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It's easy to accept that alcohol can fuel drunk drivers, but harder to accept that alcohol in expectant mothers can create felons.
Four women have joined forces to diagnose fetal alcohol syndrome in Juneau and demonstrate the link. The women are Marla Lippard, Janet Forbes, Laura Rorem and Susan Hunter-Joerns.
"We have always had anecdotal evidence about FAS and alcohol-related disorders (in the prison population), and now, with clinicians being trained in diagnostics, we will have some hard numbers to back it up," said Lippard, nationally certified as a chemical dependency counselor and clinical director for Gastineau Human Services.
Fetal alcohol syndrome/fetal alcohol effect is caused when a pregnant woman drinks alcohol, and that drink changes the developing brain of her fetus. It is a brain disorder that "manifests itself in each person so differently" so that it defies or complicates diagnosis, Lippard said.
Defendants can "appear functional before judges or their probation officers, yet be unable to handle daily life," said Forbes, outpatient after-care coordinator at GHS. Forbes has a degree in criminal justice and worked as a probation officer in Texas for seven years with a specialized case load of substance abusers.
Lippard, Forbes and Andy Swanston, GHS operations director, put together a grant for FAS diagnostic training, and sent Lippard for that training earlier this year. As they wrote the grant, they guessed that 20 percent of the prison population could be suffering from this disorder. After seeing the results of the first weeks of the new FAS diagnostic program, they believe they may have underestimated.
Juneau District Court Judge Peter Froehlich began including FAS diagnosis in his sentences on Feb. 26.
"We had anticipated 10 referrals in the course of a year, and we have had 15 or 20 in the first month," Swanston said. "It has greatly exceeded our expectations. We are real enthused about the program."
Prisoners are enthused, too, because they want answers about why they are the way they are.
"Everybody else tiptoes around an FAS diagnosis, but we have five clients waiting right now. They want to know," Lippard said.
Lippard and Forbes have big plans for their three-year grant from the state office of FAS. First, they want to diagnose anyone currently in the criminal justice system. Second, they want to develop a residential program.
"What we hope to do is not only serve people already in the (criminal justice) system but also form a residential program for people with this FAS who need mental health treatment and have chemical dependency problems. About 50 percent of those with chemical dependency also have mental health problems. We need to be able to teach them life skills," Lippard said.
"What's refreshing is we are not asked to hammer a 12-step program down (our clients') throats. GHS is letting us build what works," Forbes said.
Third, with the help of local neurologist Dr. Susan Hunter-Joerns, they hope to form a community FAS diagnosis team that will diagnose children and youth.
In Juneau, fighting FAS is a matter of education of "everybody in the community - judges, pediatricians, obstetricians, gynecologists, family practitioners," Forbes said.
"I had two friends who were prescribed a glass of wine each evening for anxiety during their pregnancies in 1996," Lippard said.
Laura Rorem, a parent advocate, has raised an adopted son and daughter, both with FAS, and sees the new GHS program as "what I have been asking for years." Her son, 25, had had 15 different diagnoses by age 15. Behavior modification didn't work.
"He worked hard in school, worked hard all his life. I have never seen anybody work so hard, and still he falls through the cracks of the system."
Her daughter, three months pregnant, is struggling not to drink with her companions, because she doesn't want a baby "like her."
After not knowing for most of their lives how to help her children, Rorem has found an answer: "Now I am saying they were born with FAS; it's a birth defect. I am changing the way I describe my children."
Ann Chandonnet can be reached at firstname.lastname@example.org.