living with FASD risk developing secondary issues such as school failure, addictions, mental health disorders, dependent living, unemployment, homelessness & incarceration (Popova et al., 2016).

28.  1/3 women binge drank during their pregnancy on a ‘special occasion’ (Muggli et al., 2016)

NOFASD Australia is an independent not-for-profit charitable organization. They are the national peak organization representing the interests of individuals and families living with Fetal Alcohol Spectrum Disorders (FASD).

 

Indigenous Approaches to FASD Prevention: Brief Interventions with Girls and Women

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BRIEF INTERVENTIONS WITH GIRLS AND WOMEN provides a brief introduction to ways of working with Indigenous girls and women to address alcohol, pregnancy, and other related concerns. It is one of five publications highlighting how FASD prevention is understood and practiced in Indigenous traditional culture. The series is a collaboration of The Centre of Excellence for Women’s Health, the Thunderbird Partnership Foundation, and the Canada FASD Research Network.

Click to view PDF:  IndigFASD-BRIEF-INTERVENTIONS_Jan2018

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