Training Alaska to better understand and prevent FASD

The cost of excessive alcohol consumption in Alaska is staggering. Though the costs to individuals and families go beyond numbers, the dollar amounts are worth mentioning. A 2006 report from the Centers for Disease Control and Prevention (CDC) estimates $734.5 million or nearly $1,100 per person and a more recent analysis by McDowell Group in 2012 pegs it at $1.2 billion annually.

What those studies and numbers aren't able to do is put faces with those mind-bending numbers, which is why Becky Porter, a licensed professional counselor and project manager with the UAA Center for Behavioral Health Research & Services (CBHRS) appreciated the recent series from the Anchorage Daily News that told the stories of four families affected by fetal alcohol spectrum disorders (FASD).

"The more that birth mothers can feel empowered to come out and talk about their situations, that lessens the stigma," Porter said.

Porter manages two projects for CBHRS, a suicide prevention initiative and the Arctic FASD Regional Training Center, which is one of five CDC-funded training centers in the nation. As project manager for the training center, she's tasked with helping her colleagues and partners around the state increase the competency of everyone from health care providers to criminal justice workers to school employees so they can better understand FASD-an umbrella term for a number of permanent birth defects resulting from maternal consumption of alcohol during pregnancy-as well as treat and manage cases.

Regional training center staff travel all over the state-Bethel, Fairbanks, Nome and Haines, to name a few-to offer continuing education sessions for medical and allied health providers. Community members who work with individuals and families affected by FASD are also welcome to attend.

FASD is a complex issue to address with sensitivity in what may be a limited office visit with a health care provider or a short encounter with school or criminal justice workers. The facts, however, seem deceptively simple.

"Any amount of alcohol, any time during pregnancy has the potential to cause problems," Porter said.

"There are so many things associated with a person who chooses to consume alcohol and then becomes pregnant," she said. "Who knows if they wanted to or meant to? There are not a lot of easy answers. It's such a complicated situation."

Encouraging open conversation and communication is key, as well as combating mixed messages.

"A lot of people will say, 'My doctor told me it's okay to have a glass of wine.' And then there are the providers who meet people and say-practically before you're through the door-'It's not okay to have a drink,' so patients don't feel like they can disclose the information if they are struggling."

In addition to their work addressing the realities of FASD, Porter and her colleagues are working on FASD prevention with continued support from the CDC.

In a recent ADN Compass piece, Porter and Diane King, CBHRS project director, detailed some of the methods they're testing in Alaska to prevent alcohol-related harm during pregnancy. They emphasize the need for a clear, unified message and more effective screening.

To that end, they're helping health care providers to implement standardized alcohol screening protocols and, if needed, some brief intervention techniques into their visits with patients.

"We know that alcohol use during pregnancy has the potential to impact the developing fetus and impact the brain development and potential for nervous system function throughout a person's life," Porter said. "We know there's a risk and even one binge-drinking episode has the potential to create problems. Continuing to educate people about that is important."

The good news? Alaska is actually ahead of the curve in recognizing and addressing FASD among our population. The State of Alaska Department of Health and Human Services reported one head-turning statistic in 2010: rates of fetal alcohol syndrome-the clinical diagnosis for one of the more severe disabilities that falls under the FASD umbrella-fell 32 percent between 1996­ and 2002.

Porter continues to be encouraged by progress in her field.

"We know so much more than 20 or 30 or 40 years ago," she said. The key to Alaska's continued forward progress will be the emphasis on clear messaging and helping health care providers and allied health workers feel confident in their abilities to better serve Alaska's urban and rural communities.

For more information about the Arctic FASD Regional Training Center, please visit their website.