Substance Use and Acquired Brain Injury

General Information & Resources

Addiction itself is a very complicated issue. As many know, brain injury is also very complex with many variables. Therefore, a combination of the two can bring forth a number of challenges.

Studies have shown there is a strong correlation between substance abuse and brain injury. In a review of eleven studies examining alcohol intoxication and history of substance abuse among traumatic brain injury survivors, Corrigan (1995) found that:

• alcohol intoxication was present in one third to one half of the recorded hospitalizations
• nearly two thirds of rehabilitation patients may have had a history of substance abuse that preceded their injuries (click here for Corrigan’s 1995 article)

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 as it can also complicate the recovery following a brain injury.

Substance use can also exacerbate problems with balance, walking and talking, and decreases inhibitions. As well, 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.

Adjusting to life after brain injury can be stressful as survivors may be coping with many losses which may include loss of self, their job, their friends, their community and sometimes their family. Turning to substances is often an attempt by the survivor to make themselves feel better. It becomes a way of coping. So the question becomes what can we do to help someone who has a brain injury and is struggling with their alcohol and substance use? There are no quick and easy answers but we can start by providing education to the individual and their families about the risks and consequences of survivors using substances. Below is a list of resources which service providers, families, and survivors can refer to for more information.
 

• Acquired Brain Injury and Alcohol & Drugs – This ABI Partnership Project pamphlet identifies eight points for survivors to consider for continuing their alcohol or substance use.
   
• Substance Abuse and Brain Injury – This is a module from the ABI Partnership's Introduction to Acquired Brain Injury Series which is designed to provide a basic level of knowledge for health care workers and other service providers, brain injury survivors, caregivers, and anyone else interested in learning more about the effects of brain injury. Also, strategies to help guide survivors and families through the lifelong process of adapting to and/or recovering from their injury are provided. In this Module you will hear a 25-minute presentation from, Jolene McLeod, B.A, BSW, RSW on Substance Abuse and Brain Injury.
   
• Alcohol Use after ABI – In this fact sheet, you will learn that alcohol use and ABI are closely related and you will learn more about the risks and facts about alcohol use after an ABI.
   
• Substance Use Brain Injury Bridging Project's (SUBI's) Client Workbook - This workbook was designed by a partnership of people at Community Head Injury Resource Services of Toronto (CHIRS) and the Centre for Addiction and Mental Health (CAMH). It was created for people who are living with the effects of a brain injury and are also having some problems due to drug or alcohol use. To get the most out of this workbook it is strongly recommended that clients review it with a counsellor who is familiar with addictions and/or is helping people after brain injury. 
   
• The Ohio Valley Center for Brain Injury Prevention and Rehabilitation’s ABUSE Screening Tool: This tool, for screening substance abuse, has been designed for use by non-substance abuse professionals during interviews with persons who have experienced traumatic brain injury. Its purpose is to help professionals frame questions and identify responses that may indicate the presence of a substance abuse problem or the risk of a future problem.

Saskatchewan Treatment Resources 

• Saskatchewan Mental Health and Addiction Services- on this page of the Government of Saskatchewan website you will see a link titled, Find Mental Health and Addictions Services in My Community, providing a comprehensive listing, alphabetically by community, of Addiction and Mental Health Services and Agencies in Saskatchewan.
   
• Substance use treatment centres for First Nations and Inuit - The National Native Alcohol and Drug Abuse Program (NNADAP) helps set up and operate addiction programs to reduce and prevent alcohol, drug and solvent abuse in Indigenous communities. It is made up of a network of programming that includes First Nations addiction treatment centres and NNADAP community-based prevention programs. This link will provide you a list of Saskatchewan based NNADAP facilities and contact information.
   
• Métis Addiction Council of Saskatchewan Inc. (MACSI) - Métis Addictions Council of Saskatchewan Inc. (MACSI) is a provincial community based addictions agency with locations in three cities across the province, Saskatoon, Regina and Prince Albert. They welcome Métis, First Nations and Non Aboriginal people who are seeking support to live safer, healthier lives free of the harmful effects of addictions.
  
  MACSI’s programs and services are unique. They are informed by a broad spectrum of influences. This includes knowledge of Métis heritage, traditional Aboriginal teachings, the 12 step recovery model, Saskatchewan’s Clinical Principles for Alcohol and Drug Misuse Services in Saskatchewan, up-to-date research and emerging trends in the field of addictions.
  Caring and qualified addictions counsellors at each centre help individuals to find the service and support that fits best. MACSI offers individualized treatment, hope and empowerment through inpatient treatment, outpatient services, drop-in day programming and community field work for youth and adults.

• Sask North Acquired Brain Injury Addictions Support Group. The purpose of this group is to bring together survivors of ABI who are interested in learning about how addiction can take over a person’s life after a brain injury. There are eight scheduled information sessions which include:

Session 1.   Cycle of Use
Session 2.   Influences of Addiction – Biological
Session 3.   Influences of Addiction – Psychological
Session 4.   Influences of Addiction – Social
Session 5.   Influences of Addiction – Spiritual
Session 6.   Influences of Addiction on Family Members
Session 7.   Post-Acute Withdrawal & Relapse Process
Session 8.   Recovery Process & Supports 

These sessions rotate, and are offered continuously. After completing a set of 8 sessions, participants are encouraged to continue with the group. Continued attendance reinforces the information, and continuing participants can be great supporters to the newcomers.

If you would like more information on the group offered in Prince Albert, please feel free to contact the Sask North ABI Outreach Team at 306-765-6480.

**The Sask North ABI Outreach Team is willing to offer information on their Addictions Group Facilitation Curriculum to professionals interested in offering an ABI addictions support group in their area. Contact the Sask North ABI Outreach Team at 306-765-6480 for information.
 

Adapting Your Service for Persons with Acquired Brain Injury (ABI)

If you are professional who is new to working with ABI survivors and/or would like to increase your success with survivors, there are a number of on-line resources that can help you adapt your treatment to better serve this population.

Below are two resources from the Ohio Valley Center for Brain Injury Prevention and Rehabilitation which you may find helpful:

• Accommodating the Symptoms of TBI web-based training module. The Ohio Valley Center for Brain Injury Prevention and Rehabilitation offers a number of on-demand modules regarding Traumatic Brain Injury. These modules are free, or can be purchased for continuing education credits. In their module, Accommodating the Symptoms of TBI, you will learn to recognize the common symptoms of TBI and how to incorporate compensatory strategies into your treatment practices. These simple, yet effective accommodations will help you increase the odds of treatment success. A booklet accompanies this training.  
   
• Treatment programs and services often need to be adapted to accommodate the disability arising from acquired brain injury.  This print resource Suggestions for Substance Abuse Treatment Providers offers simple and effective accommodations for individuals with TBI.