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Ruth Wilcock Executive Director

Addictions and Brain Injury Completing the Picture. Ruth Wilcock Executive Director. Mission of OBIA. To enhance the lives of Ontarians living with the effects of ABI through education, awareness and support. Education – In collaboration with Brock University.

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Ruth Wilcock Executive Director

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  1. Addictions and Brain Injury Completing the Picture Ruth Wilcock Executive Director

  2. Mission of OBIA • To enhance the lives of Ontarians living with the effects of ABI through education, awareness and support

  3. Education – In collaboration with Brock University • 6 continuing education courses • Over 6000professionals have completed our courses

  4. Brain Basics

  5. OBIA Support Services 1-800-263-5404

  6. OBIA Services - Personal Advocacy • Income Support Programs • ODSP (Ontario Disability Support Program) • CPP (Canada Pension Plan) • WSIB (Workers Safety Insurance Board) • Disability Tax Credits

  7. Personal Advocacy (Con’t) • Access to Services • Quality of Care and Services • General Information

  8. Provincial Network • 21 Affiliated Community Associations across the Province • Provide: • Information • Support • Prevention

  9. Addictions and Brain InjuryCompleting the Picture

  10. Outline • 1. What is Brain Injury • 2. Addiction and Substance Abuse • 3. Relationship Between Brain Injury and Substance Use/Abuse • 4. What You Can Do

  11. A Fragmented View

  12. Complex Issues Addiction Brain Injury

  13. What is Acquired Brain Injury? • Definition: • “Damage to the brain that occurs after birth and is not related to a congenital disorder or a degenerative disease such as Cerebral Palsy Alzheimer’s disease or Parkinson’s disease”.

  14. Traumatic and Non Traumatic • A brain injury can occur from: • A traumatic event • Non traumatic event

  15. Trauma • All brain injuries are traumatic to the person who sustained the injury • Trauma is often experienced: • Physically • Mentally • Emotionally

  16. Prevalence of Brain Injury • There are almost a half a million people living in Ontario with a brain injury

  17. Incidence of Brain Injury 24

  18. Brain injury is the number one cause of death and disability for Canadians under the age of 45. 25

  19. Cost of ABI The cost of ABI is measured in the hundreds of millions of dollars for medical care, rehabilitation and life long supports. 26

  20. The cost in terms of human suffering and lost potential is immeasurable. 27

  21. ABI Facts and Fiction • Fiction • All brain injuries are alike • Fact – No two brain injuries are alike

  22. ABI Facts and Fiction • Fiction • All brain injuries heal with time • Fact • Many times the damage to the brain is permanent

  23. ABI Facts and Fiction • Fiction • When one physically recovers the brain has healed itself • Fact • Person may look fine but cognitive dysfunctions are compromised

  24. ABI – The Invisible Disability • In many cases the injuries are invisible and the person suffers in silence

  25. Brain Injuries Often Go: • Undiagnosed • Misdiagnosed • Misunderstood

  26. Brain Injury and Homelessness • 53% of homeless people in Toronto have a history of brain injury. • Of the 53% of people who have a history of brain injury 70% sustained a brain injury prior to becoming homeless Source: S.W. Hwang, A. Colantonio, S. Chiu, G. Tolomiczenko, A. Kiss, L. Cowan, D.A. Redelmeier, & W. Levinson

  27. Brain Injury and Mental Health • It is estimated that the prevalence rates for co-morbid psychiatric disorders in ABI may be as high as 44%.

  28. Arrests and Brain Injury • US study found that 2% of general population arrested annually • 31% of brain injury survivors (5 years post injury)had one or more arrests

  29. Brain Injury and Prison Population • 44% of people in our Ontario prison system have a history of brain injury • 86% of prison inmates in New Zealand • 87% of county jail inmates in Washington • In a sample of 15 convicted murderers sentenced to death, Lewis and colleagues (1986) found that 100% of this death row sample had a history of severe head injury.

  30. The Brain Controls Everything • The brain controls virtually everything humans experience, including: • Movement • Sensing our environment • Regulating our involuntary body processes such as breathing

  31. Lobes of the Cerebral Cortex

  32. Frontal Lobe – (Executive) Function of the Lobes • Takes information from other parts of the brain • Formulates responses

  33. Frontal Lobe • Cognition and memory • Ability to concentrate • “Gatekeeper” on behaviour (judgment and inhibition) • Personality and emotional traits • Movement • Sense of smell • Taste • Planning, sequencing and organizing • Self-awareness • Word formation

  34. The Stigma and Tragedy of Addiction

  35. Definition of Addiction • Any repeated behaviours, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on her/his life and the lives of others"

  36. Addiction Involves: • Compulsive engagement with the behaviour and a preoccupation with it • Impaired control over the behaviour • Persistence or relapse, despite evidence of harm • Dissatisfaction, irritability or intense craving when the object- drug or other activity is not immediately available

  37. Substance Abuse and Brain Injury • One-third of ABI survivors have a history of substance abuse prior to their injury • One third of incidents that cause brain injury are drug or alcohol related • 20% of survivors who do not have a history of substance abuse problem become vulnerable to an abuse problem

  38. Quick Facts • As much as 43% of people with brain injuries can be classified as moderate to heavy drinkers • Substance abuse is reduces immediately following injury but often returns to pre-injury levels within two to five years post-discharge • Half of people with ABI and substance use problems have parents with substance use problems

  39. Drugs of Choice Include: • Alcohol 72% • Cannabis 13% • Crack and Cocaine 10% • Sedatives 2% • Heroin 1% • Other 2% *Ohio Valley Center for Brain Injury

  40. Existing Problem with Substance Abuse • Withdrawal: • Physical withdrawal • Psychological withdrawal • Issues pre-injury not addressed

  41. The Role of Dopamine • Nearly all addictive drugs, directly or indirectly, target the brain’s reward system by flooding the circuit with dopamine • Cocaine reduces dopamine receptors • Can take months/years for receptor numbers in the brain to return to pre-drug use figures

  42. Relationship of Substance Use to Brain Injury • Alcohol or illicit drugs were used before the injury • Drug and alcohol use can develop after a brain injury • Tolerance levels of substances are decreased • Social groups change

  43. A Vulnerable Population • Some reasons for substance misuse and abuse can be: • A result of chronic pain • Cognitive problems • Reduced ability to cope with life's new challenges. • Impaired insight • Lack of self awareness • Not understanding the consequences

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