1. Drugs and Alcohol
As reintegration into the community occurs, families and patients often ask about the use of alcohol and nonprescription drugs. We strongly recommend that patients abstain from the use of these substances. Mild analgesics, such as ASA or acetaminophen may occasionally be necessary and can be used. All other agents should be avoided. The effects of alcohol and other psychoactive drugs are somewhat unpredictable in a “normal” brain … these effects become much more unpredictable in the damaged brain. In general, the effects of these agents are much more pronounced in the individual who has had a brain injury. The person with impaired emotional and behavioural control will tend to lose even that control with minimal amounts of alcohol or drugs. Additionally, the person’s ability to monitor and control consumption is usually markedly impaired. Finally, the abuse of alcohol and some drugs can produce seizures in anyone, and are more likely to do so in the brain injured person. Because of these considerations, it would seem the best policy is complete abstinence.
2. Long Term Outcome
It is very difficult in the first days and weeks following a head injury to predict accurately the long term outcome. Many factors such as the type and severity of trauma, age and background of the patient, and support systems available, are all involved in determining the eventual outcome. The injured patient’s potential is determined by the extent of the brain damage and the subsequent residual (remaining) abilities of the brain. However, as with a newborn child, the degree to which this potential is achieved, depends largely on environmental factors. The patient whose family can provide support, love, and encouragement, as well as stimulation and training, is likely to do much better than the patient who is on his own or is institutionalized. Thus, the importance of the home and family cannot be overrated. The stress is tremendous but the rewards can be well worth it.
Trauma to the brain results in both physical and cognitive (intellectual) disabilities. While the physical disabilities are more obvious, the long term outcome is much more closely related to the cognitive disabilities. The person with good intellectual ability and appropriate behaviour can usually do a very good job of compensating for physical disabilities.