Canada needs to implement a sweeping set of measures, ranging from providing education pamphlets in boxes of condoms to alternatives to prison for brain-damaged inmates, says a report from a blue-ribbon panel on the epidemic of fetal alcohol spectrum disorder.
"It's time for a national agenda integrating research done and lessons learned," said Anne McLellan, the former federal health minister who headed the panel.
"The agenda must increase awareness of FASD and promote the development of effective prevention and treatment programs, as well as family support systems. The time for action is now," she said
According to the report, fashioned during a two-day conference of national and international experts, at least 3,500 children a year in Canada are born with FASD. Their lifetime treatment costs will exceed $2-million each.
Fetal alcohol syndrome disorder is the term given to brain damage caused by exposure to alcohol in utero, and which results in a broad range of behavioural and learning disabilities.
Ms. McLellan said that while FASD is "entirely preventable," it is too simplistic to merely tell women of child-bearing years to not drink alcohol.
"I'll be honest: I used to think like that before I was informed," she said.
"It would be great if it was that easy, but it isn't. Rather, we have to understand the complex reasons why women drink alcohol during pregnancy - abuse, addiction, poor living conditions and so on - and tackle those," Ms. McLellan said.
The report notes that FASD is disproportionately found in "high-risk" groups like aboriginal communities and inner cities.
The disease has a dramatic impact on families, whether it is the biological, adoptive or foster family. (Children with FASD often come from broken homes and find themselves in foster care and up for adoption in large numbers.)
It also results in tremendous lifelong demand on services, as well as medical care.
The annual economic cost of FASD is estimated to be as high as $4-billion a year in Canada. Of the total, educational and medical costs make up 60 per cent (including drug therapy and addiction treatment). Additional costs to families account for 20 per cent, and the remaining 20 per cent is for social services, lost productivity costs and other services such as costs of incarceration.
The cumulative lifelong cost of those currently living with FASD is estimated to be $600-billion, said John Sproule, senior policy director for the Institute of Health Economics, the Edmonton-based group that initiated the conference that produced the recommendations.
"Addressing this issue is crucial not only from the perspective of social justice but from the economic perspective as well," he said.
Mr. Sproule said that because FASD is a lifelong condition, there needs to be more emphasis on co-ordinating and integrating care and, in particular, ensuring a smooth transition from childhood care to adult care.
Ms. McLellan, who now works for the law firm Bennett Jones LLP, stressed that prevention is key and that education about fetal alcohol syndrome disorder "has to be integrated into federal and provincial alcohol policies."
The report calls for young people to be taught about FASD in primary and secondary school. It also recommends that educational materials be included in birth-control products such as condoms and contraceptive pills.
The expert committee did not recommend warnings on labels of alcoholic drinks, saying there is not a lot of evidence they work.
André Picard