Salam, S.S., Mitchell, C. (2022). Evaluating Alcohol, Tobacco, and Other Substance Use in Pregnant Women. In: Anumba, D.O., Jayasooriya, S.M. (eds) Evidence Based Global Health Manual for Preterm Birth Risk Assessment . Springer, Cham. https://doi.org/10.1007/978-3-031-04462-5_7
Use of tobacco, alcohol, and psychoactive substances during pregnancy is associated with increased risks of preterm birth. Concurrent use of these substances is also quite common and further increases the risk of adverse outcomes. Health-care providers should ask pregnant women about their exposure to tobacco, second-hand smoke, alcohol, and illicit substances (past and present) at every antenatal visit using validated screening instruments and offer brief interventions.
Pregnant women with alcohol or substance dependence should be assessed individually and offered psychosocial interventions (e.g. motivational interviewing, cognitive behavioural therapy, contingency management). Pregnant women should be advised to quit and referred to detoxification services or opioid substitution treatment (for opioid users). Pharmacological treatment for maintenance and relapse prevention is not recommended for amphetamine, cannabis, and cocaine dependence and requires individual risk-benefit analysis for alcohol dependence. Opioid maintenance therapy with methadone or buprenorphine is recommended for opiate dependence. Pregnant women who are current tobacco users or have recently quit should be offered psychosocial interventions (e.g. counselling, incentives, social support). Evidence on impact of pharmacological interventions for cessation of tobacco use is limited. Interventions to make public places and homes smoke-free are recommended. Evidence of impact of these interventions in reducing PTB especially in LMIC settings is low and further research recommended.
Click here to read the open access research article.
The Lakeland Centre for FASD will be hosting their 3rd Virtual Conference this year with the theme of FASD & Mental Health, It’s All Connected. Individuals with FASD face significant mental health challenges as a result of their disability. Individuals with FASD experience higher rates of mental illness than the rest of the Canadian population. An estimated 90% of people with FASD experience an additional mental health diagnosis.
FASD is known to have a greater effect on populations with poorer social determinants of health, one of which includes people experiencing homelessness. Many people experiencing homelessness struggle with mental illness and substance use disorders. Substance use concerns are also extremely common in individuals with FASD, with 53% of males and 70% of females reporting substance use issues. This rate is 5 times the rate of the general population.
Individuals with FASD may also be at a higher risk of suicidal thoughts. Researchers have shown that 43% of individuals with FASD have experienced or displayed suicidal ideation, and 23% have experienced a suicide attempt. There is increasing data to suggest that a disproportionate number of people in conflict with the law have FASD. Some researchers estimate the rate of FASD to be ten times higher inside Canadian prisons than in the general population. The legal issues associated with FASD have substantial financial implications, with estimates of annual justice-related costs at $1.2 billion per year in Canada, functioning as one of the greatest cost drivers linked with FASD.
Mental health is an extremely important consideration when discussing the needs, supports, and resources for individuals with FASD. The problem is that traditional therapeutic approaches to addressing mental illnesses are ineffective when they do not take into consideration the unique brain profile of individuals with FASD. It’s time to take a holistic approach in understanding that the mental health of people with FASD is influenced and impacted by many variables including: their physical health and well-being, their use of substances, involvement with the Justice system, suicidal thoughts or attempts and being unhoused, as well as the level of understanding by their support systems. With an integrated approach to mental health and wellness that is FASD-informed, we will see better health outcomes for individuals with FASD.
LCFASD Schedule at a Glance – TBD
For more information or to register please click here.
October 5, 2021 9:00 AM – 2:30 PM
October 6, 2021 9:00 AM – 2:30 PM
LCFASD 2022 General Conference Admission
CA$225.00 General admission includes access to the 2 day LCFASD Online Conference and Exhibition.
We are pleased to announce that the CanFASD 2021/2022 Annual Report is now available to view.
The past year has been full of exciting progress in the FASD community. The CanFASD Network, with help from our partners, published over 25 articles, 13 technical reports, 5 book chapters and participated in over 50 presentations and interviews. Over the last year we worked on 54 different research projects!
Aside from the incredible work that has been conducted in the research field, CanFASD has also launched a new trainee program, led by Dr. Kelly Harding. This pilot program was designed around the power of relationships and connections to inspire and motivate the next generation of researchers in the FASD Community.
Continuing to fulfill our mission of educating members of society the complexities of FASD is at the top of our list. Last year we hosted 9 webinars on various FASD-related topics, featuring presentations from individuals with FASD, caregivers, researchers, and service providers across Canada. In total, we had over 1,800 attendees at these webinars. Over 25,000 people are enrolled in our online learning courses! We have seven courses designed to inform professionals on effective strategies and supports for those with FASD and women and people who are pregnant.
To further share knowledge and keep individuals up to date in the FASD community, we launched an Individual Membership Program, which gives people the opportunity to become more involved with the CanFASD Network.
As experts in FASD, we know that Canada needs a coordinated, evidence-based approach to address the complexities of FASD. We have made great strides forward this year in garnering support for a National FASD Strategy, but we need help from our community members. We’re asking you to reach out to your Member of Parliament in support for a National FASD Strategy in Canada. Fill out this form and we can help connect you with your MP and provide you with some talking points. With September recognized as FASD Month, now is a great time to start spreading the word!
While we’ve made great strides to move FASD forward in Canada, we could do so much more with your support! Donate to our organization. Your contribution will help us develop and share the evidence needed to inform policies and programs for people with FASD, their families, and pregnant and parenting couples.
Thank you to all our stakeholders and community partners for staying up to date and connected with our ongoing work. Your interest and dedication to this field are integral to our success. We look forward to seeing what the future has in store for our organization and the field of FASD!
Research about preventing FASD is advancing across the globe. In 2022, CanFASD sponsored a five-part seminar series that brought together 14 researchers from around the world to share what is known about preventing alcohol use in pregnancy and supporting women’s health. View the full five-part series below:https://canfasd.ca/topics/prevention/#1657138062944-66938ca9-26cb
Frameworks for FASD Prevention
Level 1 – Raising Awareness and Community Development Work
Level 2 – Brief Intervention and Support
Levels 3 and 4 – Holistic Support during Pregnancy and Postpartum
CanFASD had the pleasure of meeting with Dr. Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health, as well as members of her staff and senior staff from the Public Health Agency of Canada. The purpose of the meeting was to discuss the need for a National FASD Strategy.
Mental Health, FASD, and the National FASD Strategy
CanFASD highlighted the increased risk of mental health and addictions issues for individuals with FASD and the need for programs and supports that are FASD-informed. Ninety percent of individuals with FASD experience mental health challenges. When unsupported, individuals with FASD experience many difficulties, highlighting the need for a National FASD Strategy.
Minister Bennett understood this completely. She recognized the complexities of FASD and understood how a National FASD Strategy would help break down the silos in our field, address FASD prevention, and improve outcomes for individuals and their families.
Discrepancy in funding for FASD
CanFASD highlighted the large discrepancies in awareness and funding support between autism and FASD, with autism receiving over $15 million in the last federal budget (including $7 million to support a National Autism Strategy). Comparatively, FASD receives 1.5 million annually through the National Strategic Projects Fund, which funds a few sporadic projects across the country. Autism affects approximately 1.5% of Canadians. FASD affects at least 4%.
Minister Bennett and her team committed to working with the government and with CanFASD to get support for a National FASD Strategy to improve outcomes for individuals with FASD and their families.
Help us bring forward a National FASD Strategy
Show your support by asking Minister Bennett to commit to a National Strategy for FASD in Canada. You can email the Honourable Carolyn Bennett, Minister of Mental Health and Addictions and Associate Minister of Health at email@example.com.
Want to go one step further? Email your Member of Parliament (MP) to talk about the impact of FASD on you and your community and ask them to support a National FASD Strategy. Look here to find out who your local MP is. If you do meet with your MP, let us know at firstname.lastname@example.org so we can make sure to keep the conversation going.
Not sure where to start? Fill out this short form and we will help you connect with your MP and give you some key points to focus on.
Retrieved from https://canfasd.ca/2022/06/22/canfasd-meets-with-minister-of-mental-health-and-addictions/?utm_source=rss&utm_medium=rss&utm_campaign=canfasd-meets-with-minister-of-mental-health-and-addictions
Voutilainen, T., Rysä, J., Keski-Nisula, L. & Kärkkäinen, O. (2022) Self-reported alcohol consumption of pregnant women and their partners correlates both before and during pregnancy: A cohort study with 21,472 singleton pregnancies. Alcoholism: Clinical and Experimental Research, 46, 797- 808. Available at: https://doi.org/10.1111/acer.14806
Pregnant women’s use of alcohol correlates with that of their partner, a new study from the University of Eastern Finland and Kuopio University Hospital shows. Paying attention to both parents’ use of alcohol may help to prevent drinking during pregnancy, as well as fetal exposure to the adverse effects of alcohol.
Exposure to alcohol is detrimental to fetal development, and there is no known safe limit of exposure. The harmful effects of alcohol may manifest during the child’s development and growth in many ways. The risk of alcohol use during pregnancy has previously been assessed mainly on the basis of the expectant mother’s previous use of alcohol, but not on the basis of their partner’s drinking habits.
The new study looked at the alcohol consumption of 14,822 Finnish women and their partners before and during pregnancy. The study covered a total of 21,472 pregnancies between 2009 and 2018.
In 86% of the pregnancies, the expectant mother reported having used alcohol before pregnancy, and 4.5% also during pregnancy. In 25% of the pregnancies, women reported that they had stopped drinking only after learning about their pregnancy, which means that the fetus may have been exposed to alcohol in the early stages of pregnancy. However, partners generally did not reduce their alcohol consumption before or during pregnancy.
Click here to read the full article.
Understanding fetal alcohol spectrum disorder
The estimated prevalence of fetal alcohol spectrum disorder (FASD) in Canada is greater than that of autism, cerebral palsy and Down syndrome combined, and the incremental cost per case of FASD over a person’s lifespan is estimated at $1.1 million.1
FASD is a lifelong disability that impacts the brain and body of individuals prenatally exposed to alcohol. Individuals frequently have challenges in their daily living and need support with motor skills, physical health, learning, memory, emotional regulation and social skills.2,3 Emerging evidence suggests that FASD is also associated with chronic disease and mental health disorders and adverse societal experiences.4,5 When undiagnosed and unsupported, individuals with FASD are more likely to experience substance use challenges, mental health conditions, involvement with the criminal justice and child welfare systems, emotional and physical abuse, trauma and disrupted housing.6
FASD occurs within a web of increased risk and vulnerabilities. All populations that use alcohol are at risk for FASD, yet we still do not understand the prevalence of alcohol consumption during pregnancy, or FASD, in Canada.
No amount of cannabis exposure is safe during pregnancy, according to our latest report, Clearing the Smoke on Cannabis: Cannabis Use During Pregnancy and Breastfeeding. Until the effects of prenatal cannabis exposure are well understood, the safest option is to avoid using cannabis. But surveys show that while cannabis is the second-most common psychoactive substance used during pregnancy (after alcohol), many pregnant or nursing people haven’t talked with their healthcare providers about the risks.CCSA
We recently shared a poster, Is It OK to Use Cannabis During Pregnancy and While Breastfeeding?, to increase public awareness about the health effects and potential risks.
Now the full report is available, with new findings that support and expand our understanding of this issue. It helps healthcare providers increase their understanding of the latest clinical evidence, so they can advise patients, and improve the health and well-being of patients and their children. The report also helps researchers understand gaps in the knowledge needed to support harm reduction efforts for this population.
Key findings include:
- The effects of cannabis can be passed onto the fetus through the placenta and onto the baby through breastmilk, and can impact the baby’s mental and physical development.
- Use during pregnancy may be associated with babies being born too small and too early.
- Exposure to cannabis during pregnancy and breastfeeding can interfere with the baby’s attention, memory and reasoning abilities, behaviour and processing of emotions, and problem-solving skills.
- Exposure can increase the baby’s risk of hyperactivity, impulsive behaviours and sleep disorders.
- Growing evidence from human and animal studies shows that paternal cannabis use can also negatively affect children’s neurodevelopment.
- The effects of CBD use during pregnancy or breastfeeding are unknown. Both clinical and preclinical studies are urgently needed to evaluate the safety of CBD use during pregnancy.
- There is not enough evidence to support using any form of cannabis to treat the negative symptoms of pregnancy, such as nausea, vomiting and pain.
- Pregnant or breastfeeding people should have informed discussions with their healthcare providers about the potential adverse effects of cannabis to help them make informed and healthy choices.
NCCIH Webinar – Visioning the Future: First Nations, Inuit, & Métis Population and Public Health Series – Environmental and Mental Health
Jun 20, 2022 11:00 AM in Edmonton
This webinar takes a holistic approach to considering Indigenous health. Such an approach looks into and beyond the physical environmental factors affecting Indigenous Peoples’ health to include the emotional, spiritual, and intellectual landscapes that influence their overall well-being.
In this webinar, Dr. Shannon Waters will examine the impact of the disrupted relationship between Indigenous Peoples and place (land, water, animals, plants) on the health of the land and all living beings. She will consider best practices for re-establishing Indigenous Peoples’ connection to and ownership/co-governance of the natural environment. Dr. Chris Mushquash will present ways in which historical and ongoing processes of colonization have disrupted Indigenous Peoples’ health and mental wellness. He will examine a full spectrum of culturally and contextually appropriate supports and services to promote Indigenous Peoples’ mental health.
More about the Visioning the Future Series:
Visioning the Future is a series of webinars offering a vision for First Nations, Inuit, and Métis Peoples’ public health. These webinars are a development of the National Collaborating Centre for Indigenous Health’s 2021 publication, Visioning the Future: First Nations, Inuit, & Métis Population and Public Health, a collaborative report offering a vision for First Nations, Inuit, and Métis Peoples’ public health. Privileging Indigenous knowledges, the commissioned report complements the Chief Public Health Officer’s 2021 public health vision report, A Vision to Transform Canada’s Public Health System.
Click here to register.