Health Promotion Disease Prevention: Fetal Alcohol Syndrome Exam 2

old medical model: the act of drinking caused the alcoholism

-"they don't care about their health" -must be shown the destruction so they'll be scared -withdrawal ends in 3 days, if they drink after that its because they have mental illness -slow suicide if you're young or drink less then your doctor, you can't be an alcoholic

prescription drug use of pregnant women

-90% of women use some form of prescription medication throughout their pregnancy -over the last 30 years, first trimester use of prescription medications has increased more than 60% -about 3.4 of every 1,000 infants born suffer from withdrawal of symptoms related to misuse of narcotic prescription medications; according to AMA it has tripled within the past decade

effects of FASD

-FASD is the leading cause of preventable intellectual disability and is leading cause of birth defects and learning and behavioral disorders, including fetal and infant death -the prevalence of FASDs in the US is estimated to be as high as 1 out of 20 school-age children, a rate similar to that of autism spectrum disorders

opioid abuse

-addiction from opioid prescriptions is the fastest rising public health problem in the US -over 2,000 deaths/ week -most fatalities due to oxycontin

FASD: the facts

-effects can be lifelong -effect development and function more so than other drugs or teratogens (alcohol crosses the placenta and enters fetal circulation, damaging cells and the DNA they contain. the fetus has the same concentration of alcohol as the mother, but for a longer period of time) -can contribute to a range of growth deficits and structural anomalies

challenges of raising a child with FASD

-most cases of FASD are never diagnosed. symptoms of FASD are identified and addressed but rarely is alcohol identified as the causal factor. -few physicians and other healthcare professionals are trained in how to identify FASD -birth mothers can face incarceration in some states -birth families can live with painful judgements and stigma

variability of outcomes

-not every woman who drinks heavily during pregnancy will give birth to a child with an FASD -not all children with an FASD have exactly the same defects or deficits -many biological and environmental factors influence the effects of alcohol on the developing fetus -pregnant women who drink alcohol tend to have lower levels of nutrients that are essential for the development of the baby (zinc, copper, iron, folate etc.)

diagnosis: alcohol use disorders (AUD)

-problems drinking that becomes sever is given the medical diagnosis of AUD. AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using -an estimated 16 million people in the US have AUD

DSM 5 criteria for AUD

-provides clinicians with a set of 11 factors that ca guide them in the diagnosis of an alcohol use disorder and its severity grade -anyone meeting 2 of the 11 criteria during the same 12 month period receives a diagnosis of AUD. the diagnosis can be mild, moderate, severe example of criteria: -experienced cravings -given up or cut back on activities that were important or interesting to you, or gave you please, in order to drink -continued to drink even though it was making you feel depressed or anxious or adding to another health problem? or after having had a memory blackout

gender differences with alcoholism

-women more frequently report a positive family history -progression of disease is quicker than men -woman's partner is more likely to be addicted than a male's partner -victims of domestic violence -men more likely to combine alcohol with RX drugs -men have more barriers to seeking help (financial problems, family pressures, social stigma etc.)

alcohol use among US women, 2011-2013

1 in 10 pregnant women reports alcohol use 3 in 4 women who want to get pregnant as soon as possible report drinking alcohol

CAGE Substance Abuse Screening Tool

1. have you ever felt you should cut down on your drinking? 2. have people annoyed you by criticizing your drinking? 3. have you ever felt bad or guilty about your drinking? 4. have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)?

Stamp out Stigma Campaign

NOFAS and the NOFAS circle of hope are working to stop the stigma of birth mothers of children with FASD and the stigma of all individuals and families living with the disorders

dosing matters in animal models

effects of moderate blood alcohol prenatally: -poor sensory motor development, poor suckling, increased hyperactivity, learning and behavioral problems effects of 1-2 binge episodes: -FAS -physical anomalies -neurochemical alterations in brain

role of frontal lobes

executive function judgement difficulty in interpreting feedback from the environment risk taking non-compliance with rules impaired associated learning spontaneity memory social and sexual behavior some aspects of language *visualizations of the brain show increased gray matter density and loss of corpus callosum

National Organization on Fetal Alcohol Syndrome (NOFAS)

mission: NOFAS works to prevent prenatal exposure to alcohol, drugs, and other substances known to harm fetal development by raising awareness and supporting women before and during their pregnancy, and supports individuals, families, and communities living with FASDs (fetal alcohol spectrum disorders) and other preventable intellectual/developmental disorders vision: a world where all children are born free of exposure to alcohol, drugs, and other substances known to harm fetal development

facial features of FAS

narrow forehead short palpebral fissures small nose small midface long upper lip with deficient philtrum

stages of alcoholism

pre-alcoholic: drinking to make yourself feel better early: thinking/planning the next time you'll have alcohol, tolerance has gone up middle: family/friends know you're drinking too much, feel guilt, sleep walking or talking late: memory problems, black-outs, drinking more and earlier, missing obligations, facial redness, weight loss or gain, tremors, liver disease, esophageal problems, paranoia

children and adults with FASD

respond slowly can't read emotions and body language can't link cause and effect think in a disorganized way forget information have difficulty with money and time use poor judgement have trouble moving information from one situation to another