Synapse - reconnecting lives

Alcohol and other drugs affect a person's ability to think clearly and control emotions and behaviour, so can interact badly with the effects of a brain injury. 

People who already had a dependence on alcohol or other drugs prior to a brain injury are likely to have an even higher dependency afterwards.

Others may find for drug use becoming a problem for the first time as they struggle with the many changes faced after acquiring a traumatic brain injury or other type of brain disorder.

Potential issues with alcohol and other drugs include:

• negative interactions with prescribed medications
• higher risk of brain injury from overdose and alcohol poisoning
• worsening of cognitive problems (e.g. memory, concentration)
• reduced social skills 
• increased depression, anger and emotional ups and downs
• impulsivity and risk-taking behaviour
• problems with physical coordination
• increased challenging behaviours. 

Should I drink after a brain injury?

Studies suggest that even 'normal' amounts of alcohol for people with a mild brain injury can have a negative outcome. Most rehabilitation specialists recommend that people abstain from alcohol for at least two years while the brain is recovering, if not permanently. 

If a person does eventually resume use of alcohol or other drugs, a major problem can be self-awareness - there may be an inability to assess accurately whether social skills, coordination, behaviour and cognitive abilities suffer with drug use. It is important to get honest feedback from family and close friends, and discuss the issue with your doctor or brain injury specialist. 

Dealing with dependency

After a brain injury, someone may have an alcohol or drug dependency for a number of reasons. They may have already had a dependency before acquiring the brain injury. The dependency may have arisen from trying to cope with depression and frustration during the recovery process. Personality changes arising from impulsivity may mean the controls are lifted on what was once a safe usage.

If possible, discuss the dangers of continued drinking or drug use after a brain injury. See if the person is willing to work with you on the issue. If they are still in a rehabilitation program, advise the team and work with them to:

• encourage the person to take responsibility for their own behaviour
• provide  consistent feedback
• help them work through any issues causing the dependency.

Routines & an active lifestyle

When a person can no longer work after a brain injury, it is often the boredom, lack of social isolation and unstructured days which contribute to a dependency on alcohol or other drugs. A preventative measure is to ensure a weekly routine is developed that has enough enjoyable activities and social interaction to provide meaningful structure to each week. 

Discuss the issues

Talk with your family member about what he or she will do when friends offer alcohol, tobacco, or other drugs to him or her. Discuss ways of coping with stress and other problems in a positive way. Go over ways to have fun without drinking, smoking or taking other drugs.

Remove the temptation by making sure there is no alcohol or prescription medications in the house. Ask one doctor to take responsibility for all medications to prevent your family member from misusing prescription medications.

Ask for help

If drinking or using drugs is causing problems for someone you care about, you are not alone. A good place to start is your State Brain Injury Association who may be able to refer you to a service that can assist with drug dependency problems in the context of a a traumatic brain injury or other type of brain disorder.