Canvassing for Opinion - aka "Blairs Brain on Cannabis"

IMHO prohibition sentiment requires inherent addiction to status quo, an incapacity to visualise beyond the here and now and a desperate desire to know others might feel the same... Reform is not revolutionary, rather it is evolutionary. Having survived banging your head against a brick wall the evolutionist relishes having stopped. / Blair

Tuesday, November 20, 2007

Fetal Alcohol, Crack Babies, Heroin Children and Cannabis Low Birth Weights.

Fetal Alcohol, Crack Babies, Heroin Children and Cannabis Low Birth Weights.

The Neonate 'scare tactics' Problem

One of the first victims of War (on Drugs), is the Truth.

The recent Oxford University review of the literature on shows 'evidentialy' there is no scientific support for the hysteria that permeates public discussion on fetal alcohol syndrome. Many people falsely believe and proselytise (aided by shonky science, anecdote and media) that even a single drink during pregnancy can cause FAS.

Were it true, western countries would suffer endemic effects of FAS! But we know that FAS is relatively rare at about 1:3000 live births.

Media driven FEAR has dramatised the issue such that pregnant women have become frantic upon realising they had eaten salad that had wine vinegar dressing consequently fearing their children would be born suffering from fetal alcohol syndrome. Of course, wine vinegar, being vinegar, contains no alcohol. Other woman have avoided access to medical help and still more have been stigmatised for life... unfairly labelled (John Kirwin, where are you?) as irresponsible because their child is subjectively somehow not what society expects of it.

The guilt burden is inequitable. The same burden has been placed on cocaine and heroin and other drug using 'mothers' absent the required standard of evidence. Some mothers have had children removed from them. This is a gross violation of the medical principle of first do no harm.

There is no evidence that light drinking, even on a daily basis, leads to fetal alcohol syndrome. health research does validate that many women who are light or moderate drinkers choose not to drink during pregnancy.

The real problem is found among frequent heavy drinkers, who most often are alcoholics consuming heavily on a daily basis throughout their pregnancies. This is not unlike tobacco (nicotine ) addiction. This is a reflection of our historical attitudes and drinking culture. We are not honest about our alcohol and adult choices. We have entrained a chronic drug dichotomy. Legal = Good, Illegal = Bad.

Some may argue that many of these 'drinking' women are poorly educated, leading somewhat marginal lives that birth FAS identified children. They might typically smoke, use illegal and other pharmaceutical drugs, can be dietary challenged [either malnourished or obese] and due to limited access or misplaced resources receive inadequate medical care during pregnancy. Typically alcohol consumption does not decline over time among such women during their pregnancy . Because of their addiction, these women resist health promotional education approaches.

Simplistic approaches suggest this is the target group to which appropriate resources need to be directed if we want to reduce the incidence of fetal alcohol syndrome. However, the writer believes that it is our normative value system that is challenging and that a cultural shift in drug policy will 'enable' better outcomes. This does not require more resources. It requires us to talk about drugs. (see Alcohol and Drugs, Sandals and Footwear. )

Of far greater concern is the role of alcohol in teen pregnancy and teen sexual health. As identified by the 1998 Health Select Committee on Cannabis and Mental Health, there are impediments to credible health promotion. We owe it to ourselves and our children to resolve the tensions that are the 'identified impediments' and use Ottawa Charter Principles 'and remove them' - that requires us to have an honest discussion in society about ALL drug use.

Where such discussion has occured (ie: Seattle and Denver) real progress has been made in making available SAFER alternatives to alcohol.

Curiously, this month the British Medical Association (130,000 PhD's) called for robust ethical debate on 'cognitive enhancing' drug issues. Are we up to it? Or yet again, as we lurch into another election year where talking about drugs is reduced to a moral 'bridge to far', we continue to believe that 'more resources' will fix everything and he/she who doles it out 'is somehow more electable'.

Blair Anderson ‹(•¿•)›

Social Ecologist 'at large'

ph (643) 389 4065 cell 027 265 7219


Maternal cannabis use and birth weight: a meta-analysis
There is inadequate evidence that cannabis, at the amount typically. consumed by pregnant women, causes low birth weight - Prescribed drugs do more harm to babies than heroin ...

In simplest terms, FAS is caused by prenatal exposure to "high" amounts of alcohol. The determination of "how much is too much" turns out to be a sticky problem. Diagnostic criteria refer to "maladaptive patterns of drinking associated with moderate to heavy alcohol consumption," and in the extreme this is not particularly difficult to identify with reasonable certainty. However, defining limits for moderate amounts of alcohol is difficult, and the resulting potentially adverse effects cannot be excluded nor definitively demonstrated. In 1996, the Institute of Medicine (IOM) of the National Academy of Sciences published the findings of a committee that was formed to conduct a literature study of fetal alcohol syndrome and related birth defects, and to provide guidance for future research and prevention efforts (3). According to the IOM committee, "The lack of diagnostic criteria for or more definitive statements regarding possible effects of low to moderate exposure to alcohol should not be interpreted as contradictory to the Surgeon General's warning against drinking alcohol during pregnancy."

Previous to the IOM report, the term Fetal Alcohol Effects (FAE) was used to describe children who have all of the diagnostic features of FAS, but at mild or less severe levels. In the IOM report the terms ARND and ARBD were recommended, and are currently preferred.

The IOM report notes that ARBD and ARND are "catch-all" categories, and the outcomes are not specific to prenatal alcohol consumption. Thus, the causal link between maternal alcohol consumption and ARBD or ARND generally is not certain, and the role of other factors may need to be excluded. Both ARBD and ARND also require documented maternal alcohol exposure, and include outcomes linked to maternal alcohol consumption through human or animal research.

Alcohol-Related Birth Defects (ARBD) includes a diverse array of physical birth defects: skeletal abnormalities, heart defects, cleft palate and other craniofacial abnormalities, kidney and other internal organ problems, vision and hearing problem.

Alcohol-Related Neurodevelopmental Disorders (ARND) includes outcomes such as decreased cranial size at birth, structural brain abnormalities (e.g., microcephaly), abnormal neurological conditions ( e.g., impaired fine motor skills, neurosensory hearing loss, poor tandem gait, and poor eye-hand coordination). The IOM report also includes a diagnosis of ARND as a result of behavior or cognitive abnormalities that cannot be explained by other familial or environmental factors, and of course there is a history of maternal alcohol consumption.

Examples of behavior and cognitive abnormalities include:

  • Learning difficulties
  • Deficits in school performance
  • Poor impulse control
  • Problems in social perception
  • Deficits in higher level receptive and expressive language
  • Poor capacity for abstraction and metacognition
  • Specific deficits in mathematical skills
  • Problems in memory, attention, or judgement
1. Lemoine et al., Ouest Medecine 21, 476-482, 1968.
2. Jones, et al. Lancet 1, 1267-1271, 1973.
3. Institute of Medicine, Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment, Stratton, K., Howe, C., and Battaglia, F, Editors. National Academy Press, 1996.

Defining Excessive Alcohol Consumption

Major Points to Remember:

  • FAS is clearly associated with alcohol dependence and abuse
  • Alcohol dependence and abuse are characterized by maladaptive patterns of drinking
  • Alcohol consumption that results in dependence is considered a diagnosable disease

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