Jennifer Delima is an Addiction and Clinical Forensic medicine specialist who hails from Alice Springs in the Northern Territory. Since moving to the Northern Territory in 2000 from mainstream Emergency medical practice in Sydney, she has had the privilege of working in a range of clinical and social environments. These have included remote Australian Aboriginal communities, remote and regional hospitals and general practices as well as Custodial medicine, caring for both adolescents and adults. These varied environments and the needs of her patient population led her to ‘continuous ongoing study’ and see her attain qualifications in Remote, rural and mainstream General practice, Health administration, Addiction medicine and Clinical forensic medicine. She believes that she has now avowed herself of ‘no more’ study and aspires to develop both a resilient Addiction medicine team at the Alice Springs hospital, as well as the Sexual Assault Referral Centre service for Central Australia. The common thread through all these varied fields of clinical practice and demographic diversity is alcohol toxicity. To this end, Jennifer’s clinical practice describes a continuous circle of bio-psycho-social impact, from adult to infant to adolescent and hence her passion to address prenatal and adult acquired alcohol brain injury. ABSTRACT “Addressing alcohol neuro-toxicity across the continuum of age” J Delima Within the Western world and with the spread of technology in the developing world, per capita consumption of alcohol continues to increase. Of great concern is the increasing trend of alcohol use by adolescents, young adults and in particular women of child bearing age, especially in populations of lesser socio-economic status. Worldwide and in Australia, population statistics demonstrate both a high volumetric intake as well as high concentration of alcohol. The population impact is further exacerbated by an attendant high proportion of unplanned pregnancies occurring within the social context of high alcohol use. Traditionally, the ill effects of alcohol have focussed upon end stage organ dysfunction e.g. cirrhosis, cardiac failure, cerebral atrophy and Korsokoff’s psychosis. Additionally, resources are limited to provide for early recognition of alcohol related neuro-toxicity and intervention. The impact upon the drinker’s family and community has historically been addressed through the realms of Justice and extremely limited social advocacy. Alcohol is a general toxin, exerting a direct toxic effect on all tissues and organs and is highly toxic to the brain. Since the 1980’s, specific research into the neuro-toxic effects of alcohol and its consequent functional impairment continues to raise the need for all clinicians to be proactive in identifying those ‘at risk’ of alcohol related toxicity and minimising the impact of alcohol misuse. Importantly, the impact is not only upon the alcohol imbibing adult but also upon the prenatal alcohol exposed foetus and infant as well as the developing child exposed to the social chaotic impact of household alcohol misuse. These latter exposures prime the individual to early and ongoing alcohol use disorder and so perpetuate the individual’s susceptibility to alcohol related chronic illness as well as an intergenerational transmission of adverse alcohol neuro-toxic effect. This session aims to highlight some of the specific neuro-toxic vulnerabilities across the various stages of growth, development and age and to also touch upon some of the health strategies and local research that may assist us better mitigate the adverse individual outcomes as well as the consequent broader societal impact of unchecked alcohol misuse. |
