Alcohol and drug related brain injury

Moderate to high levels of alcohol consumption over a long period of time, or excessive drinking over shorter periods, can lead to ARBI. In the short-term, it can reduce inhibitions and affect judgement, balance and coordination, increasing the risk of Traumatic Brain Injury (TBI) as a result of accidents.

A major reason for ARBI is thiamin (vitamin B1) deficiency. Thiamin, which is an essential nutrient for healthy brains, is not produced by the body and must be consumed in food or supplements. Alcohol interferes with the absorption of thiamin due to swelling of the stomach lining. Excessive alcohol consumption is also associated with a poor diet, which means thiamin can be lacking in the first place.

The effects of ARBI can result in:

• impaired judgment and self-awareness
• social isolation
• depression and mood disorders
• lack of motivation
• distractibility and concentration issues
• impulsivity and reckless behaviour.

There are various types of ARBI depending on where the brain injury occurs:

• Cerebellar atrophy – causes balance and coordination issues
• Peripheral neuropathy – leads to sensory issues with the hands, feet and legs
• Hepatic encephalopathy – can result from liver disease
• Frontal lobe dysfunction – affects cognition, behaviour and personality
• Wernicke’s encephalopathy – can develop due to extreme thiamine deficiency
• Korsakoff’s amnesic syndrome – also a result of extreme thiamine deficiency.

The toxic effect of drugs varies according to the type of drug and how much is taken. The consequences of drug misuse can be serious and include:

• seizures
• stroke
• heart attack
• hypoxic brain injury.

Psychoactive drugs can be divided into three general categories according to how they affect the central nervous system:

• Stimulants
• Depressants
• Hallucinogens.

Anytime you take more than one drug, there is a risk of a drug interaction. These interactions can occur between prescription medications, recreational substances, over-the-counter medicines, vitamins, supplements, and herbal remedies. A few of these interactions can be very serious, so it is important to understand the possible outcome before you take your medications. Discuss the possibility of interactions with your doctor or pharmacist, or visit websites such as NPS Medicine wise: www.nps.org.au/consumers/understanding-drug-interactions

Stimulants stimulate the central nervous system, increasing alertness and physical activity. Stimulants include caffeine, nicotine, pseudoephidrine, methylphenidates, betel nut, amphetamines, cocaine, and Ecstasy.

Depressants depress the central nervous system. In a normal dose, they can lead to euphoria, relaxation, reduced coordination, disinhibition and lack of concentration. Larger doses may lead to nausea, unconsciousness and even death. Depressants include alcohol, cannabis, barbituates, benzodiazepines, opioids, some antihistamines, muscle relaxants, sedatives, some anticonvulsives, some antipsychotics, and alpha and beta blockers.

Mixing Benzodiazepines (prescription medications often used for sleep or anxiety), opioids (e.g., heroin, morphine, codeine, pethidine, oxycontin), and/or alcohol has been responsible for many deaths.

Inhalants are a range of chemical products that are inhaled to produce a high feeling. Many of these have a depressant effect and can be obtained from a variety of household products such as glue, aerosols and petrol.

The long-term use of inhalants can cause brain damage and damage to the central nervous system as well as hearing loss, bone marrow, liver and kidney damage and depletion of blood-oxygen levels.

Hallucinogens affect a person’s perceptions, sensations, thinking and emotions. Examples include LSD, mescaline and psilocybin. Psilocybin is found in certain mushrooms that are known as “magic mushrooms” or “golden tops”.