Substance Use after TBI
Alcohol and Drug Abuse
Why do so many individuals with TBI have problems with substance use?
Substance use problems prior to injury
New substance use problems after injury
After the honeymoon
How much alcohol is safe after TBI?
When to seek help
Many people benefit from professional help when their drinking or other drug use is too much and is creating problems for them. One sign that a person could use some assistance is when they have tried to cut down on their own, but somehow the problem continues. Another sign is when people who care about a person begin worrying that he or she is drinking too much. Finally, if a person is facing legal or medical problems due to use (including having another injury) it is advisable to seek help.
A tool to assess use is available at Rethinkingdrinking.niaaa.nih.gov
How does alcohol and other drug use affect a person who has had a TBI?
- Don't Recover As Well
People who use alcohol or other drugs after they have a brain injury don’t recover as well.
- Problems in Balance, Walking and Talking
Brain injuries cause problems in balance, walking or talking that get worse when a person uses alcohol or other drugs.
- Say or Do Things Without Thinking First
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.
- Problems With Thinking, Concentration or Memory
Brain injuries cause problems with thinking, concentration or memory, and using alcohol or other drugs makes these problems worse.
- More Powerful Effect of Substances After TBI
After a brain injury, alcohol and other drugs have a more powerful effect.
- More Likely To Feel Low or Depressed
People who have had a brain injury are more likely to have times that they feel low or depressed and drinking alcohol and getting high on other drugs makes this worse.
- Can Cause a Seizure
After a brain injury, drinking alcohol or using other drugs can cause a seizure.
- More Likely To Have Another TBI
People who drink alcohol or use other drugs after a brain injury are more likely to have another brain injury.
Other reasons to avoid alcohol and other drugs
In addition, persons with TBI who use substances are more likely to experience:
- Living alone
- Feeling isolated
- Lower life satisfaction
- Interactions with prescribed drugs or other medical conditions
- Criminal activity and being arrested
- Injury or being victimized
- Additional brain damage
What is appropriate substance use treatment for a person with TBI?
Involving family and friends
Stages of changes
- Precontemplation (a person sees no problem with his or her alcohol or other drug use when there is one)
- Contemplation (the person is weighing the pros and cons of changing substance use)
- Preparation (the person has decided that a change is needed, but does not yet have a specific goal)
- Action (the person is making changes in order to reduce or eliminate the use of alcohol and other drugs)
- Maintenance (the person is sustaining successful change despite urges to use again).
Self-help approaches began with Alcoholics Anonymous (AA) and have grown to address a wide variety of addictions. Rational Recovery and Moderation Management are two other self-help approaches for alcohol problems. Narcotics Anonymous (NA) and Cocaine Anonymous (CA), both based on AA, are two of the largest self-help organizations addressing illegal drug use. AA, NA and CA use the "12-step" method, with its focus on developing personal responsibility within the context of peer support.
AA, NA, or CA groups are not for everyone at all stages of recovery. For those still at a point that they are resistant to exploring their use of alcohol or drugs as problematic, the introduction of AA/NA/CA may be too early and counterproductive. Forcing a self-help group on a person too early may create greater resistance later in the process of recovery when AA/NA/CA could be very helpful. A person may find support in other areas of their life that are as productive as AA/NA/CA, and it may be better to use these natural supports. However, we have found that people who participated in self-help groups before their injury can be more open to involvement after.
When attendance at AA, NA or CA groups is being considered there is a certain amount of planning that should take place. We think it is important for someone to accompany a person who has had brain injury and has never attended self-help groups to the first few meetings. Having someone to share the initial experience with, and talk about it afterward, can make the difference between dropping out or staying with the group.
Nuts and Bolts of Using Self-Help Groups describes what will happen at a meeting.
Living in Recovery
Living in Recovery
ContactOhio Valley Center for Brain Injury Prevention and Rehabilitation
2118 Dodd Hall
480 Medical Center Drive
Columbus, OH 43210-1245
Phone: 614-293-3802, TTY Dial 711