1. Managing the Stresses of Addiction after TBI April Smith, MSSA, LSW, Peggy Shecket, MS, CDCA, & Max Stafford, MA, LCDCIII, OCPSI-1

2. TBI in the USA According to the U.S. Department of Health and Human Services and the Centers for Disease Control and Prevention… 1.7 million people sustain a TBI each year 52,000 people die as a result of TBI 275,000 are hospitalized 1,365,000 are treated and discharged from ERs TBI rates are higher for males than females

3. Causes of TBI Falls = 35.2% Unknown= 21% MVAs= 17.3% Struck by/ Against= 16.5% Assault= 10% *Injuries commonly associated with drug and alcohol use are motor vehicle accidents, assault, domestic violence and falls.

4. Impact of Substance use on TBI According to the Colorado TBI Registry and Follow up 20% of persons hospitalized due to TBI are intoxicated at the time of injury 17% of persons hospitalized report illegal drug use during the year prior to their injury 10% to 20% of persons with severe injuries develop a substance abuse problem after TBI

5. Substance Abuse vs. Dependence Using alcohol or drugs and failing to fulfill responsibilities “Harmful use” Using alcohol or drugs in situations that could be hazardous Acquiring legal, social or interpersonal problems because alcohol or drug use Increased tolerance of alcohol or drugs Unsuccessful efforts to quit Staying high or drunk longer Spending a large amount of time and energy to get drugs or alcohol Giving up important things or activities because of alcohol or drug use Withdrawal Continued use despite physical or mental problems caused by alcohol or drug use.

6. Reasons why people use drugs and alcohol Biology- genes, environment, gender, ethnicity, presence of mental disorders Environment- family, friends, SES, quality of life, peer pressure, physical/sexual abuse, stress and parental involvement Development- onset of alcohol or drug use, brain injury, trauma Drug &/or alcohol abuse leads to changes in brain structure, function, and chemistry. Repeated use of drugs/ alcohol changes the brain’s functioning, i.e. self-control, decision making, poor impulse control. Drugs and alcohol “fool” the brain’s pleasure centers (dopamine) producing euphoria. Therefore taking the place of natural behaviors like emotions, eating, spending time with loved ones, motivation and controlling movement.

7. So what are the risks of using drugs and alcohol after TBI? The side effects of substance use can increase the symptoms of brain injury (balance, speech, judgment, memory, etc.) Increased chance of seizures Decreased satisfaction of life Poor self-care (eating, medication management, attending medical appointments,etc.) Risk of fatality mixing drugs/alcohol with medications Risk of having another injury

8. Coping Strategies Physical-exercise, movement… Mental-thought stimulating activities… Attitude- the perspective you choose to have… Examples- who inspires you… Communication- those you can speak with… Social Support- positive and supporting environments… Purpose- why should I make this choice… Planning- the big picture, but in manageable pieces…

9. Resources

10. Questions Want to email us? Smith.5855@osu.edu Shecket.3@osu.edu Stafford.97@osu.edu