FASlink submission to WHO survey on health problems related to alcohol consumption. Bruce Ritchie - September 5, 2006

Please enter your organization's views on the magnitude of health problems related to alcohol consumption: (max 300 words)

Prenatal alcohol exposure has been linked to more than 60 disease conditions, birth defects and disabilities (FASD - Fetal Alcohol Spectrum Disorders). Damage is a continuum from mild intellectual and behavioural issues to profound disabilities or premature death. This major health issue creates enormous personal, family, social, educational, social service and justice consequences, including a high rate of family breakdown and single parenting in poverty.

An individual's place, and success, is almost entirely determined by neurological functioning. The largest cause of brain injury in children is prenatal alcohol exposure. Often the neurological damage goes undiagnosed, but not unpunished.

In Canada, we estimate that more than 20% of babies have been multiply exposed to high levels of alcohol in the first trimester, before the girl knew she was pregnant. All will be affected to some degree. Continued drinking during pregnancy exacerbates the damage.

FASD is grossly under-reported. Very few doctors have been trained to diagnose it. Most prefer to use "non-judgmental" diagnoses such as ADHD, LD, MR, RAD, ODD, Bi-Polar, etc. These "symptoms" do not come with the social baggage of an alcohol associated disability. However, failure to properly diagnose and treat FASD leads to development of secondary disabilities, such as mental health problems; disrupted school experience; trouble with the law; confinement in prison, drug or alcohol treatment center or mental institution; inappropriate sexual behaviour; alcohol and drug problems; inability to live independently; and employment problems.

Impulsiveness, poor judgment, inability to predict consequences, little capacity for moral judgment or empathy, and hormones can lead to children with FASD drinking and giving birth to babies with FASD. It becomes a multi-generational problem.

While prenatal alcohol exposure is the leading cause of mental retardation, many individuals with FASD have normal to high IQ's. They can become sociopaths leading corporations, governments and military operations.

Please enter your organization's opinions on effective interventions to reduce health problems related to alcohol consumption: (max 300 words)

FASD is 100% preventable, but not curable. Early diagnosis and intensive intervention can help substantially, but the need for a supportive structure is permanent. Massive Denial surrounds alcohol issues at all levels of society and government.

Medical Education

* Teach physicians and other health professionals to screen, diagnose and treat FASD.
* Recognize and deal with the continuum, not just the extremes of FASD.
* Actively screen for alcohol use in all patients and give advice.
* Recognize medical issues of alcohol and all personal, family and societal ramifications.

FASD Prevention

* Folic acid should be added to all beverage alcohol.
* Break the cycle. Properly fund addiction intervention and rehabilitation programs.
* Identify women at risk of having children with FASD and intervene.
* Meconium testing for Fatty Acid Ethyl Esters should be mandatory for every birth.
* Intensive family and social service supports for FASD and recovering alcoholics.
* Poverty breeds, and is a result of, substance abuse. Deal with it.

Alcohol Vendors

* The beverage alcohol industry pays less than 1% of the total damages caused by their products. Increase taxes on beverage alcohol.
* All tax revenue to be returned to support rehabilitation programs and victims of alcohol.
* Remove all incentives for governments to promote alcohol.
* End all government supports for beverage alcohol industry, including *wine and beer tourism*.
* End all alcohol advertising
* Alcohol must be served with food.
* Breathalyzers in all alcohol establishments
* Ban alcohol sales incentives, contests, games.
* Ban *Happy Hour* discounted promotions. They encourage binge drinking.

Public Education

* Educate the public that addiction is a medical issue not a moral failure.
* Educate children from a very young age about dangers of alcohol.
* Have youth design anti-alcohol programs targeting youth.

Research

* Better diagnostic tools.
* True incidence and scaling of FASD damage.
* Chemically turn-off addiction center in brain.

Additional comments: (max 300 words)

FASlink Fetal Alcohol Disabilities Society serves some 400,000 people annually. The FASlink Archives online contain more than 110,000 FASD related documents. Our membership is worldwide but most are in Canada and the USA, from the most remote locations to urban centers. FASlink partners with St. Michael's Hospital FASD Diagnostic Clinic. St. Michael's is a teaching hospital affiliated with the University of Toronto.

The cost of FASD to affected individuals is incalculable and tragic. FASD exacts a tremendous price from families in quality of living, physical and mental health, and financially. In Canada's federal, provincial and municipal budgets, alcohol damage may represent more than 50% of the Justice budgets, 20%+ of the Education budgets, 10% of the Health budgets, 80% of the Child Protection budgets and 50%+ of the Social Welfare budgets.

Break a raw egg (without breaking the yolk) into a bowl. Add 1 ounce of alcohol. Gently stir some of the alcohol into the egg white. Watch the effects on the egg white. White streaks will form in the clear portion. Alcohol literally cooks the egg. "Here is your baby's brain on alcohol".

"FAS represents the largest environmental cause of behavioral teratogenesis yet discovered and, perhaps, the largest single environmental cause that will ever be discovered." -Riley, E. P., and Vorhees, C. V.

"Of all the substances of abuse, including heroin, cocaine, and marijuana, alcohol produces by far the most serious neurobehavioral effects in the fetus." -Institute of Medicine 1996 Report to Congress

Any attempt to control the beverage alcohol industry is met with well financed attacks. They finance tainted research, organizations purporting to deal with the results of alcohol, and some politicians. Individuals and organizations become addicted to the money if not the product. Society's Massive Denial is the hallmark of 3000 years of beverage alcohol.