Brain Injury and Addiction

By Ruth Wilcock, Executive Director, OBIA

For many, the cool autumn weather is the prelude to one of the most marvellous times of the year—the holiday season. People become preoccupied with making to do lists, coordinating and attending various holiday parties, and arranging family dinners. This is all done in anticipation of sharing the holiday season with those who mean the most to us.

Unfortunately, for others, the hustle and bustle of the holidays do not evoke sentiments of warmth and connectedness but rather triggers feelings of pain, loss and loneliness, leaving them grappling with how they are going to cope. During our celebrations we must also carry these people in our hearts. Some people cope by simply withdrawing and isolating; others cope by finding comfort and relief in various ways, including the use of substances.

Having been asked to do a number of presentations on brain injury and addiction over the last few months, the topic has been strongly on my mind. I have great empathy for those who struggle with addictions. Prior to working in the brain injury field, I was the Executive Director of a long term residential drug and alcohol rehabilitation facility. In retrospect, I worked with a number of clients who had an addiction issue and had also sustained a brain injury.

Addiction in and of itself is a very complicated issue. As many know, brain injury is also very complex with many variables. Therefore, a person who has sustained a brain injury and is also struggling with addiction, has a number of challenges that he or she faces and these can sometimes feel insurmountable.

Studies have shown that there is a strong correlation between substance abuse with survivors of brain injury.

Approximately one-third of traumatic brain injury survivors have a history of substance abuse prior to their injury. Furthermore, twenty percent of people who do not have a substance abuse problem become vulnerable to substance abuse after a brain injury. So, for some survivors of brain injury, substance abuse or addiction is an old problem carried forward and for others, it becomes a new challenge. Regardless of whether one has a brain injury or not, alcohol and drug habits are difficult to change. However, it is important to note that there are increased challenges and risks for someone who has a brain injury and uses substances, including impeding recovery following a brain injury.

Substance use can also exacerbate problems with balance, walking and talking, and decreases inhibitions. Furthermore, the use of alcohol or drugs can negatively interact with prescribed medications. There is also a significant increase in the risk of sustaining another brain injury. When we are working with or are in relation to someone who has this dual diagnosis we must start at the place of compassion. Adjusting to life after brain injury can be stressful as survivors are coping with so many losses, including the loss of self. Other losses can include their job, their friends, their community and sometimes their family.

Turning to substances is often an attempt by the survivor to somehow make themselves feel better. It becomes a way coping.

There is no question that survivors of brain injury are a vulnerable population. So the question becomes what can one do to help someone who has a brain injury and is struggling with addiction? There are no quick and easy answers; sometimes we need to begin at the basics, such as educating individuals and their families about the risks and consequences of survivors using substances. It is also important to encourage the survivor to engage in other activities that do not centre on alcohol and or drugs. Some further interventions may include detoxification programs, residential treatment and twelve step programs. Another avenue of support is the Substance Use Brain Injury Building Project (SUBI) spearheaded by Dr. Carolyn Lemesky.

We all know the holiday season can be a very challenging time for some. If you are a survivor or a family member of a survivor who is struggling with substance abuse please know that you are not alone.

OBIA’s support services department is available to offer you support and direction. Feel free to contact our support services department at 1-800-263-5404 or obia@obia.on.ca for help with this issue or any other challenges that you may be facing. For more information on the Substance Use and Brain Injury Bridging Project you can go directly to subi.ca.