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Underage Drinking Stance to Senator Dodd
February 17, 2004
The Honorable Chris Dodd's Office
U.S. Senate
448 Russell Senate Office Building
Washington, DC 20510
Dear Senator Dodd:
On behalf of the National Organization on Fetal Alcohol Syndrome (NOFAS), thank you for your recent efforts to address the problem of underage drinking in our society. Your candor on the subject during the hearing of the Senate HELP Subcommittee on Substance Abuse and Mental Health Services on September 30 was very much appreciated. NOFAS has been watching the Senate's progress on steps to reduce the sheer volume and impact of underage drinking, and we would like the chance to highlight those who drink while pregnant as a distinct risk group among underage drinkers.
NOFAS is a nonprofit 501(c)(3) organization that aims to raise public awareness of fetal alcohol spectrum disorders (FASDs) and to develop and implement new ideas in prevention, education, intervention, and advocacy in communities throughout the Nation. Fetal alcohol exposure is the leading preventable cause of mental retardation and birth defects, and can affect up to 40,000 births each year. This amounts to roughly 1 out of every 100 births in the United States, making FASD more widespread than spina bifida, Down Syndrome, cerebral palsy, cystic fibrosis, and muscular dystrophy combined. Also, symptoms of FASD can range from ADHD to autism, with a whole host of other behavioral disorders in between. The scope of FASD is wide, as prenatal alcohol exposure adds to a host of factors that put the total health and well-being of a newborn child in danger.
On the bright side, FASD is 100 percent preventable if a woman completely stops using alcohol while pregnant. There is no safe time and no safe amount of alcohol that can be consumed during pregnancy. This is the case regardless of whether a prospective mother is under the age of 21 or of legal drinking age. However, there are many pressures that can be distinct hardships for young or teenage mothers who might be struggling with alcoholism. Therefore, NOFAS has a special commitment to prevent drinking among underage girls who are pregnant or engaging in sexual behavior that could lead to pregnancy. As a result of this activity, along with the countless health and behavioral concerns that result from underage drinking, NOFAS supports efforts to stop youth from turning to alcohol.
Though we support almost all of these efforts, NOFAS is against one of the proposals quoted in testimony offered by Ms. Wendy Hamilton of Mothers Against Drunk Driving (MADD). Ms. Hamilton stated that "[t]he Federal government should require States to achieve designated rates of retailer compliance with youth access provisions as a condition of receiving block grant funding, similar to the Synar Amendment's requirements for youth tobacco sales." This recommendation first came from a September report from the National Academy of Sciences (NAS). While MADD must be praised for their commitment to prevention, the potential cuts in substance abuse prevention funds that would result from a Synar-like amendment go against the goal of reducing underage drinking. The National Association of State Alcohol and Drug Abuse Directors, Inc. (NASADAD) has stated that "[t]he Synar provision required States to enact laws prohibiting tobacco sales to minors and to achieve an 80 percent compliance rate among
tobacco vendors . . . The penalty for noncompliance with Synar is a severe 40 percent cut to the State's Substance Abuse Prevention and Treatment (SAPT) Block Grant managed by State substance abuse authorities. State substance abuse authorities, however, often do not have jurisdiction over tobacco nor do they have enforcement authority over this issue."
Some of the programs that might suffer from these sorts of cuts target prevention and treatment efforts for pregnant women with alcohol dependence. Since these women are considered a high-risk group by the Substance Abuse and Mental Health Services Administration (SAMHSA), there are programs to address them in every State; these programs would certainly be threatened by a Synar-like rule for underage drinking. Such programs have been shown to be very effective in reducing dependency, and often they are the only thing keeping alcoholic women from full relapse. If anything, we should increase access to treatment options for at-risk women, not cutting funds that will reduce the already dwindling number of beds available at in-patient rehabilitation clinics.
NOFAS would like to offer a few ideas on how to shape policy to reduce underage drinking, while focusing on some of the unintended-and defenseless-victims of such behavior: unborn children. Any media campaign, parental outreach, or community involvement program would benefit from including information on the effect of alcohol on a fetus. Studies have shown that youth engaging in sexual behavior while having several drinks on more than one occasion per week are a very high-risk group. Ingham, Stone, and Clemens found in 2000 that "of 15- to 19-year-olds who have had sex with someone they knew for less than 1 day, 61 percent of females and 48 percent of males said alcohol or drugs was the reason." Also, Dr. Ed Riley of the University of California at San Diego says that 70 percent of children with FAS are born to high-risk mothers who have had a child before with the disorder. For many of them, this pattern begins in their teens, and the relationship between alcohol, sex, and pregnancy does not leave them until much later, if at all, in their lifetime. For all of these reasons, NOFAS recommends that, as part of your underage drinking initiatives, you:
- Highlight the harmful effects of alcohol exposure on a fetus, specifically the division of the neural crest at 7-8 weeks into gestation
- Mandate including information on the dangers of drinking while pregnant in middle and high school health and sexual education curricula
- Include educating parents on the behavioral aspects of addiction, especially surrounding sexual activity and substance abuse during their children's early teenage years
NOFAS has implemented several programs to address these goals over the past 5 years, such as media campaigns, kindergarten through 12th-grade curricula, information packets, and training modules. We would be happy to provide you with more details on how all of these could be integrated with your prospective underage drinking efforts and work toward the development of a comprehensive prevention program in the future.
In the past, NOFAS also has worked with the alcohol industry to combat the problem of maternal alcohol use through media campaigns, educational presentations, and outreach programs. We are grateful to them for the support they've given us, and we trust that there are many more chances for working together with those in the alcohol industry and those who advocate for the prevention of underage drinking and the costs it imposes on society. The suggestion during the September 30 hearing that the alcohol industry take the lead on specifically addressing the impact of media campaigns and other prevention strategies to reduce underage drinking is a good one, and something that NOFAS is delighted to support. We look forward to getting involved in this issue, and we see the potential actions of the Federal government as a much-needed chance to increase awareness of the danger posed by underage drinking. Those with FASD are some of the many victims linked with alcohol use, but they are an under-apprecia ted group that must be addressed by those looking to lessen the harm of alcohol and underage drinking in our society.
Thank you for taking the lead on this issue, Senator Dodd. We at NOFAS look forward to working with you and your staff to craft and support laws that will prevent underage drinking. Please remember that underage drinking is a problem not only for our children, but also for our unborn grandchildren as well. Risk behavior patterns start early in life, and it would be a mistake to ignore an aspect of alcohol addiction that can lead to irreversible mental harm and disability among our Nation's children.
Sincerely,
Thomas Donaldson
Executive Director
NOFAS
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