Substance use and addictions

New FASD Resource for Addictions Professionals

The Canadian Fetal Alcohol Spectrum Disorder Network (CanFASD) leads the world in FASD response; Aotearoa New Zealand and Australia often follow their lead because of similarities in our demographics (including indigenous communities) and societal attitudes towards alcohol and substances.  

CanFASD has recently published a new guide for addiction professionals entitled Moving Towards FASD-Informed Care In Substance Use Treatment. The guide provides evidence-based practices to support people with FASD who are in treatment for substance use.

Click here to download the new guide, or read on for a brief intro on treating those with FASD.

We are enormously grateful, as always, to CanFASD for enabling us to share this guide.

Substance use and FASD

Fetal Alcohol Spectrum Disorder (FASD) is a lifelong disability impacting the brain and body of people prenatally exposed to alcohol. FASD impacts at least 4% of people and is more common than autism, cerebral palsy, and Down syndrome combined.

People with FASD experience high rates of alcohol and substance use and misuse. One Canadian study found that 38% of people with FASD were using or misusing alcohol and 46% other substances.

However, those affected by FASD have brain-based differences that can make it hard for them to succeed in traditional substance use treatment. These differences can impact language, memory, attention, learning, participation, emotional responses, and adaptive functioning.

Research has shown that a key barrier to addiction treatment success is a lack of knowledge on the part of professionals about FASD and how it impacts treatment.

CanFASD have given ten points to consider when treating those with FASD.

Adjusting substance use treatment for those with FASD

1. Reframe how you think about behaviour

Behaviours in people with FASD may relate to the brain-based differences they experience. For example, missing appointments, often losing or forgetting to bring materials, and missing medication doses can be related to memory impairment. Providing time management assistance (i.e. visual schedules) and creating a strong structure and routine can help.

2. Identify and screen for FASD

With high rates of substance use in this population, it’s important to know if the individual you are treating has FASD. This guide will give you the information you need to adopt the appropriate FASD screening tool for your setting.

3. Support entry into programming

Take the time to intentionally consider the barriers to eligibility and access that prevent people with FASD from starting or even seeking out your treatment program.

4. Adjust your treatment to the individual

Like all clients, a ‘one size fits all’ approach isn’t effective for people with FASD. Adjust your approach to fit the needs of each individual by considering their experiences, collaborating with external supports, and incorporating targeted interventions.

5. Support transitioning out of treatment

Make a plan to phase the individual out of treatment that will encourage them to maintain healthy outcomes. The plan should focus on their strengths, consider their experiences and needs, and collaborate with external supports and services.

6. Collaborate with other external services

People with FASD have complex needs and often access other heath, social, housing, legal, transportation, childcare, and cultural services. Consider the individual’s needs and facilitate referrals or connection with external services.

7. Integrate FASD prevention into treatment

The stigma surrounding substance use in pregnancy can be a barrier to accessing treatment. Engaging people in safe and respectful discussions about alcohol and substance use can be critical to ensuring they access and stay in treatment, and is an important factor in reducing alcohol use in pregnancy.

8. Provide continuing FASD training and education

Ensure each member that is involved in the care and treatment of people with FASD is well trained in how to best support these individuals. This includes those who administer treatment, as well as administrative and management personnel.

9. Use harm reduction, relational, and person-first approaches

Treatment should be culturally safe, strengths based, trauma-informed, sex- and gender-informed, and should promote interdependence. Recognise that there can be healthy solutions beyond abstinence. Consider adopting creative and relational approaches for those with FASD to better support their wellbeing.

10. Evaluate the program success

Make sure your program is accountable and responsive by monitoring and evaluating your program. This can help you to adjust things that aren’t working and to know what techniques may be more effective.

Moving Towards FASD-Informed Care In Substance Use Treatment explains these concepts in much more detail. Download the full guide here.