Pubdate: Fri, 28 Nov 2014
Source: Victoria Times-Colonist (CN BC)
Page: C5
Copyright: 2014 Times Colonist
Contact: http://www2.canada.com/victoriatimescolonist/letters.html
Website: http://www.timescolonist.com/
Details: http://www.mapinc.org/media/481
Author: Sheryl Ubelacker

DRUG USE LINKED TO CONCUSSION

Teenagers Who Have Suffered Head Injuries Report Higher Intake Of
Drink And Narcotics

Teenagers who have suffered a concussion or other traumatic brain
injury are more likely to report using alcohol and drugs compared with
peers with no history of such an injury, researchers have found.

Use of non-prescribed tranquilizers and opioids as well as illicit
drugs such as cannabis, cocaine and even crystal meth was two to four
times higher among Ontario high school students who had experienced a
traumatic brain injury (TBI) than classmates who hadn't had a serious
blow to the head, the researchers reported in a study published in the
Journal of Head Trauma Rehabilitation.

The study, which analyzed data from the 2011 Ontario Student Drug Use
and Health Survey, found that one in five of the Grade 9 to 12
students reported they had had a previous TBI.

Besides having a higher rate of alcohol and drug use, students in this
group were also 2.5 times more likely to have smoked one or more
cigarettes daily during the previous year and nearly twice as likely
to have engaged in binge drinking - consuming five or more alcoholic
drinks in one sitting - in the previous month.

"It's a really toxic combination when you have the two together,"
co-principal researcher Dr. Michael Cusimano said of mixing a head
trauma with alcohol or drug use. "And it's alarming how early this is
occurring. This is Grade 9 to Grade 12.

"We know that people who have alcohol or substance use problems don't
recover as well from a brain injury," said Cusimano, a neurosurgeon at
St Michael's Hospital in Toronto. "They can't participate as well in
the rehab and they don't recover their original abilities as well as
people who have not been using drugs and alcohol."

In addition, adolescence is an age when the brain is still developing
- - and having a TBI and exposing the brain to the effects of alcohol or
drugs may "greatly impair" that development, he said.

Researchers defined a TBI as any hit or blow to the head that resulted
in a student being knocked unconscious for at least five minutes or
spending at least one night in hospital due to symptoms associated
with the injury. Some of the brain injuries could have been classified
as concussions, which are mild to moderate forms of brain injury.

The study looked at reported TBIs and substance use among Ontario
students, using responses from a representative sample of 6,383
respondents who took part in the survey. Data allowed researchers to
determine substance use habits and TBI history, but not which came
first, the brain injury or the use of alcohol or drugs.

"People with these injuries may be using these substances more, but
the effects of the injury may be such that it may predispose them to
use the substances more often as well," said Dr. Robert Mann, a senior
scientist at the Centre for Addiction and Mental Health who co-led the
study.

"On the other hand, we also know that people who are substance users
may be more likely to have these kinds of injuries," said Mann. "The
classic example is alcohol. Alcohol impairs psychomotor performance,
so you're more likely to have an injury, perhaps more likely to have a
head injury."

Many recreational drugs can affect physical performance and judgment,
setting up a person for potential harm, he said.

In any given year, about five per cent of teenagers will suffer a
concussion or other brain injury, and about 60 per cent of them will
occur while participating in sports.

"What we found in this research is that these injuries are more common
than we would have thought and that also there does appear to be a
cluster with these injuries of problematic behaviour, substance abuse
and mental health concerns," Mann said.

"And we know that substance use problems and mental health problems in
adolescence can result in problems later on in life."

Concussions and other brain injuries can cause dizziness, confusion,
memory loss, headache, nausea or vomiting. Depending on the severity
of the injury, symptoms can persist for some time. Concentration and
the ability to remember may be impaired; the person can be irritable,
depressed and have marked personality changes; sensitivity to noise
and light, along with disturbed sleep, are also common.

Cusimano said it's possible some teens with a traumatic brain injury
turn to alcohol or drugs to deal with such symptoms, trying to make
themselves feel better by self-medicating.

"I think parents, coaches, teachers and guidance counsellors need to
be aware of this toxic combination of drugs, alcohol and brain injury,
and they need to at least inquire about them," he said.

"So if they have a TBI, they need to inquire about drugs and alcohol.
And if they use drugs and alcohol, they need to inquire about brain
injury. Both things need attention."  
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MAP posted-by: Jo-D