The welcome news that the Local Drug Action Team (LDAT) led by Tony Brown has been successful in securing funding to Make FASD History provides much-needed opportunity for public education about the devastating effects of foetal alcohol spectrum disorder (FASD) in our community.
However, it raises two questions.
First, why does the health-conscious Newcastle public know so little about the burden of morbidity from FASD: that is, the emotional cost to families with affected children and the lifetime cost to the community of the person with intellectual disability from FASD which is estimated to be in the order of several million dollars.
The effects of alcohol use during pregnancy on the embryo and foetus were first recognised in the 1960s and I recall making the diagnosis of FASD in the mid-1970s. After I retired from the Newcastle medical school in 2005, I worked for almost 10 years in the remote Kimberley region. In my clinics in Fitzroy Crossing and Halls Creek I saw many cases of children with FASD, and, from a headcount of these cases among the known population of children under the age of five, I estimated that the prevalence was at least one quarter. Several years later, the Lililwan Study conducted by Dr James Fitzpatrick confirmed the extent of intellectual disability.
This evidence for an epidemic of brain damage to unborn children was a key plank in the advocacy for alcohol restrictions that were implemented in 2007 in Fitzroy Crossing. The courage of the Aboriginal cultural leaders in their fight against the river of grog was the event that precipitated the federal government’s action for this problem, with Newcastle LDAT now a beneficiary. We should be inspired by the example of the brave women of Fitzroy Crossing who confronted the shame of the effects on their grandchildren of their relatives’ drinking in pregnancy.
In the wider community, silence from shame and guilt are but part of the reason why FASD is so little recognised: previous reluctance of midwives to ask about alcohol abuse, and ignorance among young doctors as to the possibility of FASD being a cause of behavioural and developmental problems, have conspired with this silence.
Second, why is there absence of outrage over this entirely preventable condition? This is in contrast to the justifiable public outrage about the health effects of groundwater pollution around Williamtown; from residual lead contamination of soil at Boolaroo; and from the effects on lung disease from air pollution from coal dust along railway lines and downwind from the huge open-cut mines of the valley.
Outrage reflects the degree of personal choice to exposure to the risk, given that the risk is known. It is, therefore, maximal when the water we drink or the air we breathe is polluted or poisoned. In contrast, having a drink with friends is a personal choice for us all, yet for young women who may not be aware of the risk, it can have a devastating effect on their embryo.
This, therefore, presents an ethical conundrum, for if my outrage is the cause of your shame or guilt, is it morally justified? To resolve this we have to sublimate our concern in a constructive way through community awareness so that young women are supported by their peer group in choosing to avoid alcohol when planning a family, and in avoiding an unanticipated conception when drinking.
A study of the global prevalence of fetal alcohol spectrum disorder (FASD) estimates that it affects as many as 8 out of 10,000 children, highlighting the need to improve public education about the potential harm of drinking alcohol during pregnancy.
Drinking alcohol during pregnancy may harm the developing fetus. A wide range of resulting health problems have been observed including defects of the heart, kidneys or bones, problems with brain development, low IQ, and hyperactivity. This group of conditions is known as fetal alcohol spectrum disorder (FASD). Affected children may have mild to severe health problems. However, it is not possible to predict the severity from the amount or timing of their mother’s alcohol consumption. There is no safe amount or safe time of alcohol consumption for a pregnant woman.
It is important to know the prevalence of a condition in order to look at patterns of occurrence. This helps…
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There is an agony that descends upon a family when a child is diagnosed with a neurological and behavioral disability. Imagine adding to that by realizing this child’s disability is 100% incurable, and 100% preventable.
That is the case with FASD: fetal alcohol spectrum disorders.
Ann Carrellas, Michigan FASD Taskforce member and associate director of research at Wayne State University’s Developmental Disabilities Institute, and Juline Lloyd, a nurse and adoptive mother to a son with FASD, joined Stateside today to explain the disorder and how to prevent it.
According to Carrelas, the pregnant women who drink the most are actually “white women who are educated.”
“The latest study shows that it could be 1 in 50 to 1 in 20 children has a fetal alcohol spectrum disorder,” Carrelas said.
That’s higher than the autism spectrum.
FASD is even more pervasive in the foster care system, where Carrelas said it’s estimated that 70% of children have been affected by prenatal alcohol exposure.
Lloyd also said that according to the National Organization on Fetal Alcohol Syndrome, “35% of the people that have an FASD have been in jail or prison.”
“I think it affects every aspect of society,” she said. “It affects schools, it affects the criminal justice system, it affects families, and it’s something that’s not understood. And I guess people don’t understand fetal alcohol spectrum disorder as a disability. They think it’s a behavior and if we start to understand it as a disability, we might be able to make more progress.”
Listen above for the full conversation.
Fetal alcohol spectrum disorders (FASD) are seen in children who are exposed to alcohol while in the womb. Lately, the theory that the cells in the brain’s immune system causes neurological damage is being questioned by scientists, reveals a new study.
“In order to develop treatments for this condition, we must first understand how alcohol affects the developing brain,” said Ania Majewska, Ph.D., an associate professor in the Department of Neuroscience at the University of Rochester Medical Center (URMC) and lead author of the study.
‘Microglia located in the brain and spinal cord help in destroying infections and clearing damaged cell tissues.’
The new study was published in the journal Brain Behavior and Immunity.
“While the hypothesis that dysfunctional immune cells play a role in fetal alcohol syndrome is logical and enticing, it appears that this idea may be a scientific dead end.”
Exposure to alcohol in the womb can lead to fetal alcohol spectrum disorders (FASD), a condition that causes lifelong physical and cognitive impairments, and for which there is no available treatment.
The symptoms suffered by individuals with FASD can range from poor impulse control and attention, learning disabilities, compromised fine motor skills, and delays in the ability of the brain to process visual and auditory information. FASD is diagnosed in about one out of every 100 babies born in the U.S.
Scientists have long struggled to understand the biological mechanisms by which prenatal exposure to alcohol causes neurological damage. One theory that has emerged in recent years is that microglia may play a role in FASD.
While microglia have long been recognized as the foot soldiers of the brain’s immune system, seeking out and destroying infections and tidying up damaged cell tissue, scientists are now beginning to appreciate the other important functions the cells perform. For example, Majewska and her colleagues have shown that microglia play a critical role in learning and memory by helping maintain and rewire the connections between networks of neurons.
Because microglia are constantly monitoring the environment in the brain and become mobilized when they detect infection, injury, or other toxic elements, scientists have speculated that alcohol may be activating these cells and causing them to either abandon their role nurturing the connections between neurons or possibly even mistakenly attacking neurons they perceive as injured.
To test this theory, the researchers exposed mice to alcohol early in development. Using a wide array of techniques including genetic markers and an advanced imaging technology called two-photon microscopy, the scientists were able to observe the activity of the microglia in the brains of these mice and compare them to healthy animals. They found that there was no difference in the activity of the microglia between the two groups.
“While this work does not prove that microglia do not respond to alcohol in different brain areas or in different contexts of exposure, it does call into question a long-standing theory and shows that, in some cases at least, alcohol can elicit cognitive dysfunction without engaging microglia,” said Elissa Wong, a graduate student in Majewska’s lab and first author of the study.
“This in turn suggests that microglia may not be the best therapeutic target for treatment of FASD.”
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Ontario Health Minister Eric Hoskins announced on Monday that the province will provide an additional $72.6 million over the next three years for psychotherapy programs.
Hoskins said the money is expected to help more than 100,000 people suffering from mental health conditions.
“Structured psychotherapy is an evidence-based, life-saving treatment for illnesses such as anxiety and depression,” Hoskins said in a news release.
“Public funding for this intervention is a major milestone toward ensuring that people with mental illness receive just and equitable access to the health care they deserve.”
Speaking at the start of Mental Illness Awareness Week at the Centre for Addiction and Mental Health (CAMH) in Toronto, Hoskins said the money is part of the province’s $140-million investment in mental health services over three years.
CAMH provides inpatient and outpatient clinical supports for people with complex mental illness, patient and family resources, and recreation facilities.
The amount is in addition to the $3.7 billion that Ontario invested in mental health services in 2015-16, he said.
CAMH Queen West site redevelopment begins
Hoskins said the province will invest in the following programs:
- In-person individual and group psychotherapy counselling programs coordinated through Ontario’s four specialty mental health hospitals — CAMH, Ontario Shores Centre for Mental Health Sciences, Royal Ottawa Health Care Group and Waypoint Centre for Mental Health Care — through the help of community-based providers.
- These programs will be provided through local primary care providers and community mental health agencies, and will also be available remotely through the Ontario Telemedicine Network.
- Bounce Back, a coaching program managed by Canadian Mental Health Association Ontario, which includes telephone support and instructional workbooks that help people learn skills to address problems related to moderate depression and anxiety.
- Online mental health self-management tools coordinated by the Ontario Telemedicine Network.
According to the Ontario government, people can access these programs by speaking to their primary care providers and visiting local community mental health and addictions centres.
Hoskins also drew attention to the beginning of construction for CAMH’s Queen West site redevelopment.
The redevelopment means 655,000 square feet of new space will be constructed. The expansion will include 235 inpatient beds, an emergency room open 24 hours, research and education facilities, and parks and retail space within CAMH’s neighbourhood.
Hoskins said Ontario is investing up to $633 million in CAMH’s expansion.
According to the news release, about 30 per cent of Ontario residents will experience mental illness or substance abuse at some point in their lifetime.
“Investment in #CAMHRedevelopment will improve our ability to treat #mentalillness nationwide, and around the world” – @DrEricHoskins