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Parent's Guide: alcohol, drugs & children with a brain injury

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Parents guide

Parent's Guide: alcohol, drugs & children with a brain injury

Like adults, young people drink and use drugs for many reasons, both positive (to feel good) and negative (to escape problems).

All families can find the situation challenging, but for the young person with a brain injury, the issues are often more complex. In general, drugs and alcohol are riskier for someone with a brain injury than for other young people.


A brain injury increases vulnerability

The issues are complex for young people with brain disorder such as a

brain tumour, traumatic brain injury, meningitis or encephalitis. 


For example:


Alcohol and drugs can dramatically affect someone with a brain injury - considerably more than someone without a brain injury - and this increases the risk of an accident or police attention. Alcohol and drug use after a brain injury also carries a greater risk of causing further brain damage, or triggering seizures.


Some young people with a brain injury drink or use drugs to mask painful experiences or cope with stress-frequent heavy drinking may thus be an indicator of other problems.


A brain injury often affects the skills that are needed to use drugs and alcohol sensibly and safely - motivation, insight, memory, organization and planning. Also the desire to have friends and fit in may make a young person with a brain injury more vulnerable to peer group pressure.


Alcohol can also interfere with many medications, especially anti-epileptic drugs which are commonly taken after a head injury.


Should I prevent my child from using drugs?

For some parents or carers, 'no' may seem like the most sensible message. Other parents assume they can't - or shouldn't - prevent experimentation with 'forbidden' activities and they therefore aim to reduce the chance of harm to the young person.


Forbidding use can sometimes have the opposite effect of what is intended. It may be more constructive to set clear limits - for example, one can of beer at a party - rather than saying 'no alcohol'.


Carrying out any plan - whether it involves saying no to drugs or using them safely - may be difficult if a young person has problems with self-control, judgement and decision making, or difficulty understanding information, anticipating problems, and following through a plan of action.

If self-control is difficult, it may be best to focus on controlling exposure to drugs and alcohol. This means setting clear limits and keeping some control over the young person's social environment.


It may help to discuss this with a professional who understands both brain injury and substance abuse; or, if not available, someone with expertise in youth substance abuse, and make sure they understand the issues relating to your child's a brain injury.


Above all, you should, as a family, choose the approach that suits your own style, values and circumstances.


Can my child learn responsibility?

For almost all young people with a brain injury, the short answer is 'yes'-given an approach tailored to the young person's particular abilities and problems. Parents often find it valuable to talk with a professional about this. A professional can assess your child's strengths and problems, and work with you to develop and carry out a program to teach the skills needed.


The following broad guidelines may also help:

  • Be responsible yourself in your use of alcohol and drugs, and talk about responsible use with your child
  • Teach your young person ways to resist peer pressure - for example, always carry a full glass at a party, or fill your own glass with soft drink
  • Drop off and pick up the young person from parties, or pay for a cab fare home
  • Don't say 'no' to everything, as this may push young people towards problem behaviour
  • Young people with a brain injury may also need firm and clear rules about what's acceptable and safe.


How can I tell if my child is using drugs?

It's not always easy. The effects of a brain injury can look like intoxication, and other so-called 'warning signs' can be similar to the effects of a brain injury, such as disregard for others, a drop in school performance, slurred speech or emotional outbursts and rapid mood swings. A child could also have worsened memory problems and social isolation.


It can be difficult to decide whether these are simply part of the brain injury, or a sign of problems with alcohol or other drugs. Your best guide, as a parent, is probably your own knowledge of your child and your 'gut feeling'.


What if I think there is a serious problem?

Young people seldom tell their parents about a drug or alcohol problem, either spontaneously or when asked directly. Someone with experience of brain injury, young people and substance abuse - if you can find such a person - can provide useful guidance. Otherwise, find someone with experience in young people and substance abuse, and ensure they understand the issues relating to your child's brain injury.


For some young people, drug use can become a serious and debilitating problem, but most who experiment with drugs grow out of it with little or no long-term damage. Drug use is a reason for concern, but not for panic.

If your child needs professional assistance, you may have to support him/her in seeking this. Difficulties with short-term memory, organization and planning can prevent young people from taking the initiative themselves. Ideally, find someone who is knowledgeable about both brain injury and drug issues. In reality, you may need to talk to, and bring together, a brain injury specialist and a person who is knowledgeable about drug and alcohol issues.


Try to keep channels of communication open - be ready to talk and listen in a supportive, non-judgemental way. Take a 'problem solving' approach, possibly with outside expert advice. Be clear about how you and your family approach the issue. You need to deliver a clear, consistent message to your young person with a brain injury.


Discipline needs to be rational and sensible. Don't start something you can't carry through (for example, threatened punishments), but set firm limits on what you will and won't do.


Do whatever you can to make sure your child is safe, even when he or she is doing something you don't approve of.


Consider talking with someone at the school - maybe your child's teacher, the year level coordinator, the school nurse, the school counsellor - bearing in mind any confidentiality issues for your child. A school with a positive and preventive approach to drug-related issues can be very supportive and helpful.

Provide your child with opportunities for being involved in community activities in a positive way - for example, in sports teams or youth groups.

Do things together with your child, and as a family. Show an active interest in his or her activities and notice achievements.


Find out what you can about drugs and the actual risks involved. Contact your Brain Injury Association for organizations offering useful advice, information and services in relation to alcohol and other drugs.

References and further information

Many thanks to Brain Foundation Victoria for permission to adapt their material for this fact sheet.


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