ACEs | Alcohol's Harm to Others | Secondhand Drinking

It is likely most readers know someone or they are the someone who has personally experienced alcohol's harm to others | secondhand drinking. The tragedy is we hardly talk about it in ways that can change the lives of those affected -- especially the lives of children. In other words, we hardly talk about it in ways that can prevent, intervene, or treat adverse childhood experiences (ACEs).

Alcohol’s Harm to Others | Secondhand Drinking and the ACEs Connection

One of the 10 ACEs measured in the original CDC-Kaiser ACE Study was living with a family member who was a problem drinker or alcoholic. 

The toxic stress outcomes for a child that are associated with this particular ACE are the result of coping with their family member's drinking behaviors. Drinking behaviors include: verbal, physical, emotional abuse; neglect; blackouts; sexual assault; breaking promises to stop or cut down; shaming, blaming, denying; domestic violence; unpredictable behaviors; alcohol-induced crime; and driving while impaired, to name a few. Drinking behaviors are the result of the chemical and structural brain changes caused by alcohol abuse and the brain mapping around the characteristics of and risk factors for developing alcoholism. 

Coping with these drinking behaviors, as a child, can result in that problem drinker or alcoholic causing up to 7 more of the 10 ACEs measured in the original ACE Study. These additional ACEs include: physical, sexual and verbal abuse; physical and emotional neglect; witnessing a mother being abused; or losing a parent to separation, divorce or other reason. It is not uncommon for a child growing up with a family member who is a problem drinker or alcoholic to experience at least 3-4 ACEs.

And it's not only the problem drinker or alcoholic's behaviors that affect that child. It is the problem drinker or alcoholic's drinking behavioral affects on every other member in the family, and then the way the other family members interact with the drinker, the child and each other. All of which causes crushing, life-robbing, toxic stress outcomes for all concerned -- especially for the child. 

Emerging Research on Alcohol's Harm to Others (AHTO)

The above offers prime examples of alcohol's harm to others | secondhand drinking. These are two terms that identify the very real,quality-of-life, health-harming impacts of a person’s drinking on others. 

Secondhand Drinking, for example, is a term I coined in 2009 to raise awareness about the negative impacts a person’s drinking behaviors has on others.  Secondhand drinking directly affects an estimated 75 million Americans, including moms, dads, husbands, wives, children, brothers, sisters, grandparents, close friends, boyfriends, girlfriends. It indirectly affects tens of  millions more, including co-workers, fellow-students, innocent bystanders – even the tax payers and citizens of a community. And this is just in America!

As such, it is likely most readers know someone or they are the someone who has personally experienced secondhand drinking. The tragedy is we hardly talk about it.

Fortunately, that’s about to change, thanks to several recent studies being conducted around the world on Alcohol’s Harm to Others (AHTO), such as:

  • One in New Zealand: “Recently researchers have started to focus on alcohol-related harms to people other than the drinker; described as the ‘collateral damage,’ ‘second-hand effects,’ or ‘negative externalities’ of drinking (Connor and Casswell 2012).”
  • One in Australia: “…almost three-quarters of all adults in Australia were negatively affected over a one-year period by someone else’s drinking…. (Laslett et al 2010).”
  • One in Five Indian States: “Approximately 83% of respondents reported at least one alcohol-related harm from having a heavy drinker in their lives across domains of physical, sexual, psychological, financial and social harm (Esser et al 2016).”

 

My hope is this AHTO research expands to incorporate the kinds of harm to others associated with toxic stress because of the ACEs-toxic stress connection and because living with a family member who is a problem drinker or alcoholic can result in a child's ACE score reaching 3 or 4 or even a staggering 8.

To learn more about this AHTO research and other concepts, check out my post on BreakingTheCycles.com, "Alcohol's Harm to Others | Secondhand Drinking."

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Karen Clemmer posted:

Lisa you are so right!  Please see slide #25 for an image that supports what you are saying. 

Talking to women of reproductive age and asking just "one key question" would you like to have a baby in the next year - opens up a whole conversation. 

Talking with women of reproductive age about the risk of FAS is often motivation enough to change behavior and reduce risky drinking.  Women who continue risky drinking (especially if pregnant or wanting to get pregnant) often need extra support and possibly a referral to treatment.  

Blaming and shaming women often results in women avoiding those experiences - especially in healthcare settings.  

Also of interest (see attached CDC document) is who has the highest alcohol consumption rates - for me, it was not who I expected! 
Thank you for opening this very important discussion!
Karen  

Thank you, Karen!! I really appreciate you sharing these resources and your additional comments. Your "one key question" is an excellent approach.
Lisa

Lisa you are so right!  Please see slide #25 for an image that supports what you are saying. 

Talking to women of reproductive age and asking just "one key question" would you like to have a baby in the next year - opens up a whole conversation. 

Talking with women of reproductive age about the risk of FAS is often motivation enough to change behavior and reduce risky drinking.  Women who continue risky drinking (especially if pregnant or wanting to get pregnant) often need extra support and possibly a referral to treatment.  

Blaming and shaming women often results in women avoiding those experiences - especially in healthcare settings.  

Also of interest (see attached CDC document) is who has the highest alcohol consumption rates - for me, it was not who I expected! 
Thank you for opening this very important discussion!
Karen  

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See slide 25 for image re ETOH exposure during fetal development
Karen Clemmer posted:

In California Maternal Infant Health Assessment (MIHA) data is available from women who gave birth in the previous year.  There is a significant time delay due to the sampling process etc. Looking at some of the CA regions - up to nearly 23% of pregnant women self reported alcohol use during pregnancy.  

Here are metrics and definitions: 

Any binge drinking, 3 months before pregnancy: Drank four or more alcoholic drinks in one sitting (within about two hours) at least one time during the three months before pregnancy. (Q39, 41)
Any alcohol use, 1st or 3rd trimester (2010-2012 only): Drank any alcoholic drinks in an average week during the first or last three months of pregnancy. In 2011, the phrase in italics was added to the question on drinking during the first trimester of pregnancy: “During the first 3 months of your pregnancy (including before you knew you were pregnant for sure), about how many drinks with alcohol did you have in an average week?”  
Any alcohol use, 3rd trimester: Drank any alcoholic drinks in an average week during the last three months of pregnancy. (Q39, 42) 

Adverse experiences during fetal development - especially alcohol exposure (which causes structural changes that do not recover over time) are preventable. 

Copied from the attached journal article:
".... there is no known safe level of alcohol consumption during pregnancy ... FASD, a major cause of intellectual disability, is completely preventable with abstinence from alcohol from conception to birth. Awareness of these risks will empower women to help their children achieve their full potential. 

Thank you for sharing all of this information, Karen. 

The fact a newborn comes out with basic survival capabilities, breathing, sleeping, sucking, beating heart, relieving self of waste..., means there is brain development during pregnancy, because EVERYTHING a person (infant, child, teen, adult) does requires neural networks, which are cell-to-cell communications via an electro-chemical signaling process.  The alcohol in the mother’s bloodstream passes through to her fetus through the placenta. Given the developing fetus does not have a fully developed liver, its liver is unable to metabolize the ethyl alcohol chemicals, which is what makes a mother’s drinking during pregnancy harmful to her baby. The ethyl alcohol chemicals interrupt the chemical portion of the brain's electro-chemical signaling processes, i.e., its normal cell-to-cell communications processes.

Helping mothers understand this can help them appreciate the "why" of how alcohol damages the brain during fetal development, and thus why it's so important mothers not drink during pregnancy.

Lisa

In California Maternal Infant Health Assessment (MIHA) data is available from women who gave birth in the previous year.  There is a significant time delay due to the sampling process etc. Looking at some of the CA regions - up to nearly 23% of pregnant women self reported alcohol use during pregnancy.  

Here are metrics and definitions: 

Any binge drinking, 3 months before pregnancy: Drank four or more alcoholic drinks in one sitting (within about two hours) at least one time during the three months before pregnancy. (Q39, 41)
Any alcohol use, 1st or 3rd trimester (2010-2012 only): Drank any alcoholic drinks in an average week during the first or last three months of pregnancy. In 2011, the phrase in italics was added to the question on drinking during the first trimester of pregnancy: “During the first 3 months of your pregnancy (including before you knew you were pregnant for sure), about how many drinks with alcohol did you have in an average week?”  
Any alcohol use, 3rd trimester: Drank any alcoholic drinks in an average week during the last three months of pregnancy. (Q39, 42) 

Adverse experiences during fetal development - especially alcohol exposure (which causes structural changes that do not recover over time) are preventable. 

Copied from the attached journal article:
".... there is no known safe level of alcohol consumption during pregnancy ... FASD, a major cause of intellectual disability, is completely preventable with abstinence from alcohol from conception to birth. Awareness of these risks will empower women to help their children achieve their full potential. 

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Cissy White (AC Staff) posted:

I like the phrasing - Alcohol's Harm to Others (AHTO) as opposed to labeling people as adult children of alcoholics, etc. Is that newer phrasing? 

Hi Cissy,

I appreciate your support - thank you!

And, yes, the AHTO is a relatively new term - really helps us appreciate just how many - even beyond the immediate family - are affected by a person's drinking.

Lisa

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