We are living in an epidemic of “Neurodevelopmental Disorder associated with Prenatal Alcohol Exposure” (ND-PAE) – the medical diagnosis for the range of social/communication, cognitive, motor/sensory, and mood/anxiety issues caused by our social drug of choice. It is vastly misunderstood by the public since many of the children are inadequately diagnosed and improperly treated. The condition is known more widely as Fetal Alcohol Spectrum Disorder (FASD).
In in recognition of FASD Awareness Day, I would like to encourage people who care about the minds of children to walk on Washington, DC – the “Millions who Recognize FASD” March. If each year, 40,000 new babies are born with this preventable form of brain damage in this country, 1 in 20 school aged children have this condition, and it’s been over 40 years since it was identified, there are now more than 1.6 million people with brain damage that could have been prevented since we found out about this problem in 1973. We now know that it can happen with as few as 4-5 servings of alcohol (less than a Long Island Iced Tea) in the 3rd week of pregnancy. With 13.5% of women binge drinking and 50% of pregnancies unplanned, we have an epidemic of FASD.
These children are being born in many cases to women who already have the disorder themselves and/or are unable to take care of the children. In my practice, I have a number of children adopted from foster care where there are 9+ children, all in Child Protective Services – rotating between foster care placements until they are finally adopted by unsuspecting parents who are ill-informed of the issues and ill-equipped to handle the multiple, complex neurodevelopmental needs. In a sense, the middle class families who adopt the children become their “social services agency” – providing educational opportunities, comprehensive mental health and medical care, and a nurturing home that is better than they would have had otherwise. Unfortunately, many of the children have scars from their early childhood experiences – being locked in closets, left at home unattended without food, or shuffled between extended family members where they are sometimes abused.
In 1995, a rural area of North Carolina, I asked the question to women coming into a halfway house for pregnant women – “Why do you keep coming back? Why has our program not helped? Why do you return every two years with another alcohol and substance exposed infant?” They said, “Because the government keeps taking them away from me.” At that point, we decided to shift the tide in this epidemic. There we developed a 24-unit transitional housing community where women in recovery can live and parent their own children with supportive services provided in an on site community building we built from the ground up in 2 years with $1.8M. It opened my second year of medical school. The women sign as a part of their lease agreement that they will be working or in school, participate with parenting classes on site, and undergo routine alcohol and drug screening. In exchange, they are able to receive counseling, parenting support, transportation, housing vouchers, and many other supports to raise their children in their own apartments. The courts reunite the women with their children from foster care so they can parent the children more effectively themselves.
It is time for the alcohol industry to be accountable for causing brain damage in children – our nation’s most valuable resource. Each year, the combined income from the sales of alcohol – beer, wine and liquor – is $227 billion. The average cost in 2003 to care for children with full Fetal Alcohol Syndrome was estimated at $5.4, which does not account for the children with brain damage that do not have the facial features. It also does not account for the productive years of life lost, the family crises and dysfunction that ensues in taking care of these children, and the cost of criminal justice issues that can arise. That means we can at increase the figure by 3-4 fold to account for the range of children, adolescents, and adults with this to $16.2 – $21.6 million.
It is time to shift the tide in this public health crisis. This is a call to action for families and individuals struggling with this disorder to join with me for a walk on Washington, DC, if not this year, then next year. Let’s bring awareness to the need for supportive services for children with this disorder; for mothers stuck in a cycle of poverty, homelessness, and alcohol/other drug abuse; and for society to understand that it’s social drug of choice is stripping the minds of children, silently within the womb, before we even know they exist. We need to hold the alcohol industry accountable for its product – not just putting a small, discrete label on the bottles or giving a few dollars to a national organization for a cocktail hour at a fundraising event. We need funding for services and programs – in the educational system, the medical community, the justice system, and nonprofit sector to identify, treat, and prevent this condition.
The children are our future and we must begin today stemming the tide of this preventable epidemic caused by prenatal alcohol exposure.