Alcohol, Caffeine and other Drugs

Most rehabilitation specialists will advise against drinking alcohol for at least one to two years after brain injury, or even indefinitely.

The body uses essential vitamins and minerals to break down alcohol, which can lead to nutritional deficiencies when alcohol intake is excessive. There is also a risk of further injury when a person with brain injury is under the influence of alcohol. For those who choose to drink alcohol after a period of time, it should be in moderation. Family members can observe any negative impacts, such as worsening behaviours or other impairments.

Because alcohol and other drugs affect a person’s ability to think clearly and control emotions and behaviour, they can interact badly with the effects of a brain injury.

People who already had a dependence on alcohol or other drugs prior to injury might continue to struggle with this after, and in some cases it can become a bigger problem. While, for others, drug use can become a problem for the first time as they struggle with the many changes that come with a traumatic brain injury or other type of brain disorder. Potential issues include:

• negative interactions with prescribed medications
• higher risk of brain injury from overdose and alcohol poisoning
• worsening of cognitive problems (e.g. memory, concentration)
• reduced social skills
• increased depression, anger and emotional ups and downs
• impulsivity and risk-taking behaviour
• problems with physical coordination
• Increased challenging

Studies suggest that even ‘normal’ amounts of alcohol for people with a mild brain injury can have a negative outcome. Most rehabilitation specialists recommend that people abstain from alcohol for at least two years, if not permanently, while the brain is recovering.

If a person does eventually resume use of alcohol or other drugs, a major problem can be self-awareness; there may be an inability to recognise when social skills, coordination, behaviour and cognitive abilities are suffering with drug use. Honest feedback from family and close friends can help, and doctors and brain injury specialists are available for further support.

After a brain injury, someone may develop an alcohol or drug dependency for a number of reasons, perhaps trying to cope with depression and frustration during the recovery process, or personality changes lifting their internal controls around what was once a safe usage.

If possible, discuss the dangers of continued drinking or drug use after a brain injury and see if the person is willing to work with you on the issue. If they are still in a rehabilitation program, advise the team and work with them to:

• encourage the person to take responsibility for their own behaviour
• provide consistent feedback
• help them work through any issues causing the dependency

When people can no longer work after a brain injury, the boredom, social isolation and unstructured days can contribute to a dependency on alcohol or other drugs. A preventative measure is to develop a weekly routine that has enough enjoyable activities and social interaction to provide meaningful structure to each week.

Families can offer support by discussing what to do when friends offer alcohol, tobacco or other drugs. Positive discussions about how to cope with stress and other problems is helpful, along with a combined approach on the type of activities that could be enjoyed without drinking, smoking or taking drugs.

Families can remove the temptation by making sure there is no alcohol or prescription medications in the house. Having one doctor who takes responsibility for all medications will prevent a family member from misusing prescription medications.

Support is available for those who are concerned that drinking or using drugs is causing problems for someone they care about.

Contact Synapse for referral to services that assist with drug dependency problems in the context of a brain injury on 1800 673 074.