Women and Substance Abuse - Literature review Example

Student’s Name] [Instructor’s Name] [Class] Women and Substance Abuse Introduction Substance abuse has been recognised as a problem for many decades but it is only recently that the social impact and the familial impact of substance abuse have come to the forefront as they relate to the women in Australia. In this regard and in recent times, several research journals have published studies and articles concerning the issues of women, pregnancy, breastfeeding and substance abuse of which three are discussed in this paper along with their relative strengths and weaknesses as related to the topic. Alcohol and Pregnant Women in Australia The first article has been written by Giglia and Binns (2007) and it undertakes a study of alcohol abuse patterns for women in Perth. Not only does the study look at the data for alcohol consumption for pregnant women, it also looks at women who are lactating and nursing their children. Women are traditionally warned not to consume alcohol at all during pregnancy due to the risks associated with the Fetal Alcohol Syndrome which is a part of the Fetal Alcohol Spectrum Disorder. This disorder is a set of genetic birth defects that may be caused by the mother of the child consuming alcohol during pregnancy. As described by Day (1992), while it is understood that alcohol negatively affects the foetus before birth, the exact biological and chemical processes are still being studied. Giglia and Binns (2007) discuss the problem of substance abuse (particularly alcohol) and recognise that the problem exists in a minority of females even while they are pregnant. For women who engage in drinking to the point of substance abuse, the chances of FAS (Foetal Alcohol Syndrome) and other such complications see a marked increase. However, the research conducted by Giglia and Binns (2007) shows that even at levels less than substance abuse levels, there may be complications and problems. Their study looked at women from two public hospitals within Perth and the women were given a baseline questionnaire to complete. The questions were repeated when they were discharged and the women were followed up with phone interviews up to a year after the delivery of their children. The questions resulted in useful data about alcohol use patterns during and after pregnancy and the analysts noted that a third of the women stopped drinking altogether during their pregnancy (Giglia and Binns, 2007). However, the rest continued to drink even as they were pregnant even though the majority of them remained within the national standard of two drinks per week. After the delivery of the child, almost half of the total number of women were back to consuming alcohol. A small minority were above the national limits for alcohol consumption and a few could be put in the substance abuse category. Interestingly, Giglia and Binns (2007) make a recommendation that safe alcohol intake levels should be developed as a policy guideline which can suggest the amount of alcohol that can be imbibed by a pregnant or nursing woman without potentially risking the health of the infant. This is interesting since earlier studies conducted by Streissguth (1997) as well as Abel and Sokol (1987) suggest that there is no safe level of alcohol consumption for a woman who is pregnant. For these researchers, any consumption of alcohol which is done during pregnancy or while nursing may be seen as substance abuse since that puts the child at risk with regard to FAS. In fact, the consumption of alcohol by the mother who is pregnant has been connected to more severe social problems for the child such as the incidence of adolescents running to trouble with the law or problems in education such as dropping out of school (Streissguth, 1997). Children of mothers who engage in substance abuse or alcohol abuse may also show mental health issues themselves such as addiction to certain or they may themselves engage in substance abuse (Streissguth, 1997). The American study done by Abel and Sokol (1987) shows that foetal exposure to alcohol during pregnancy is amongst the leading reasons of mental retardation in the United States which makes the incidence rate of FAS comparable to the incidence rate of other developmental issues such as Down syndrome. It is therefore difficult to conceive of a safe limit of a teratogen such as alcohol and even if there is a ‘safe limit’ it is perhaps better to avoid it altogether. The recommendation from the American surgeon general is to completely abstain from alcohol use not only for pregnant women but also those who are planning to have children soon (Streissguth, 1997). This makes the policy recommendation for having a safe limit concerning alcohol consumption as suggested by Giglia and Binns (2007) a difficult concept to agree with. The researchers themselves noted that “In America, the Centres for Disease Control and Prevention (CDC) have reported figures of any alcohol use by pregnant women in the previous 30 days of 12.4% in 1991, 16.3% in 1995 and 10.1% in 2002 (Giglia and Binns, 2007, Pg. 497)”. These figures are much lower than the Australian numbers and could serve as a policy guide for those who seek to advice women with regard to safe alcohol consumption when they are pregnant or nursing. Substance Abuse and Breastfeeding Alcohol abuse is often connected with smoking and this relationship was examined with regard to breastfeeding women in Australia by Giglia et. al. (2006). In a year-long longitudinal study, the researchers found that women who consumed alcohol or smoked during pregnancy had a lower rate of being nursing mothers and also had a shortened duration for which they breast fed their children. International and Australian guidelines for breastfeeding targets were missed by the majority of such women therefore the secession of smoking as well as other forms of substance abuse is to be highly recommended for women who plan to have children. This report is entirely positive in its approach since the impacts of smoking on a woman’s health as well as the unborn foetus are well documented and commonly known. The recommendations made by Giglia et. al. (2006) are to encourage cessation of smoking while the woman is pregnant and to enter into a cessation programme before deciding to start a family or have a child. Further, the researchers also report that smoking mothers may hide their problems due to the fears that they may be labelled as ‘smoking mothers’ who do not care about their children. This stigmatisation may cause them to avoid seeking help therefore it should be avoided to encourage them to seek help in breaking the habit. Alcohol Abuse and Teen Children Alati et. al. (2005) engaged in a long term study in Queensland which showed that teenagers whose mothers engaged in alcohol abuse regularly and showed signs of being depressed were more likely to develop alcohol abuse problems as adults. The study was initiated in Brisbane at the Mater Hospital more than twenty years ago and followed the lives of children whose mothers regularly consumed alcohol. The study also reports that the children of women who engage in alcohol abuse may show signs of aggression and violent behaviour which can be seen as signs that require early intervention. In fact, as early as age 14, the children exhibited the influences of their mother’s depression and alcohol consumption but the actual onset of the disorder manifested itself at age 21 (Alati et. al., 2005). This gives the government and other social organisations a chance to undertake an intervention when young teens show these early symptoms and their mother’s behaviour shows a pattern of substance abuse in general and alcohol in particular. Summary Implications As discussed by Forrest and Florey (1991) as well as Day (1992), it is difficult to say what level of consumption or frequency of alcohol use is safe while a woman is pregnant. Further, as studies done by Alati et. al. (2005) and Giglia et. al. (2006) have shown us, any amount of teratogen intake might be considered substance abuse therefore the only recommendation which can come from a nurse or a health services provider should be complete cessation of the harmful activity. While this should be the primary target, even a drastic reduction in intake could be helpful since it could bring the pregnant woman in line with the permitted national guidelines. However, noting the effects which alcohol consumption has on women especially in connection with substance abuse that can affect their children far beyond their infancy, it becomes an important recommendation from the doctors and scientists who are working with substance abuse problems to tell all women to completely avoid alcohol consumption during pregnancy. After pregnancy, moderation becomes the key and any signs of abuse problems should be immediately tackled with professional help. At the same time, there should not be a stigma associated with women who continue to engage in substance abuse while they are pregnant or nursing since that itself may cause them to delay seeking help. Works Cited Abel, E. and Sokol, R. 1987, ‘Incidence of fetal alcohol syndrome and economic impact of FAS related anomalies’, Drug and Alcohol Dependency, vol. 19, no. 1, pp. 51-70. Alati, R. et. al. 2005, ‘Teens affected by mother's depression, drinking’, Alcoholism & Drug Abuse Weekly, vol. 17, no. 48, pp. 7-8. Day, N. 1992, ‘The effects of prenatal exposure to alcohol’, Alcohol Health and Research World, vol. 16, no. 2, pp. 328-244. Forrest, F. and Florey, C. 1991, ‘Reported social alcohol consumption during pregnancy and infant development at 18 months’, British Medical Journal, vol. 303, no. 1, pp. 22-26. Giglia, R. and Binns, C. 2007, ‘Patterns of alcohol intake of pregnant and lactating women in Perth, Australia’, Drug & Alcohol Review, vol. 26, no. 5, pp. 493-500. Giglia, R. et. al. 2006, ‘Maternal cigarette smoking and breastfeeding duration’, Acta Paediatrica, vol. 95, no. 11, pp. 1370-1374. Streissguth, A. 1997, Fetal Alcohol Syndrome: A Guide for Families and Communities, Brookes Publishing. Word Count: 1,658 Read More