Alcohol after a brain injury

“I developed epilepsy because of my injury. Drinking triggered my seizures so I decided to give up because for me prevention was far better than cure. It was hard at first but I feel better in general now and have more money in my pocket.” – Damien from Co Kerry

After a brain injury, most people want to know when they can go back to having a drink or if it is safe to drink at all.

We have produced this booklet to:

  • Help answer these questions.
  • Suggest ways to reduce the amount of alcohol you drink or how to avoid it.
  • List where to get more information or support if you need it.

Alcohol is widely consumed in Ireland. However, it is a drug that has powerful effects on our brains. Alcohol works by changing our brain chemistry. This is what makes us feel relaxed, happy or sad when we drink.

A brain injury causes a loss of brain cells and may cause scar tissue. This can affect how well our brain works. The damage to the brain makes it more sensitive to alcohol and other drugs. We don’t yet fully understand all the ways that alcohol affects an injured brain. What we do know is that the effects are greater and are not easy to predict.

Any substance such as alcohol or drugs can affect how our brain works whether we have a brain injury or not. For people with a brain injury, the effects of drugs or alcohol are increased.

Should people with a brain injury drink alcohol?

This is a decision that brain injury survivors are faced with as they recover. Some people find they lose their taste for alcohol and do not find it hard to give up. However, most people want to get back to having a few drinks.

The reality is that drinking after a brain injury comes with a number of risks. In making your decision, we suggest you talk to people you trust and consider the following eight points.

1. Alcohol has a greater effect on you due to your brain injury.

  • Your tolerance for alcohol is likely to be reduced. This means that the normal guidelines for safe amounts to drink per week are too high for people with a brain injury. Most people find they become tipsy, light-headed or sleepy with less alcohol than before.
  • If you are driving it is not safe to drink at all.
  • You are likely to become intoxicated more quickly.
  • You may react to drinking in ways you don’t expect – for example, becoming aggressive, disorientated or having a seizure.

2. Alcohol can slow down, or hinder, your recovery.

  • Recovering from a brain injury can take longer than you think. Many people continue to recover for months or even years after their injury.
  • Your brain has to work extra hard to re-learn everyday things as you recover. Drinking can slow down your progress.
  • Drinking alcohol can prevent you from making the fullest recovery possible.
  • Alcohol can also make it more difficult to learn new information or skills.

3. Alcohol affects memory, concentration and thinking skills.

  • A brain injury may reduce your ability to pay attention, concentrate, remember things or process information quickly. Drinking will make these difficulties worse.
  • When you are drinking, you will not be able to use any coping strategies you have learned for dealing with memory difficulties or other problems.
  • If you are drinking on a night out and your memory is already poor, you may be putting yourself at risk. You could lose your keys, phone or money and have difficulty getting home safely.

4. Drinking can increase the chance of having a second brain injury.

  • Statistics show that having a brain injury increases the chance of you suffering a second one.
  • Drinking increases the chance of suffering a second brain injury even more. The most likely reason is that alcohol increases the effects of any difficulties caused by the brain injury – for example, balance.

5. Alcohol can cause seizures (fits) after a brain injury.

  • If you drink alcohol after a brain injury, you are more likely to have a seizure even if you have not had one before.
  • If you are taking anti-seizure medication, drinking can prevent it from working properly.

6. Drinking increases difficulties with talking and understanding.

  • If your brain injury has affected your speech, being under the influence of alcohol can make talking harder.
  • Drinking may also make it more difficult for you to understand what people are saying.
  • If drinking makes communicating more difficult, it can cause frustration, confusion and arguments.

7. Alcohol makes poor judgement and impulsivity worse.

  • The Frontal lobes (and other linked parts) of our brain help us to avoid doing things that may offend other people, cause trouble or be too risky. After a brain injury, our ability to avoid these difficulties can be reduced.
  • Drinking makes difficulties like this worse. You may find it hard to control what you say or do – for example, taking risks, saying exactly what you think or doing things you later regret.
  • If anger or mood swings are affecting you since your injury, there is support available. See the Mood Swings, Irritability, and Anger Page for tips, information and who to contact.

8. If you feel depressed or anxious, alcohol can make this worse.

  • After a brain injury, you have a higher chance of feeling low or depressed. Drinking can make this worse.
  • Alcohol can also make you feel more anxious.
  • If anxiety or depression are affecting your life, contact your GP. See the Feeling Low or Anxious Page for more advice and information.

What you can do to cut down or cut out alcohol

 What you can do

Not drinking increases your chance of making the best recovery that is possible for you. It is much easier to make changes in your life if you replace one habit (for example, going to the pub) with a new habit (going to a new group or activity).

  • Get support from family and friends to help you to cut down or stop drinking. Replace alcoholic drinks with non-alcoholic ones instead.
  • Meeting up with other people may help. Many people find it beneficial to talk to others going through similar challenges. See Help and information tab below for some support organisations.
  • Refusing a drink can be awkward. Make it easier by planning ahead. Be ready with a phrase such as ‘No thanks. Since my injury I feel better if I don’t drink.’
  • Make a list of your reasons to stop drinking and a list of the benefits of stopping. Any time your determination weakens, read back over the lists to keep yourself motivated.
  • Keep a note of how you are getting on. Reward yourself when you make positive changes.
  • If you use alcohol to cope with stress, emotions like anger or feeling low, try other ways of dealing with them – for example, doing relaxed breathing, meditation or gentle exercise, talking to someone you trust, doing a hobby or something else relaxing.
  • When meeting friends, suggest other places rather than just the pub – for example, bowling, a concert, the cinema or go to a café to talk instead.

Alcohol can interfere with prescription medication. Talk to your GP about this.

Some signs of a drinking problem

Some signs you could have a drinking problem

  • Drinking early in the day to steady your nerves or to ‘get going’.
  • Trouble at home due to your drinking.
  • Drinking faster than other people or having a quick extra drink at the bar when you are ordering.

If you think you have a problem:

  • Talk to someone you trust. If somebody close to you says they think you have a drinking problem, try to take what they say on board.
  • Get support. Having a brain injury can make it harder to give up alcohol and other substances.
  • Make an appointment with your GP.
  • Contact the HSE’s confidential Drugs and Alcohol Helpline on t: 1800 459 459 or email: helpline@hse.ie

Help and information

Psychologists

Headway offers free community-based brain injury assessment, counselling and rehabilitation in Cork, Dublin, Kerry and Limerick. t: 1890 200 278

To access a public psychologist, your GP or Public Health Nurse can refer you. HSE t: 1850 24 1850 or visit www.hse.ie

To find a registered private psychologist, contact the Psychological Society of Ireland. t: 01 472 0105 or visit www.psihq.ie

Occupational Therapists

To access a public Occupational Therapist, contact your local HSE Health Office or Health Centre. HSE t: 1850 24 1850 or visit www.hse.ie

To find a private Occupational Therapist, contact the Association of Occupational Therapists of Ireland. t: 01 874 8136 or visit www.aoti.ie.

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