BRAIN INJURY 101

•Brain Injury Glossary • What is a Brain Injury • Common Challenges/Tools to Help • Concurrent Disorders • Substance Use & Brain Injury •

Substance Use - Brain Injury

There is significant research to indicate an overlap of brain injury, substance use and criminal behaviour. This should be taken into account when assisting someone with a brain injury navigate the justice system. Research on this topic has found that:

  • Children and young adults experiencing Traumatic Brain Injury (TBI) are at greater risk of developing substance use disorders and engaging in criminal activities compared to those without Traumatic Brain Injury (1)
  • In a study of substance abuse and crime patterns, 327 patients with various severities of Traumatic Brain Injury (TBI) reported a high preinjury incidence of moderate and heavy drinking; 81% and 47% among those with and without arrest histories, respectively (2)
  • There is an increased risk for legal difficulties/criminal misconduct with ongoing substance use following a TBI (3)

THE FACTS & COMMUNITY SUPPORTS

What is Substance Use Disorder?

What is a substance use disorder?

  • A substance use disorder is diagnosed when the repeated use of alcohol and / or drugs causes a significant problem with health and / or a failure to meet major responsibilities at work, school or home.
  • Addiction is often defined as a complex, chronic disease that affects the functioning of both the brain and the body.  When addicted, people continue to use a substance even though they know that it is causing them harm. It is described as a chronic, relapsing disorder because the changes in the brain circuits involved in processing rewards, stress and self-management can last a very long time—well after a person has stopped using drugs.
  • Often the term addiction is used when a substance use disorder is severe. The term misuse may be used to describe excessive or risky use that has not developed into an addiction.

Symptoms of problematic substance use

  • Using more of the substance that was intended, and for a longer period of time
  • A desire to cut back and being unable to do so
  • Spending a great deal of time getting, using or recovering from the use of the substance
  • Strong cravings/desire to use the substance
  • Use of the substance interferes with regular activities or obligations
  • Use of the substance continues despite the fact that it causes significant problems
  • Using when it is physically risky to use
  • Using is causing physical or psychological problems (or making them worse)
  • Using more of the substance to get the same effects (tolerance)
  • Feeling symptoms of withdrawal, and using the substance to feel ‘normal’

Consider that:

  • 82% of Canadians drink 7 or fewer drinks per week
  • Only 6% of Canadians drink 15 or more drinks per week
  • The risks that come with drinking increase at the number of drinks rises

Substance Use and Brain Injury

Substance Use and Brain Injury – Facts 

  • 25 – 30% of people who are treated for brain injury were intoxicated at the time of the injury
  • More than half of all people who are admitted to Acquired Brain Injury (ABI) rehabilitation programs have a history of substance use
  • Brain injury early in life more than doubles the risk for problems with substance use later in life
  • 20% of people will develop a new problem with substance use after brain injury
  • Using substances increases the risk of re-injury
  • People with brain injury and substance use disorders are also at high risk to have other mental health problems

Navigating the mental health and addictions system

  • After a brain injury, it may be more difficult for someone to participate in treatment for substance use disorders because most treatment programs are based on the idea that a person has or can develop the ability to manage the urge to use. For a person with a brain injury self-management and self-control are often a problem
  • Difficulties with memory may also make it more difficult for a person with brain injury to participate in treatment of substance use. People with brain injury may have a much harder time remembering appointments, conversations or decisions about treatments, including any actions they agree to take.
  • Treatment programs will often involve multiple supports and phases: individual treatment, enrollment in formal services, residential and/or out- patient, peer support, family. Since most services are voluntary so your family member, once accepted, can opt out themselves at any point in the treatment process

Resources & Information: Substance Use and Brain Injury Project (SUBI)

  1. Matheson, F.I., Mclsaac, K.E., Fung, K., Stewart, L.A., Wilton, G., Keown, L.A., Nathens, A.B., Colantonio, A., & Moineddin, R. (2020). Association between traumatic brain injury and prison charges: a population-based cohort study. Journal of Brain Injury, 1-8. DOI: 10.1080/02699052.2020.1753114
  2.  https://www.houston.va.gov/docs/research/Graham.pdf
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171742/
  4. BIST.ca – “What is a Brain Injury”
  5. Information provided by Dr. Carolyn Lemsky, Ph.D.,C.Psych ABPP-CN
  6. The Substance Abuse and Brain Injury (SUBI) project