Substance use

It is estimated that approximately one in five Canadians aged 15 years and older experience substance use in their lifetime [1]. Substances include:

• Alcohol
• Opioids and other prescription drugs
• Tobacco
• Cannabis
• Methamphetamines
• Cocaine
• Heroin
• Ecstasy

Problematic substance use is when any substances are used in a manner, frequency, situation, or amount that is harmful to a person or those around them [2]. Examples of situations of problematic substance use that can lead to a brain injury include:

• Excessive consumption causing impaired faculties (i.e. loss of balance or reduced vision)
• Impaired driving
• Opioid overdose
• Lowered inhibition and an increase in risk-taking behaviour

Barriers to recovery for substance use and brain injury

Individuals coping with addiction/problematic substance use and brain injury face a lot of challenges that make recovery more difficult.

Lack of services for complex needs

Brain injury survivors that are struggling with addiction/withdrawal do not have access to many rehabilitation services that can treat both addiction and brain injury.  Either the program requires participants to be sober, or the addiction programs are not equipped to handle the complex needs of people with brain injury. This makes it difficult for people to get the help they need.

Continuing addiction after brain injury

People with a brain injury may have a continuing addiction that they struggle with during their recovery. In some cases, an addiction may develop post-injury. The use of substances (including alcohol) can have negative effects on a person’s recovery and even make symptoms worse.

Stigma

There is a stigma around substance use/addiction that can impact the quality of life for the survivor and their support circle [3]. A stigma is framing a situation in a negative light, and is often adopted by society as a whole.

The stigma surrounding substance use is made worse when you factor in the stigmas that still exist around brain injury and disabilities. It can take a long time to dismantle these stigmas, and they can be harmful to people.

• Stigmas surrounding substance use – information from the Government of Canada

Advocating for more support for substance overdose survivors

Survivors of opioid overdose, addiction and brain injury need more supports and services that can help them cope with these concurrent challenges. Advocating for more research into the relationship between overdoses and brain injury as well as services is one way to bring further attention to this important issue.

Visit the advocacy section of our website to find out how to be an effective advocate as well as templates for letters.

Addiction & problematic substance use

Substances like alcohol can have detrimental effects on a person before and after a brain injury. This is especially true if a person is coping with addiction.

Addiction is used to describe an attachment to a substance or behaviour that is out of control [4]. The Centre for Addiction and Mental Health (CAMH) indicates that you can determine if you or someone you know has an addiction if there 4 C’s are present:

• Craving
• loss of Control of amount or frequency of use
• Compulsion to use
• use despite Consequences

In extreme cases, addiction and problematic substance use can completely destroy a person’s life, leading to homelessness, severe health consequences (such as brain injury) and a loss of support from family and friends.

• Information on addiction from CAMH
• More information on substance use and brain injury
• Information about problematic alcohol use from the Government of Canada

Opioids and brain injury

Problematic substance use is a big problem in Canada, costing thousands of lives and billions of dollars. Here are the most recent statistics from the Canadian Centre on Substance Use and Addiction.

• Substance use costs Canadians almost $46 billion a year (2017)
• Over 5,000 people died from opioids in 2017

Illegal street opioids laced with dangerous components such as fentanyl increase the risk of overdose and can cause catastrophic brain injury or death through oxygen deprivation.

• More information on opioid overdose and brain injury
• The Government of Canada Opioid Crisis fact sheet

While there are a lot of statistics on the number of deaths related to the opioid crisis in Canada, more information is needed on the number of people who acquire a brain injury due to an opioid overdose.

Resources

• The Substance Abuse and Brain Injury (SUBI) project
• Substance Use and acquired Brain Injury – The ABI Partnership Project
• Substance Abuse/Brain Injury Client Workbook – The Homeless Hub
• Opioid Overdose – The Government of Canada
• Opioids Survivors Guide – British Columbia Centre on Substance Use
• Get help: Problematic substance use – The Government of Canada

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