Important common concerns for individuals with brain injury

1. People who use alcohol or other drugs after they have had a brain injury don't recover as much or as fast as people who don't use alcohol or other drugs.

If an individual with a brain injury begins to use alcohol and other drugs, much of the progress that they gained during the recovery process may be lost. Because brain cells were lost in the injury, the remaining brain cells must work harder for the person to do some of the same activities that they did before the injury. If the remaining cells are compromised by alcohol or drugs, they will not be able to take over the duties of the dead cells. Skills that could have been regained are lost.

2. Brain injuries cause problems in balance, walking or talking that get worse when a person uses alcohol or other drugs.

For people whose brain injury caused difficulties with balance, mobility and production of speech, alcohol and other drugs exacerbate the problem. Even without a brain injury, alcohol and other drugs impair functioning in these areas.

3. People who have had a brain injury often say or do things without thinking first, a problem that is made worse by using alcohol and other drugs.

Disinhibition is a common problem associated with both traumatic brain injury and substance abuse. Not being able to control what you say or do can lead to a myriad of problems, such as increased risk-taking, arguments, or other socially inappropriate behavior. While the person with the brain injury may learn compensatory strategies to control their behavior, they are unable to utilize these strategies effectively when under the influence of alcohol or other drugs.

4. Brain injuries cause problems with thinking, like concentration or memory, and using alcohol and other drugs makes these worse.

Many people have to learn new skills, or relearn old ones, following a brain injury. People may have trouble with concentration, memory, problem-solving, and other thinking skills. Alcohol and other drugs can also interfere with the ability to think and learn new information. The combination can produce even more serious impairments.

5. After a brain injury, alcohol and other drugs have a more powerful effect.

Brain injury results in a loss of brain cells. Those cells that remain must do their own work plus the work of the cells that are lost. Because there are less cells after a brain injury, more alcohol/drugs go to fewer cells, increasing the impact of the alcohol/drugs on that person's ability to function effectively. the individual becomes intoxicated more quickly, and the effect of the alcohol or other drug is much greater. In addition, alcohol and other drugs interfere with the effectiveness of prescribed medications.

6. People who have had a brain injury are more likely to have times when they feel low or depressed and drinking alcohol and getting high on other drugs makes this worse.

Being depressed is fairly comon after a brain inury. Some people may attempt to cope with these feelings by drinking alcohol or using other drugs. While initially people may "forget" their problems, when they become sober the problems are still there. They may begin to drink more, so that the forgetfulness will last longer. However, alcohol is a depressant. It becomes an endless cycle, with depression leading to substance abuse which leads to increased depression, which decreases functional activity, which increases depression once more.

7. After a brain injury, drinking alcohol or using other drugs can cause a seizure.

Some people who sustain a brain injury have an increased risk for seizures. Those who are at a very high risk are given medication to prevent seizures. Alcohol and other drugs increase the chance that even those at the lower levels of risk will have a seizure. Further, alcohol and other drugs prevent the seizure medications from doing their job, increasing the risk of seizures even more.

8. People who drink alcohol or use other drugs after a brain injury are more likely to have another brain injury.

A person who has difficulty thinking clearly, walking smoothly, reacting quickly due to a brain injury is at triple the risk for another injury. The person who then further clouds his/her abilities with alcohol or drugs will have an even higher risk for another injury for some of the same reasons. Second and subsequent injuries will cause more harm than the initial injury. The destruction of more cells as the result of a second injury will leave even fewer cells to do the same jobs, and some abilities will be lost because there are not enough cells to make these functions possible.

Individuals with brain injury have found these eight messages are important to consider when contemplating choices about alcohol and other drug use following a brain injury. We support abstinence for persons who have survived traumatic brain injury as the choice that provides the best possibility for quality recovery, regardless of a person's previous use history.