Government of Canada: Consultation on strengthening Canada’s approach to substance use issues

Are you ready to provide your thoughts on Canadian Drugs and Substances Strategy (CDSS)?

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The purpose of this consultation is to ask Canadians for new and innovative ideas on how to further strengthen the federal government’s health-focussed approach to substance use issues through the Canadian Drugs and Substances Strategy (CDSS).

How to participate

Use the online questionnaire to provide input on possible next steps in the CDSS.

You can also share your story about how substance use has impacted your life or the lives of people you know.  Your stories will help inform our potential next steps in the CDSS, and may be published in our public report on the summary of the input received during the  consultation with your consent (your name will remain anonymous).

Who should participate in the consultation

This consultation is open to all Canadians, and everyone is invited to share their ideas.

In addition, Health Canada would like to hear from:

  • people with lived and living experience with substance…

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Inclusion Alberta: Recommendations for the PDD review

“Inclusion Alberta”: A blog post from edmontonfetalalcoholnetwork.org A very good read…..

59caae21995b5InclusionAB_vert_rgbInclusion Alberta has drafted a document to assist Albertans in their participation and contribution to the government’s PDD Program Review. As per previous communications, we would like to remind everyone that you can participate directly by attending community conversations in your part of the province, completing the online survey, and/or submitting your ideas in writing, via video or other media.

Information on how to participate and when and where community conversations are occurring can be found at the Government of Alberta’s web page for the review. We think it particularly important that parents of young children with developmental disabilities participate as this Review provides an opportunity to influence the shape of supports and services you will likely require in the near future for your son or daughter to have a meaningful and inclusive life.

We understand the issues and recommendations in our document do not cover the full breadth of…

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FASD: An Intergenerational or Transgenerational Phenomenon

Fetal alcohol spectrum disorders or FASD is a debilitating condition caused by the exposure to alcohol during the prenatal period. In other words, a consequence of maternal consumption of alcohol [Reviewed in (Liyanage et al., 2017)]. That is what the basic and most famous definition of FASD.

But I’d like to ask the question, is it only caused by the maternal consumption of alcohol during pregnancy. Or does alcohol exposure rather have intergenerational or transgenerational consequences?

FASD An Intergenerational or Transgenerational Phenomenon

The history and the drinking behavior of the mother prior to getting pregnant may influence their drinking behavior during pregnancy as well. In fact, a study by Chang, 2006 says “Previous alcohol use by the pregnant woman was the strongest predictor of prenatal alcohol use.” (Chang et al., 2006). The maternal drinking behavior is also known to be impacted by father’s (male partner’s) alcohol or substance abuse behaviors as it may encourage the mothers to continue drinking (Högberg et al., 2016). The domestic violence, spousal abuse and trauma caused by partner’s alcohol problems may be a causative factor for some women to seek alcohol as a way of relief (Gearing et al., 2005), regardless of their awareness of the harmful effects of alcohol. Therefore, the paternal contribution to FASD may not be simply ignored. We should also praise the partners who made an attempt to change their drinking behaviors after being aware of the pregnancy and the partners who protect mothers from consuming alcohol (Gearing et al., 2005; Högberg et al., 2016).

A child with FASD and a mother who consumed alcohol while pregnant already makes it a problematic phenomenon of two generations. But mother and the child are not the only ones entangled in this problem. Their family is the next generation that is impacted. For example, grandparents, close or distant relatives, sometimes neighbours often acquire the role of ‘caregiver’ of the child with FASD (Healthy Child Manitoba, 2015; Hussain et al., 2012) as well as the mother who is undergoing social stigma, shame, guilt and sometimes alcohol dependency issues and required to abide by properly organized intervention programs. Therefore, the issues associated with FASD and alcohol go far beyond a single family.

Due to the nature of their disease conditions and impaired ability to follow rules, many youth and adults with FASD get involved with the justice system (Flannigan et al., 2018). They may cause community disturbances, violent behaviors among other crimes. Therefore, at this point, it becomes a societal problem beyond a single family.

The above explains the Intergenerational Phenomenon of FASD’.

But what is this ‘Transgenerational Phenomenon of FASD? Transgenerational means the effects of alcohol exposure could be transmitted over generations, from father or mother to the children. This is best explained by transgenerational epigenetic mechanisms.

Epigenetic mechanisms are processes that cause changes beyond the genomic sequence, such as DNA methylation and histone post-translational modifications, the changes that occur on DNA and DNA bound proteins (Liyanage et al., 2014). The transgenerational epigenetic concept suggests that the insult of alcohol exposure preconception to the father or the mother, that can make heritable epigenetic changes in germ cells (sperms/eggs) [Reviewed in (Liyanage et al., 2017)]. Such that, the memory of the alcohol insult is transmitted to the child. There is some evidence to support this theory of transgenerational epigenetic memory in animal models (Abbott et al., 2018; Govorko et al., 2012; Popoola et al., 2017).

This concept of transgenerational epigenetic transmission of alcohol insult makes the issue of alcoholism and FASD even more problematic as the prevention of alcohol consumption by both parents or men and women in their childbearing ages can be quite challenging. Another important question is how many generations this memory of alcohol insult can be transmitted. Evidence from animal models suggests that the epigenetic memory of alcohol insult to the genes in sperms (male germline) can be transmitted up to three generations (Govorko et al., 2012). Another study suggested that the maternal drinking may not only affect the child who was exposed to alcohol but also the grandchildren adding more evidence to the transgenerational phenomenon (Abbott et al., 2018; Rose, July 13 2017). Additionally, a 2018 study also showed evidence in an animal model that the prenatal alcohol exposure may cause alcohol drinking behaviors up to three generations (Nizhnikov et al., 2016). Some studies involving humans have shown a correlation between alcohol consumption by grandmothers and FASD symptoms in their grandchildren (Kvigne et al., 2008).

If we debunk the well-known myth that fathers don’t play a role in FASD, further research may be able to provide more insights into preconception alcohol consumption and its relationship to FASD.

We should understand that this Phenomenon does not necessarily mean that one or two bears taken by our ancestor great-grandmothers may make all of us into alcoholics or individuals with FASD. Both alcoholism and FASD are multifactorial in origin. I.e. there are numerous risk factors including genetics, epigenetics, nutrition, lifestyle, other substance abuse to name a few (Liyanage et al., 2017). But preventing such possible transgenerational harm is our responsibility. That is why it is absolutely necessary to raise awareness of the harmful effects of alcohol consumption, especially among the youth to avoid alcohol or use protection during intercourse if alcohol consumption occurred.

Note: Opinions expressed are solely of VR Writers and do not express the views or opinions of any others…

References

Abbott, C. W., Rohac, D. J., Bottom, R. T., Patadia, S., & Huffman, K. J. (2018). Prenatal ethanol exposure and neocortical development: A transgenerational model of fasd. Cereb Cortex, 28(8), 2908-2921. doi:10.1093/cercor/bhx168

Chang, G., McNamara, T. K., Orav, E. J., & Wilkins-Haug, L. (2006). Alcohol use by pregnant women: Partners, knowledge, and other predictors. Journal of studies on alcohol, 67(2), 245-251.  Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16562406

https://www.ncbi.nlm.nih.gov/pmc/PMC1540454/

Flannigan, K., Pei, J., Stewart, M., & Johnson, A. (2018). Fetal alcohol spectrum disorder and the criminal justice system: A systematic literature review. Int J Law Psychiatry, 57, 42-52. doi:10.1016/j.ijlp.2017.12.008

Gearing, R. E., McNeill, T., & Lozier, F. A. J. J. I. (2005). Father involvement and fetal alcohol spectrum disorder: Developing best practices. 3, e14.

Govorko, D., Bekdash, R. A., Zhang, C., & Sarkar, D. K. (2012). Male germline transmits fetal alcohol adverse effect on hypothalamic proopiomelanocortin gene across generations. Biol Psychiatry, 72(5), 378-388. doi:10.1016/j.biopsych.2012.04.006

Healthy Child Manitoba. (2015). Every day is an adventure: What parents and caregivers need to know about fetal alcohol spectrum disorder (fasd) Retrieved from Manitoba, Canada: https://www.gov.mb.ca/healthychild/fasd/fasd_caregivers.pdf

Högberg, H., Skagerström, J., Spak, F., Nilsen, P., & Larsson, M. (2016). Alcohol consumption among partners of pregnant women in sweden: A cross sectional study. BMC public health, 16, 694-694. doi:10.1186/s12889-016-3338-9

Hussain, F., & Alarcon, K. (2012). Grandparents get help raising children with fasd.   Retrieved from http://www.indigenousreporting.com/2012/story-6/

Kvigne, V. L., Leonardson, G. R., Borzelleca, J., & Welty, T. K. (2008). Characteristics of grandmothers who have grandchildren with fetal alcohol syndrome or incomplete fetal alcohol syndrome. Matern Child Health J, 12(6), 760-765. doi:10.1007/s10995-007-0308-y

Liyanage, V. R., Curtis, K., Zachariah, R. M., Chudley, A. E., & Rastegar, M. (2017). Overview of the genetic basis and epigenetic mechanisms that contribute to fasd pathobiology. Curr Top Med Chem, 17(7), 808-828.  Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27086780

Liyanage, V. R., Jarmasz, J. S., Murugeshan, N., Del Bigio, M. R., Rastegar, M., & Davie, J. R. (2014). DNA modifications: Function and applications in normal and disease states. Biology (Basel), 3(4), 670-723. doi:10.3390/biology3040670

Nizhnikov, M. E., Popoola, D. O., & Cameron, N. M. (2016). Transgenerational transmission of the effect of gestational ethanol exposure on ethanol use-related behavior. Alcohol Clin Exp Res, 40(3), 497-506. doi:10.1111/acer.12978

Popoola, D. O., Nizhnikov, M. E., & Cameron, N. M. (2017). Strain-specific programming of prenatal ethanol exposure across generations. Alcohol, 60, 191-199. doi:10.1016/j.alcohol.2017.01.002

Rose, J. (July 13 2017). Alcohol during pregnancy could have “transgenerational effects” study says, but don’t freak out.   Retrieved from https://www.romper.com/p/alcohol-during-pregnancy-could-have-transgenerational-effects-study-says-but-dont-freak-out-68836

 

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