Saving Babies from Exposure to Alcohol
SAMHSA recently released a new publication in the Treatment Improvement Protocol (TIP) series, Addressing Fetal Alcohol Spectrum Disorders. The FASD TIP highlights the importance of preventing alcohol-exposed pregnancies and identifying the unique needs of individuals in treatment for mental and/or substance use disorders that may have been prenatally exposed to alcohol.
Fetal Alcohol Spectrum Disorder (FASD) refers to a range of disorders that can occur when a fetus is exposed to alcohol. These effects can be life-long and include physical, mental, behavioral, and learning disabilities. Individuals with FASD require more intensive and personalized services, and early diagnosis and intervention have been identified as critical to improve outcomes and minimize secondary disabilities. Yet, individuals with FASD often go undiagnosed or are misdiagnosed, are difficult to identify early and may not receive appropriate intervention and services. If identified early, appropriate treatment will help reduce the development and impact of disabilities – however, prevention really starts before the baby is born.
SAMHSA’s Center for Behavioral Health Statistics and Quality (CBHSQ) reports that among pregnant women aged 15 to 44, 8.5 percent reported current alcohol use, 2.7 percent reported binge drinking, and 0.3 percent reported heavy drinking. Recent estimates suggest that there may be as many as 200,000 new cases of FASD in the U.S. each year. The damage caused by prenatal alcohol exposure is permanent and the effects cannot be reversed. The multifaceted and lifelong aspects of FASD place a high burden on those directly affected by this preventable condition and place a high economic cost on society. Amendah, Grosse, and Bertrand (2010) found that incurred health costs are nine times higher for children with an identified FASD than for children without.
The new FASD TIP will help alleviate barriers in providing successful treatment for individuals while also helping organizations select an appropriate prevention approach. In an effort to address issues faced by both frontline personnel and organization administrators, this TIP contains three parts:
- Clinical strategies for FASD prevention and intervention;
- An implementation guide for program administrators, including a section that examines cost factors related to FASD services;
- An online literature review on FASD.
SAMHSA urges behavioral health professionals to address the clients’ feelings and experiences as well as to be sensitive to issues such as gender, ethnicity, cultural background, and sexual orientation.
Alcohol Exposure in Pregnancy
Research findings have been inconsistent about the amount of alcohol that can damage a fetus. However, it’s clear that alcohol exposure can be detrimental to a developing baby and abstaining from drinking alcohol during pregnancy is recommended. The new FASD TIP describes effective prevention strategies.
Many factors can affect the development of FASD. These include how much alcohol and how often a woman drinks, and the trimester(s) in which she drinks. Developing FASD also depends on genetics, possible use of cigarettes or other drugs, general health and nutrition, age, and levels of stress or trauma. The amount of alcohol that damages an unborn baby differs based on the individual. Therefore, the safest route to prevention is to avoid drinking alcohol during pregnancy.
Addressing FASD in Adolescence and into Adulthood
Youth with FASD face a multitude of challenges in adolescence and into adulthood. They may be easily influenced by peer pressure and lack impulse control. They may not understand cause and effect or learn from mistakes. For example, a youth with an FASD may not see any problem with driving a car he knows was stolen if he wasn’t the one who stole it. Many youth who become involved with the juvenile justice system often cycle through with no recognition of their FASD-related disabilities, since many FASD-affected people do not display physical abnormalities. Adolescents and adults with FASD often experience a breakdown in family relations, disruption in school, unemployment, homelessness, and alcohol and substance use. The new FASD TIP provides clinical vignettes designed to portray the provider–client interactions that might take place when providing FASD prevention or intervention services.
Other SAMHSA Efforts
In 2001, SAMHSA established the Fetal Alcohol Spectrum Disorders (FASD) Center for Excellence (CFE), a collaboration among researchers, providers, government agencies and private organizations to address the challenges of FASD. The FASD CFE vision is to reduce the number of infants who are exposed to alcohol prenatally; to increase the functioning of persons who have an FASD; and to improve the quality of life of individuals and families affected by FASD.
The FASD Center also offers downloadable FASD evidence-based materials to the public, and links to SAMHSA’s federal, state, national and community partners’ resources. The Center also supports the Birth Mother’s Network – a network of women who have had an alcohol-exposed pregnancy. The FASD Center facilitates conference calls for them to collaborate with partners to promote FASD awareness and prevention, and to promote appropriate systems of care to improve the lives of individuals living with FASD and their families.