Bullied teens more likely to smoke, drink and use drugs

FILE PHOTO - A cigarette burns in an ashtray at a pub in Prague(Reuters Health) – Children who are bullied in fifth grade are more likely to become depressed and experiment with drugs and alcohol during their teen years than their peers who weren’t victimized by other kids, a U.S. study suggests.

Researchers followed almost 4,300 students starting in fifth grade, when they were around 11 years old. By tenth grade, 24 percent of the teens drank alcohol, 15 percent smoked marijuana and 12 percent used tobacco.

More frequent episodes of physical and emotional bullying in fifth grade were associated with higher odds of depression by seventh grade, which was in turn linked to greater likelihood of substance use later in adolescence, the study found.

“We drew on the self-medication hypothesis when trying to understand why peer victimization may lead to substance use over time,” said lead study author Valerie Earnshaw, a human development and family studies researcher at the University of Delaware in Newark.

“This suggests that people use substances to try to relieve painful feelings or control their emotions,” Earnshaw said by email. “So, youth who are bullied feel bad, or experience depressive symptoms, and then may use substances to try to feel better.”

For the study, researchers examined data from three surveys conducted from 2004 to 2011 among students at schools in Houston, Los Angeles and Birmingham, Alabama.

Students were asked if they had used tobacco, alcohol or marijuana in the past 30 days and how often they had been victims of bullying by their peers in the previous year. Questions on peer victimization touched on both physical aggression like shoving and kicking as well as emotional taunts like saying nasty things about them to other kids.

At the start of the study in fifth grade, about 10 percent of participants said they had been victims of bulling. This was more common among kids who had chronic illnesses, sexual minorities and boys.

By seventh grade, almost 2 percent of the students reported symptoms of depression.

And by the end of the study in tenth grade, substance use was more common among the kids who had previously reported bullying and depression.

The study isn’t a controlled experiment designed to prove that bullying directly causes depression or that mental health issues directly cause substance use. Another limitation of the study is its reliance on teens to accurately report any episodes of bullying, symptoms of depression or substance use, the authors note.

It’s also possible that teens who are bullied may later wind up drinking or using drugs because their peer groups include many adolescents who do both of these things, whether on sports teams or among crowds of particularly aggressive kids, said Bonnie Leadbeater, a psychology researcher at the University of Victoria in Canada.

“Being ‘trapped’ in these networks can be particularly problematic in high school, where you see the same people every day,” Leadbeater, who wasn’t involved in the study, said by email.

“Youth with multiple networks beyond school through sports, music, art, religious activities, volunteering and work are more apt to find friends and others who see their talents, strengths and abilities,” Leadbeater added. “These strengths are often established in late elementary school.”

The trouble with bullying that leads to mental health problems is that teens with depression and anxiety are more likely to withdraw from peers and lack interest in most things.

“Young teens need to have ways of dealing with peer conflict before it becomes bullying,” Leadbeater said. “Young teens need to believe that getting help is normative and that bullying is not.”

SOURCE: bit.ly/2q0qRAQ Pediatrics, online May 9, 2017.

Retrieved from: http://www.reuters.com/article/us-health-bullying-depression-idUSKBN1852IY

FASD and epigenetics

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This Q&A, is a talk with Western University (Ontario) researcher Ben Laufer about the latest science on FASD and how it influences our genetics.

What is epigenetics?

Traditionally, science has told us that children are the sum of their parents’ genetics. Recently, though, we’ve discovered that it’s actually much more complicated. Just think about identical twins, who can have entirely different personalities and even contract different diseases. Another example is the famous case of Dolly the sheep – she had striking physical and mental differences from the “original” animal from which she was cloned.

Clearly, “nurture” ( life experience) influences “nature” (genetics). But there’s also another factor, one which is responsible for passing on the “memories” of the experiences of previous and current generations. This factor is called epigenetics, which is Latin for “above genetics.”

How does it work?

In a sense, the epigenome can be thought of as the software to our genetic hardware. It’s just like loading Word or Powerpoint on your computer: the software is a set of instructions to tell the hardware what it should do, where it should do it, and when it should happen. Another analogy is that the genetic code is the spelling of a language and the epigenome is the punctuation. A sentence can mean something completely different if you change its punctuation (remember Eats, Shoots, and Leaves?). Like raw computer hardware or a book with no punctuation, every cell in our body has essentially identical DNA. And yet, a liver cell is utterly different from a brain cell – all because of the epigenome.

For scientists, the debate over nature versus nurture has been solved. Rather than being separate forces, the two are intimately connected. In order to form and develop, humans need both genomes and epigenomes.

Epigenetics has resulted in a fundamental paradigm shift in science. It suggests that genetic determinism is an outdated concept. Epigenetic research shows that a child inherits more than the genes of their parents. DNA is not destiny. It’s just one piece of the puzzle.

What does epigenetics have to do with FASD?

Alcohol is part of a class of chemicals called teratogens, which are known for their devastating effect on the developing embryo/fetus. Alcohol is a textbook teratogen that acts by altering epigenetic marks through a complex process known as DNA methylation. Prenatal exposure to alcohol causes the widespread death of cells that the developing brain can’t afford to lose. Alcohol’s impact on the epigenome is what leads to Fetal Alcohol Spectrum Disorders (FASD).

Fetal Alcohol Syndrome (FAS), which is diagnosed in one percent of the general population, is the leading preventable cause of intellectual disability in the Western world. Unfortunately, when it comes to overall fetal alcohol exposure, the numbers are much higher than that. In Canada, 10-15% of pregnant women (depending on province) report they consume some alcohol during pregnancy. We do know that people tend to underreport the amount of alcohol they actually drink, which means the real numbers are probably even higher. Although alcohol-exposed children don’t all go on to develop full-blown FAS, many do fall under the much broader umbrella term of FASD. Even more might display challenges that don’t meet the threshold for an FASD diagnosis, but that may still be connected to the prenatal alcohol exposure. This represents a serious public health issue of unprecedented scale.

What is your research all about?

During my research with Dr. Shiva Singh and his lab at Western University, we’ve conducted numerous molecular and behavioural studies on mice. We found that prenatal alcohol exposure causes massive changes to the epigenome. We’ve also found that differences in the timing and level of alcohol exposure have a huge effect on what kinds of problems occur. Our findings were confirmed by more recent human analyses, which we worked on in collaboration with Dr. Joachim Kaplanga. We even identified a group of epigenetic alterations that can identify prenatal alcohol exposure non-invasively. However, it will be many years before we can develop these findings into a commonly accesible clinical test.

What are the implications of this research?

Despite the slow pace of the research world, the information we’ve discovered should be communicated to the public as soon as possible. One simple statement we can promote is, “No safe time, no safe amount [of alcohol].” Another important observation we can share is that the changes to the brain caused by prenatal alcohol exposure continue to affect brain development throughout childhood and even adulthood.

We’ve also learned two things that are very striking. In the past, we believed that the effects of prenatal alcohol exposure couldn’t be inherited by the affected person’s children. But research has shown that some of the effects of prenatal alcohol exposure can, in fact, be passed on to future generations via the epigenome. We also thought that the mother’s alcohol consumption during pregnancy was the only thing that mattered. What we’ve learned is that the father’s consumption of alcohol can alter his epigenome and cause deficits in his future children. It’s all a lot more complicated than we used to think.

What does this mean for parents, especially adoptive parents? Is there anything we can do with this knowledge?

It’s actually not all bad news! Plasticity is a key part of epigenetic programming and brain development. This means the epigenome is constantly sensing and adapting to its environment. We can’t yet correct the initial damage caused by fetal alcohol exposure, but plasticity means that effects on future development can be corrected, at least to some extent.

Dr. Singh and our lab are now examining how fetal alcohol exposed mice respond to different environments. Intriguingly, and inspiringly, what we see is that good parental care and an enriched environment make all the difference. It doesn’t just help – it actually brings the mouse to a level of mental functioning similar to their unexposed peers that are raised in a standard environment.

The opposite is also true. Fetal alcohol-exposed mice that experience poor levels of care are much more seriously affected. This means that while there may not be an absolute cure, there is a way to greatly help improve the quality of life for alcohol-exposed children: the love, care, and understanding of a family.

Ben Laufer is currently finishing his Ph.D. research in biology with Dr. Shiva Singh at Western University in Ontario. More information about their research and its impact can be found at www.benlaufer.com.

Retrieved from: https://www.bcadoption.com/resources/articles/fasd-and-epigenetics

Public Health Agency of Canada investing in projects to address Fetal Alcohol Spectrum Disorder

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OTTAWA, May 5, 2017 /CNW/ – Drinking alcohol during pregnancy can result in a baby being born with Fetal Alcohol Spectrum Disorder (FASD), which includes a range of physical, mental or behavioural difficulties that last a lifetime. No amount of alcohol is safe during pregnancy.

Today, the Honourable Jane Philpott, Minister of Health, announced $3.6 million in federal funding for five projects aimed at preventing and screening for alcohol use in pregnancy. Project leads will work with medical and allied health professionals, social service providers and researchers to equip frontline care providers with the tools, information and best practices they need to help screen, counsel and treat women at risk of using alcohol during pregnancy.

The funding will also improve surveillance of FASD in Canada to better identify individuals and population groups most in need of support, help direct future prevention and diagnostic services, and improve care for those living with FASD.

There is no single solution to prevent FASD and that is why the Government of Canada is investing in education, prevention and screening, as well as partnering with internationally recognized experts, to help reduce the incidence of FASD.

Quick Facts

  • FASD is the leading known cause of preventable developmental disability in Canada.
  • While the disorder is present from birth, people are often not diagnosed with FASD until later in life when symptoms related to learning challenges and social problems emerge.
  • A number of conditions, such as hearing loss, visual impairment and conduct disorder, have been found to occur more frequently among individuals with FASD than in the general population.
  • While the exact prevalence of FASD in Canada is not known, the Public Health Agency of Canada estimates that one in every 100 Canadians is affected.

Quotes
“The use of alcohol during pregnancy during pregnancy can have devastating consequences.  The funding announced today is an important step toward fostering a national conversation about FASD, and action in a wide range of settings, by a variety of health care providers.”
The Honourable Jane Philpott, P.C., M.P.
Minister of Health

“Alcohol is not harmless. It is a mind-altering drug and there are health risks associated with drinking, especially during pregnancy.”
Dr. Theresa Tam, Chief Public Health Officer of Canada

Associated Links
Fetal Alcohol Spectrum Disorder in Canada – New Project Funding
The Chief Public Health Officer’s Report on the State of Public Health in Canada, 2015: Alcohol Consumption in Canada

The invisible disability caught in Canada’s prison system

The young man was illiterate, had an IQ below 70 and couldn’t tell time on an analog clock.

After receiving a court-ordered curfew, he started asking other people to notify him when it was 8 PM, in order to comply with that condition. Karrie-Noelle Plohman — an outreach program manager at Winnipeg’s Touchstone FASD Program who worked with the man — recalls that he quickly became aware of what it looked like outside at certain times, and when the sun set.

But the seasons changed. The sun started setting at different times.

“So he ended up getting repeated curfew breaches simply because he couldn’t actually tell time,” Plohman says.

It’s just one of the many problems that people with Fetal Alcohol Spectrum Disorder (FASD)  face in the criminal justice system due to difficulties with impulse control, learning from mistakes and understanding complex instructions or abstract concepts of cause and effect.

These issues are well documented. But advocates suggest that Canada’s federal, provincial and territorial governments are largely failing to actually address them — and arguably contributing to the overcrowding crisis in penitentiaries, along with the high recidivism rates.

As the ability to diagnose people improves, some of the harshest critics of the justice system are pushing for a radical overhaul of how people with FASD are dealt with in the Canadian criminal justice system, as well as posing broader questions about whether such people even belong in carceral institutions in the first place.

“We keep cycling someone through and recriminalizing people with FASD on breaches because they don’t understand what probation orders are or can’t quite connect the dots how their behaviour could lead to a breach, which could land them back in jail,” Plohman says.

“It’s a totally distinct, specific condition that’s clogging the jails and the courts.”

Plohman says she recently heard of a judge who always knew there was going to be someone with FASD coming before him based solely on the physical size of the file.

“It’s a totally distinct, specific condition that’s clogging the jails and the courts,” says Larry Bagnell, a Liberal MP who recently proposed a private member’s bill that would amend the Criminal Code to require the specific consideration of FASD in sentencing and incarceration.

Jonathan Rudin, program director of the Aboriginal Legal Services of Toronto, adds that people with FASD get “really uncomfortable” with the type of stimulation that are present in courtrooms and carceral institutions, which can lead to people accepting court-ordered conditions without necessarily understanding them.

In addition, Plohman says that court-appointed lawyers are also usually “quite overwhelmed” and don’t have a lot of time to spend with people prior to walking into court, meaning that people with FASD will often be encouraged to say “yes” to conditions without having any concept of what they’re actually agreeing to.

Unfortunately, there aren’t any clear numbers on the percentage of individuals with FASD in prisons, jails and remand facilities.

Howard Sapers, Canada’s former correctional investigator and current independent advisor to Ontario on corrections reform, says that one study estimates the number is between 13 and 26 percent, a “pretty wide variance.”

A 2008 report by Public Safety Canada cited anecdotal evidence that 50 percent of Indigenous inmates had FASD, while 100 percent of Indigenous community members with FASD had experienced incarceration. Meanwhile, a 2013 meta-analysis conducted by the Edmonton-based Institute of Health Economics concluded that FASD prevalence in correctional systems ranged between 9.8 and 23.3 percent.

In other words, estimates are all over the map.

“People in the justice system often don’t know that someone has FASD.”

Rudin of the Aboriginal Legal Services of Toronto says the lack of precision is at least partly due to FASD being an “invisible disability,” noting it’s almost impossible for an adult to get a diagnosis as there’s no simple blood test or ability to verify maternal alcohol consumption during pregnancy.

“People in the justice system often don’t know that someone has FASD and because the justice system moves so quickly our default position is everyone is competent and everyone understands what’s going on,” Rudin says.

But Sapers says Canada’s criminal justice system has vastly improved the tools, science and resources it uses to do screening and assessment.

And there are increasingly rapid ways to diagnose FASD, he says, with additional technologies under development; he points to initiatives in New Zealand, Australia and Washington state as ahead of anything found in Canada.

However, Sapers emphasizes that diagnosis doesn’t necessarily translate into better care or more therapeutic environments. That’s especially relevant given the criminal justice system often incarcerates people for a limited amount of time: he notes that in Ontario, the average length of time in provincial system is less than 60 days.

“The bottom line is that it’s really the behaviours — the manifestations of the disorder — that corrections needs to do a better job of addressing,” Sapers argues. “And frankly, I’ve come to a position where I’d rather see more effort being put into treating people as if we had a diagnosis than counting on our ability to provide a diagnosis.”

That’s why organizations like the Aboriginal Legal Services of Toronto often operate with the default assumption that people may have cognitive difficulties such as FASD.

Most of Bagnell’s Liberal colleagues voted against the bill, resulting in a 170-133 loss.

Rudin says that means physically reading out instructions to all clients and attempting to create an environment where people feel comfortable asking questions. That follows some initiatives in Manitoba, which has developed graphics and very plain language to explain what certain probation and bail conditions mean.

It’s also why Bagnell introduced Bill C-235 in February 2016, aiming to introduce four major changes: allowing judges to order an assessment for FASD, mitigate the sentence if it’s a positive assessment, require correctional staff to treat people with the conditions differently and ensure there’s a clear plan in place upon release to prevent the “revolving door” effect.

Most of Bagnell’s Liberal colleagues voted against the bill, resulting in a 170-133 loss.

Prime Minister Justin Trudeau didn’t vote, but high-ranking ministers such as Public Safety Minister Ralph Goodale, Justice Minister Jody Wilson-Raybould and Finance Minister Bill Morneau all opposed the measures.

Bill Blair, Parliamentary Secretary to the Minister of Justice, told the House of Commons that his government opposed the bill because it singled out FASD, to the exclusion of other disabilities. “I want to emphasize at the outset that the government fully supports the very laudable objectives of the private member’s bill,” Blair added.

Surprisingly, 15 Conservative MPs broke party ranks and voted for it, along with a sizable contingent of Liberal backbenchers.

“This is not necessarily a criminal justice issue.”

Bagnell says he’s going to continue lobbying for parts of the bill to be included in other pieces of legislation, especially the ongoing review of the Criminal Code by Minister Wilson-Raybould.

But perspectives differ on that efficacy of such goals.

As Plohman points out, it almost becomes more of an ethical question about whether it’s even desirable to criminalize people with disabilities who don’t actually have the capacity to modify or fix their behaviour in the way that we would assume they should.

“This is not necessarily a criminal justice issue,” Sapers concludes. “Do you punish somebody because they’re intellectually impaired? Do you punish somebody for their addiction or mental illness? These are valid questions that speak to the purpose of the criminal justice system. From that standpoint, it is a broader social issue as opposed to a narrow criminal justice issue.”

Retrieved from: https://news.vice.com/story/the-invisible-disability-caught-in-canadas-prison-system

When mental health and addiction collide

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Which comes first, a mental health issue or an addiction?

There’s no one answer; it depends on the individual’s circumstances. Here’s an example to illustrate: Jack became depressed after he lost his job and his partner, and after several weeks he turned to alcohol as a means to cope.

Regardless of what comes first, when a person like Jack develops a mental health disorder and an addiction at the same time, it’s called comorbidity or concurrent disorders. A specific behaviour or the use of a substance becomes a problem when it impacts negatively on a person’s health, relationships, and performance at work. The frequency, duration and intensity of the behaviour or use – and its consequences – determines whether the addictive behaviours meet the criteria set for a subtype of mental health disorders called substance-related and addictive disorders.
Awareness
A person with a mental health disorder is twice as likely to have a co-occurring substance use problem as the average person. Different drugs have different chemical molecules that influence how effectively the brain works regarding making decisions, self-control and compulsion.
If you’re concerned about your mental health or that you may be at risk for an addiction to alcohol, drugs or gambling, complete the Drugs-Alcohol-Gambling (DAGS) self-screening tool for some insights on your current risk and recommendations for action. The Centre for Addiction and Mental Health (CAMH), Canada’s largest mental health and addiction teaching hospital, has endorsed self-screening tools to Check Your Drinking or Check Your Gambling. Of course, the purpose of these kinds of self-screening tools is not to self-diagnose; rather, to increase your own self-awareness and decide if some form of action is warranted.
Obtaining information about alcohol and drug services available to you may be the first step. Health Canada has a website available with a number of resources listed by province. In Ontario, there is a provincial Alcohol and Drug Information Linewith Canada-wide resources and a free confidential information line that is available 24/7, which provides more options specific to your needs and location. Both websites provide links to specific outpatient and inpatient/residential programs that can be contacted directly, such as the Centre for Addiction and Mental Health (CAMH) and Edgewood Health Network (EHN) – Bellwood, as well as other options.
Accountability
We all own our mental health, whether it’s good or bad. There’s no magic pill or instant solution to mental health and addiction problems. The first step is admitting to yourself that you have an issue and that your current coping strategy is not working. Denial, shame and fear are normal responses that can make it hard for some to ask for or seek help for themselves.
If you do need help, understand that professionals who work in addictions are experienced dealing with people thinking and feeling the way you do. Know that you are not alone. Each year, millions of people with comorbidity issues seek help and, with some work, dedication and collaboration, are able to get their mental health back on track.
Action
If you may be at risk for a comorbidity issue, it is important for you to decide to ask for, and accept, help.
Never self-diagnose – The mind is powerful, and self-talk can fool us, especially when an addiction, or a risk for one, is involved. If you’re concerned, that’s enough to move from an internal conversation to having a real open and honest talk with an addictions or mental health professional or your family doctor.
Accepting help is a sign of strength – If you are driving to work and your car breaks down, calling a mechanic to help get you back on the road is a smart plan. No one is judged for calling a mechanic, but stigma can paralyze some people from ever asking or accepting help for their addiction and mental health issues. They remain stuck and at increased risk of both their addiction and mental health issues worsening, as well as increased risk for those issues having a negative impact on their health, career, and relationships.
Asking for help and accepting it is a sign of strength and bravery. Typically, you’re not the only person who is suffering because of comorbidity. By being responsible to yourself, you are often also being responsible to your loved ones as well.

Deal with one thing at a time – Set realistic expectations, and understand that regaining your health will take time. It’s common for a person who struggles with a mental health issue and addiction to expect things to get on track fast, once they get the addiction under control. Health and change will come step by step, one day at a time. How many days it takes is not as important as following your recovery plan daily. What you do today and the choices you make, no matter how small, help create a forward momentum towards your future. Yes, day 143 typically is easier than day five.

Few people can correct an addiction and mental health issue overnight, but small moment-to-moment choices can lead to big changes in the long run. Allow yourself time to heal, grieve and grow – and with time, you will. Many people have made this challenging and worthwhile journey; it’s not easy, but it is possible.

Bill Howatt is the chief research and development officer of work force productivity with Morneau Shepell in Toronto.

Hester Dunlap is a Clinical Psychologist at Edgewood Health Network (EHN) – Bellwood in Toronto.

Lisa Couperthwaite is a Clinical Psychologist at the Centre for Addiction and Mental Health (CAMH) Work, Stress & Health Program in Toronto.

Retrieved from: https://beta.theglobeandmail.com/report-on-business/careers/workplace-award/when-mental-health-and-addiction-collide/article34886318/?ref=http%3A%2F%2Fwww.theglobeandmail.com&cmpid=rss1&click=sf_globe&service=mobile

Good News: Judge Rules Wisconsin Law That Sent Pregnant Woman to Jail Unconstitutional

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Tamara Loertscher has been embroiled in a suit with the State of Wisconsin challenging the constitutionality of the 20-year-old law that led to her jail time. On Friday, a federal judge blocked the law—finally marking some good news after months of legislative attacks on reproductive rights in the state.

In 2014, Tamara Loertscher voluntarily sought medical help for depression and a severe thyroid condition that caused debilitating lethargy, both of which she had been self-medicating with marijuana and methamphetamine. She also suspected she might be pregnant. Although Loertscher was confident in her ability to abstain from drugs once her medical concerns were treated, hospital staff confirmed she was pregnant and reported her to social service authorities. After a hospital telephone hearing in which she was denied counsel, she was eventually held in the Taylor County Jail for 18 days, during which she was held in solitary confinement and threatened with being tased.

After her release, Loertscher submitted to drug testing throughout her pregnancy, which confirmed that she had ceased all use of substances on her own. She gave birth to a healthy baby in January 2015.

Since the incident, Loertscher has been embroiled in a suit with the State of Wisconsin challenging the constitutionality of the 20-year-old law that led to her jail time. On Friday, a federal judge blocked the law—finally marking some good news after months of legislative attacks on reproductive rights in the state.

Wisconsin’s 1997 Act 292, also known as the “Cocaine Mom Law,” threatened people who use drugs or alcohol during pregnancy with involuntary detention and potential separation from their children. The law was the legislature’s response to a 1997 Wisconsin Supreme Court ruling that a fetus was not a “child” within the meaning of the Children’s Code, the law that confers jurisdiction for the state to seize endangered children.

In the 1990s, amid media frenzy over the now-debunked “crack baby” fears, the state Department of Children and Families (DCF) had been “taking custody” of fetuses to force pregnant people into involuntary treatment for drug or alcohol use and charging them with child abuse and neglect. But after the 1997 ruling, without a “child” involved, DCF lost the power to subject pregnant adults to Child in Need of Protective Services (CHIPS) proceedings. So the legislature devised a convoluted law that created a new procedure, known internally at the state agency as UCHIPS (Unborn CHIPS), specifically for detaining pregnant people.

The law permitted the detention, at any stage of pregnancy, of a pregnant person who “habitually lacks self-control” in the use of alcohol or drugs “exhibited to a severe degree” that poses a “substantial risk” that the infant will be “seriously affected or endangered” at birth. Neither law nor science provides a clear definition for any of these terms, which has led to women who have stopped all use of drugs being locked up for months. Worse yet, the law did not confer a right to counsel in key hearings.

Loertscher’s suit alleged that the law violated a number of constitutional rights, including rights to medical decision-making, reproductive privacy, due process, and equal protection. Last fall, represented by National Advocates for Pregnant Women, the Reproductive Justice Clinic at NYU School of Law, and the Perkins Coie law firm, Loertscher filed a motion for summary judgment, seeking a ruling on the law’s constitutionality before trial. Friday’s ruling granted that motion, declaring the law unconstitutionally vague.

Specifically, the judge ruled that the law violated the right to due process. The U.S. Constitution’s guarantee of due process requires that the law clearly define what is prohibited. To be valid, a law must give a person of ordinary intelligence notice of what is required and provide meaningful standards to law enforcement in order to avoid arbitrary enforcement. The court focused its analysis on two central concepts at the heart of the law: “habitual lack of self-control” and “substantial risk to the physical health of the unborn child.”

In a true win for science in an age of “alternative facts,” the court acknowledged the lack of medical accord as to how or whether substances affect infant outcomes. It seized upon the state’s expert’s admission that they had testified to matters beyond their expertise, and pointed out that neither the defendants nor the experts could provide a clear definition of “habitual.” Lawyers representing the state attempted to use a dictionary definition, a tactic chided by the court as a “festival of circularity.” The court concluded that with such amorphous standards, “[e]rratic enforcement, driven by the stigma attached to drug and alcohol use by expectant mothers, is all but ensured.”

So what comes next? The court’s injunction applies statewide, preventing the state from using the law against pregnant people. Thus far, the state has been quiet as to whether it plans to appeal the ruling. But in practical terms, there are two critical, intertwined results of this law.

The first is that healthcare providers will no longer be called upon to act as agents of law enforcement against their own patients. The law itself contained no requirement that physicians breach their patients’ confidentiality, but the litigation revealed pervasive confusion among medical personnel as to what was required and what would happen to patients once reported. Dr. Kathy Hartke, chair of the Wisconsin Section of the American Congress of Obstetricians and Gynecologists (ACOG), was one physician catalyzed to speak out against the law based on her own patients’ Kafkaesque experiences after Act 292’s enactment. She recently described the medically nonsensical law to Wisconsin Public Radio: “We don’t lock [pregnant] women up if they’re diabetic and they’re not following their treatment plan or if someone is smoking a pack a day, which causes more fetal deaths than some of these other drugs that could be used.”

Second, and most importantly, pregnant people will know that they can seek medical care without fear of being subjected to interrogations, investigations, and involuntary detention. Even though the State of Wisconsin claimed that it had an interest in protecting fetuses that justified detaining pregnant people, medical groups like ACOG and the American Medical Association disagree, warning instead that threats drive people away from care.

Loertscher, meanwhile, is barred—by precedents whittling away people’s right to compensation for civil rights claims—from recovering money damages for the trauma she suffered. But she may still be vindicated in another forum. In October, assisted by the Human Rights and Gender Justice Clinic at the CUNY School of Law, she recounted her experience to the United Nations Working Group on Arbitrary Detention, a group of international experts appointed to investigate and report on human rights concerns. Moved by Loertscher’s story, the group condemned Wisconsin’s law in a statement that presaged the federal court’s ruling. It denounced the law’s lack of due process, standards for enforcement, or representation for the pregnant person. Calling the law “obviously gendered and discriminatory in its reach and application,” the working group recommended that it be “replaced with alternative measures that protect women without jeopardizing their liberty.” The group will submit its full public report on the visit to the United States this September. This report is likely to include information about several other states with similar laws not affected by this injunction, laying the groundwork for advocates to call for change beyond Wisconsin.

And beyond its substantive content, the ruling closes a painful chapter: Litigation often requires plaintiffs to continually relive their trauma for years. Loertscher, who has a health-care background, aspires to create safe, healing spaces for pregnant people going through what she experienced. Friday’s outcome marks a first step toward that vision for pregnant people across Wisconsin.

Retrieved from: https://rewire.news/article/2017/05/02/judge-rules-wisconsin-law-sent-pregnant-jail-unconstitutional/

 

Regulating marketing of alcohol can help reduce consumption, harm

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Washington, D.C., April 18, 2017 (PAHO/WHO) – Countries can improve public health by regulating the marketing of alcoholic beverages to reduce its consumption and related harms, and the Pan American Health Organization has developed new principles for countries to consider in developing these regulations.

The new PAHO publication, “Technical note: Background on alcohol marketing regulation and monitoring for the protection of public health,” provides elements that governments can use to strengthen legal and regulatory frameworks that would help reduce or eliminate exposure to alcohol marketing.

Alcohol marketing is widespread in the Americas, with modern marketing techniques that go beyond traditional print and electronic media advertisements to include branded merchandise, sponsorships of sporting teams and events, discount pricing, social media, and sales or supply at educational or health establishments.

Substantial evidence now associates alcohol marketing with young people’s drinking behavior, according to the PAHO publication and the scientific journal Addiction.  Studies have found that the more young people are exposed to alcohol marketing, the more likely they are to start drinking earlier, and to drink more if they are already drinking. The harmful use of alcohol is one of the four most common preventable risk factors for major noncommunicable diseases and an important risk factor for violence and injury. It also has an impact on other health conditions including HIV/AIDS and tuberculosis, as well as on economic and social development.

The document is based on the Global Strategy to Reduce the Harmful use of Alcohol of the World Health Organization (WHO), as well as the subsequent PAHO Regional Plan of Action. It complements a 2016 PAHO report on Alcohol Marketing Regulation, and was built in consultation with experts, representatives from several Member States and PAHO staff.

The PAHO publication notes that a comprehensive ban on alcohol marketing is likely the only way to eliminate risk of exposure for those most needing protection, such as youth and other vulnerable groups.

The publication: “Technical note: Background on alcohol marketing regulation and monitoring for the protection of public health”, is available in this link

Facts on Alcohol in the Americas

  • Alcohol consumption in the Region of the Americas is higher on average than in most parts of the world.
  • Estimates show a high prevalence of heavy episodic drinking among 15-19 year-olds in the Americas (29.3% for adolescent boys and 7.1% for adolescent girls).
  • Alcohol is the leading risk factor for death and disability among people aged 15-49 years in the Americas.
  • Nearly 40% of countries in the Americas have no restrictions on alcohol marketing, and none has a full ban on marketing. Seven countries have reported having self-regulatory codes, despite evidence showing they are not effective in reducing youth exposure to alcohol marketing.
  • Youth are 5 times more likely to drink alcohol brands that advertise on national television, and 36% more likely to use brands that advertise in national magazines.
  • Youth exposed to ads containing a “party” theme were 19 times more likely to initiate drinking and about 4 times more likely to initiate binge drinking.

Links

— Technical note: Background on alcohol marketing regulation and monitoring for the protection of public health
PAHO report on Alcohol Marketing Regulation
Scientific journal Addiction: The Regulation of Alcohol Marketing: From Research to Public Health Policy. This supplement was published with financial support from Alcohol Research UK and the Institute of Alcohol Studies
PAHO/Alcohol

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