Canada's Drug Strategy - Situational Analysis : Fetal Alcohol Syndrome/Fetal Alcohol Effects and the Effects of Other Substance Use During Pregnancy

Acknowledgment

During the course of this project, the principal investigator, Carole Legge, became ill and sadly died on December 4, 2000. Carole became involved with this project to further the knowledge on substance use and pregnancy in Canada. Her commitment to issues related to fetal alcohol syndrome will be greatly missed by colleagues across the country. This report is dedicated to her.

Thanks are expressed to Susan Rosidi of Canadian Centre on Substance Abuse (CCSA) for managing the mail-out program survey, Jill Austin (CCSA) for preparing statistical analyses, Virginia Thomas for conducting the French language and Aboriginal interviews, and to Richard Garlick (CCSA) for editing this report. Appreciation is also expressed to the project steering committee members for their guidance and support throughout the project. Finally, thanks are extended to the many persons who gave their time to share information with the project as key informants or program survey respondents.

The findings of this report reflect the results of a survey completed in November 1999. Since that time, several provinces and territories have implemented other FAS/FAE-related programs. Therefore, it has not been possible to account for all subsequent initiatives. The information presented is based on the responses of key informants and this has resulted in some limitations to the results. Please contact your provincial and territorial government for further information.

Introduction

Alcohol and other substance use during pregnancy is a problem inseparable from many other issues and factors in the lives of mothers, children, their families and communities. Although Fetal Alcohol Syndrome (FAS), Fetal Alcohol Effects (FAE) and the effects from other substance use during pregnancy are preventable, solutions are complex and must be viewed from a broad-based context that requires commitment and long-term planning on the part of many (Health Canada, 1996).

The effects from alcohol use during pregnancy vary with the timing, amount and duration of alcohol consumption, the general health of the mother and the resources available, but can result in FAS/FAE. Epidemiological research into FAS/FAE is incomplete, but the associated human and economic costs are significant and lifelong, as it is a leading cause of mental disability and preventable birth defects.

The effects of other substances e.g. cannabis, opiates, inhalants, etc., during pregnancy are less well understood but thought nonetheless to be significant. These effects also vary with the manner of use and the health and social circumstances of the mother.

1.1 Context and Project Purpose

In the spring of 1999, the Canadian Centre on Substance Abuse (CCSA) undertook this situational analysis project on Fetal Alcohol Syndrome/Fetal Alcohol Effects and the effects of other substance use during pregnancy for Health Canada. This project was supported by a national steering committee and involved a review of FAS/FAE-related activity across Canada, based on the results of key informant interviews and a survey of programs to December, 1999. This analysis will follow a life-span approach.

1.2 Organization of the Document

The following section will describe the methodology used for the key informant interviews and the mailed surveys. A profile of activity across Canada will be discussed. The profile will be organized according to the primary categories as defined in Section 2.2.1:

• Prevention
• Identification
• Intervention

The following categories will be discussed in support of the primary categories:

• Community and systems supports
• Research
• Policy

A listing of the issues identified by key informants with respect to the above topic areas will be presented. It is important to note that specific initiatives cited in this discussion are presented only as examples of activities to illustrate a trend or pattern.

The sections entitled Profile of Activities and List of Resources present a more complete list of activities and resources, broken down by jurisdiction.

A list of members of the steering committee for this project and a copy of the interview questions can be found in the Appendices.

Data collection for this analysis was finished in December, 1999. Since then, further developments have occurred. It is not possible to account for all recent initiatives; however, some of the more significant include:

• The Prairie Province Partnership on FAS was expanded in 2000 to include the Yukon, Nunavut and Northwest Territories, and became the Prairie Northern FAS Partnership¹;
• The Correctional Service of Canada’s National Headquarters Working Group on FAS/FAE;
• The federal government’s National Advisory Committee on FAS/FAE coordinated by Health Canada;
• The Motherisk Program newsletter Fall 2000 (#12) that is fully dedicated to FAS/FAE research;
• Health Canada’s National First Nations and Inuit CPNP/FAS/E Steering Committee held regional discussion and feedback sessions resulting in the development of a National Framework for the First Nations and Inuit FAS/FAE Initiative.
• Health Canada’s Childhood and Youth Division of Population and Public Health Branch held regional discussion and feedback sessions across Canada.
• January 2000, Health Canada announced an $11 million initiative for FAS/FAE to build on the work of partners at the provincial, territorial and community levels.
  

It should also be noted that a related Health Canada project, Enhancing FAS/ARBD Interventions at the Prenatal and Early Childhood Stages in Canada, provides information on best practices, and funding for the Community Action Program for Children (CAPC), Canada Prenatal Nutrition Program (CPNP) and Aboriginal Headstart Program (AHS).

1 Prairie Northern FAS Partnership will be used throughout this document.