Monday, February 4, 2013
Commentary: Addressing Fetal Alcohol Spectrum Disorders in Addiction Treatment
Addiction treatment professionals can play a vital role in
preventing the leading known cause of intellectual disabilities, birth
defects and neurobehavioral disorders in the world, Fetal Alcohol
Spectrum Disorders (FASD).
Each year 125,000 American newborns are prenatally exposed to heavy
or binge alcohol consumption, 20 times the number exposed to
methamphetamine and inhalants. Alcohol is a teratogen—a substance known
to be toxic to developing babies. Of the most common substances of
abuse, including marijuana, cocaine and heroin, alcohol produces by far
the most serious neurobehavioral effects in the offspring of
substance-using women.
FASD is not typically included in addiction treatment curriculum. One
problem is that there is not a code for it in the DSM manual of mental
health disorders, and as a result, psychiatrists and psychologists are
not informed about FASD.
FASD may also be an unexamined cause for high recidivism in addiction treatment. There are several reasons why this may be:
• Women may have used alcohol and drugs while pregnant and be afraid to discuss in group;
• Women may have children with undiagnosed FASD, and may not be educated on appropriate parenting techniques; and
• Clients themselves may have been prenatally exposed to alcohol and have unidentified learning and behavioral disorders as a result.
• Women may have used alcohol and drugs while pregnant and be afraid to discuss in group;
• Women may have children with undiagnosed FASD, and may not be educated on appropriate parenting techniques; and
• Clients themselves may have been prenatally exposed to alcohol and have unidentified learning and behavioral disorders as a result.
Preventing FASD in Addiction Treatment
If a woman drinks while she is pregnant, there is a risk for having a child with FASD regardless of ethnicity, education or socio-economic status. A woman does not have to be an alcoholic to have a child with effects; however, women that suffer with alcoholism are at the highest risk. Women who use other drugs are also at high risk for having a child with FASD, since many use alcohol as well. Women who drink should be counseled about using effective contraception to avoid pregnancy.
If a woman drinks while she is pregnant, there is a risk for having a child with FASD regardless of ethnicity, education or socio-economic status. A woman does not have to be an alcoholic to have a child with effects; however, women that suffer with alcoholism are at the highest risk. Women who use other drugs are also at high risk for having a child with FASD, since many use alcohol as well. Women who drink should be counseled about using effective contraception to avoid pregnancy.
Since FASD is preventable, all clients and their families receiving
addiction treatment should be educated on the hazards of drinking while
pregnant. Men may not cause FASD directly, but they have a very
important role in prevention. They can encourage and support women not
to drink while pregnant, or at risk for pregnancy.
Treatment is an appropriate time to learn about FASD. If clients
realize that some of their children may have effects from prenatal
alcohol exposure, a counselor is there to provide them with support and
resources. Treatment professionals should provide opportunities for
women to discuss many of the difficult issues around mothering and
parenting. They can provide women with language to talk to their
pediatricians and other health care providers about possible exposures
to ensure that the children are receiving assessments and appropriate
services.
Recognizing FASD in Clients
People with FASD often go unnoticed as having a brain disorder because the majority of individuals have borderline intelligence or above. This is a lifelong disability and the cognitive, behavioral, emotional and social difficulties can each appear across a continuum of severity, from mild to profound. They may experience a daily fluctuation of attention and focus. Many will struggle with understanding cause and effect relationships or the ability to predict future behaviors. Individuals are typically naïve and are easily led into situations. They may have problems in judgment, memory and social skills, but because they have strong expressive language skills they appear higher functioning than they are. It is not uncommon for a client with FASD to be unsuccessful and sometimes terminated from treatment. These individuals need structure, support and understanding. If counselors better understood the typical behavioral profile of a client with FASD, and how to modify treatment, treatment outcomes could improve.
People with FASD often go unnoticed as having a brain disorder because the majority of individuals have borderline intelligence or above. This is a lifelong disability and the cognitive, behavioral, emotional and social difficulties can each appear across a continuum of severity, from mild to profound. They may experience a daily fluctuation of attention and focus. Many will struggle with understanding cause and effect relationships or the ability to predict future behaviors. Individuals are typically naïve and are easily led into situations. They may have problems in judgment, memory and social skills, but because they have strong expressive language skills they appear higher functioning than they are. It is not uncommon for a client with FASD to be unsuccessful and sometimes terminated from treatment. These individuals need structure, support and understanding. If counselors better understood the typical behavioral profile of a client with FASD, and how to modify treatment, treatment outcomes could improve.
Recognizing that a person “can’t” perform, rather than “won’t”
perform, immediately changes the dynamic in a service relationship. By
recognizing the disability of FASD and modifying systems of care, we can
improve outcomes for clients. Adults often need lifelong transitional
and behavioral support.
Below are suggestions for improving treatment for individuals with FASD:
• Train staff to modify treatment plans and treatment;
• Plan for long-term treatment and aftercare options;
• Include the entire family in treatment;
• Assist clients with housing, vocational, educational, day-care, respite, recreational and other services;
• Assist clients with Supplemental Security Income, public assistance, food stamps, Medicaid/Medicare and other disability programs;
• Counselors should consider the possibility of past victimization in these clients;
• Counselors should know best treatment practices and recommendations for clients with FASD; and
• Addiction treatment agencies should pursue assessments and diagnosis for clients (and/or children of clients) when they suspect a person has FASD.
• Train staff to modify treatment plans and treatment;
• Plan for long-term treatment and aftercare options;
• Include the entire family in treatment;
• Assist clients with housing, vocational, educational, day-care, respite, recreational and other services;
• Assist clients with Supplemental Security Income, public assistance, food stamps, Medicaid/Medicare and other disability programs;
• Counselors should consider the possibility of past victimization in these clients;
• Counselors should know best treatment practices and recommendations for clients with FASD; and
• Addiction treatment agencies should pursue assessments and diagnosis for clients (and/or children of clients) when they suspect a person has FASD.
There is much that can be done to address FASD in addiction
treatment. The National Organization on Fetal Alcohol Syndrome (NOFAS),
founded in 1990 as a voice for individuals, families and caregivers
living with FASD, disseminates information and resources, provides
referrals to specialists, and offers a 22-unit certification program for
addiction professionals (www.nofas.org).
Kathleen Tavenner Mitchell, MHS, LCADC
Kathleen T. Mitchell is currently the Vice President and
International Spokesperson for the National Organization on Fetal
Alcohol Syndrome and a noted speaker/author on Fetal Alcohol Spectrum
Disorders (FASD) and Women and Addictions. She founded the Circle of Hope (COH), an international peer mentoring network for women who have used substances while pregnant.
Sunday, February 3, 2013
Injection Drug Users With Hepatitis C Are “Super-Spreaders” of the Virus
People who inject drugs and have hepatitis C are
“super-spreaders” of the virus, who are likely to infect 20 other
people, a new study finds. Half of hepatitis C virus transmissions take
place in the first two years after a person is initially infected.
Researchers from the University of Oxford in England say early
diagnosis and treatment of hepatitis C in people who inject drugs could
help prevent the spread of the virus, HealthDay reports.
Hepatitis C, which can be spread through contact with infected blood,
may lead to scarring of the liver, or liver cancer. There is no vaccine
for the disease, the article notes. Many people with hepatitis C are
unaware they have the disease, and go undiagnosed for more than a
decade.
“For the first time we show that super-spreading in hepatitis C is
led by intravenous drug users early in their infection,” study author
Gkikas Magiorkinis said in a university news release.
“Using this information, we can hopefully soon make a solid argument to
support the scaling-up of early diagnosis and antiviral treatment in
drug users. Helping these people and stopping the spread of hepatitis C
is our ultimate target.”
The study appears in the journal PLoS Computational Biology.
Thieves Steal Prescription Drugs From Medicine Cabinets in Open Houses
Prescription drug thieves are stealing from medicine cabinets during open houses, ABC News reports.
Home sellers usually lock up valuables such as jewelry, electronics
and personal information, but often don’t think of securing their
medicine cabinets. A San Diego realtors’ group is warning homeowners
about these thefts. “The take away here is common sense,” Anthony
Manolatos of the Greater San Diego Association of Realtors told ABC
News. “When an agent is showing your home and you’re not there, take
your valuables with you or lock them in a safe.”
The Drug Enforcement Administration (DEA) has observed this trend.
“Stealing drugs from open houses is indeed a technique drug thieves use
to obtain controlled substance prescription drugs,” said the DEA’s
Barbara Carreno. She said drugs stolen during open houses include opioid
painkillers, anti-anxiety drugs, ADHD drugs, Xanax and Valium.
DEA enforcement groups, called tactical diversion squads, have found
drugs on the black market that have been stolen during open houses,
Carreno added.
Friday, February 1, 2013
The Hope Share: A Live Storytelling Event
85 million people in the U.S. have been affected by addiction and
over 20 million are in long-term recovery. Imagine if each of them came
forward to share a story of recovery or a message of support.
The Hope Share, a new
story-sharing portal created by The Partnership at Drugfree.org, is
designed to elevate stories of recovery and inspire others to speak out
and help break the stigma and discrimination surrounding addiction.
We’ve teamed up with proud partners of this project, InTheRooms.com and Faces & Voices of Recovery, to host a unique upcoming virtual experience – The Hope Share: A Live Storytelling Event.
Taking place on Wednesday, February 6th at 9 p.m. EST, participants
are encouraged to share their video stories of hope using their webcam
during this 90-minute LIVE event to help inspire others and spark
meaningful conversation around alcohol and other drug problems and
addiction.
To participate in this event, visit Meeting Room 1 here at 9:00 p.m. EST on February 6th.
The event will be moderated by InTheRooms.com and will feature Pat
Taylor, Executive Director, Faces and Voices of Recovery, and Jerry Otero, a Parent Support Specialist and clinical social worker from The Partnership at Drugfee.org.
Share your powerful story and help encourage families who are
struggling with a young person’s addiction, and let them know that there
is hope, and that recovery is possible.
To participate in this event, visit Meeting Room 1 here at 9:00 p.m. EST on February 6th.
Gene Mutations Linked With Increased Risk of Dying From Cocaine Abuse
New research suggests people with common genetic mutations
have an almost eightfold increased risk of dying from cocaine abuse. The
mutations affect the chemical messenger dopamine in the brain.
Dopamine is vital to the functioning of the central nervous system.
Cocaine blocks transporters in the brain from absorbing dopamine, HealthDay reports.
The mutations are found on two genes. The Ohio State University
researchers found about one in three white people who died of cocaine
abuse had these genetic mutations. A different combination of mutations
affects the risk of dying from cocaine abuse in black people, the
researchers noted in a news release.
The study appears in the journal Translational Psychiatry.
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