Transcript Slide 1

NATIONAL INDIGENOUS DRUG AND ALCOHOL CONFERENCE
Alcohol and other Drug-Related Brain Injury
Adelaide 16 June, 2010
Nick Rushworth
Executive Officer
Brain Injury Australia
“…peak of peaks”
ACQUIRED BRAIN INJURY (ABI)
any damage to the
brain that occurs
after birth
…causes?
 stroke
 accident or trauma
 brain infection
 neurological diseases (Parkinson's
disease, Huntington's disease
etc.)
 oxygen loss (asthma, neardrowning etc.)
 alcohol or other drug abuse
alcohol and other
drug-related
brain injury
 …alcohol
 marijuana/ cannabis
 petrol…
PHYSICAL DISABILITY
 nerve damage
 poor balance and coordination
 fatigue
 loss of sense of taste or smell
 vision and hearing
disturbance
 speech impairment
COGNITIVE DISABILITY
poor memory and concentration
(2 in every 3)
= reduced ability
- to learn
- to plan and
- to solve problems
“CHALLENGING BEHAVIOUR”
for 2 out of 3, the most disabling
 increased irritability
 poor impulse control
 verbal and physical
aggression
 paranoia, psychosis
alcohol-related brain injury 1
 (“dose response”?)
 NHMRC guidelines (2009) – “2 standard” per
day ≠ “risk drinking”
 National Drug Strategy Household Survey
(2007) @ “long-term high risk” = 3.8%
(men), 2.7% (women)
 National Drug Research Institute (2008) 44%
of alcohol “consumed at levels that pose
risk in the long-term”
alcohol-related brain injury 2
 National Aboriginal and Torres Strait Islander
Health Survey (2004-05 - consumption
week prior to the survey) - 16% adults @
long-term /chronic, “risky / high risk”
alcohol consumption (↑13% in 2001)
 [age-standardised] ATSI were 2X likely to
drink at short-term risky/high risk levels at
least once a week than non-ATSI
alcohol-related brain injury 3
 “2 million Australians at risk of
permanent brain damage”
 Men @ 6 standard drinks per day
(women @ 3 drinks) X 8-10
years = “high risk of brain
damage”
alcohol-related brain injury 4
 cerebellar atrophy
 Wernicke's Encephalopathy
 Korsakoff's [Amnesic] Syndrome
(Wernicke–Korsakoff Syndrome)
 hepatic encephalopathy
cannabis/ marijuana[-related brain injury] 1
National Aboriginal and Torres Strait
Islander Health Survey, 2004-2005:
- 43% reported “having tried” marijuana
- 23% had “used it” in the last 12 months
NT Select Committee on Substance
Abuse:
- survey mid-1980s “did not detect” use
in Top End
- 1999: 55% males, 13% females
cannabis/ marijuana[-related brain injury] 2
 2001 – 2002: 67% males = 2X non-ATSI
NT population (NT rate = 1.7 times
higher)
 “concern over cannabis use is lower
than warranted…serious long-term
effects of cannabis use will become
more evident over time, as effects
take hold in populations currently
engaged in habitual, heavy use.”
petrol-[related brain injury] 1
(“…lack of verifiable data…”)
 60 deaths in the NT
 2006 : 600 in Central Desert
region “sniffing regularly”,
120 “with permanent brain
damage”
petrol-[related brain injury] 2
 (“…it is in the remote regions of the
NT, SA and WA that petrol sniffing
is found…”)?
 (National Aboriginal and Torres
Strait Islander Social Survey,
2001-2002 : 4% in non-remote
areas “had sniffed petrol” (4% had
“used other inhalants”)?
petrol-[related brain injury] 3
 “…petrol sniffing has declined significantly in
central Australia over the last two years.”
 sniffers in the APY lands: 178 people (2005) ↓70
people (2006) + “anecdotal reports indicated
that petrol sniffing has been very limited or
non-existent in the six months to August
2008“
 Opal @ 70 communities
 [drug use] migration?
TRAUMATIC BRAIN INJURY (TBI)
results from external force
applied to the head
(ATSI = 3X)
 motor vehicle accidents
 assaults
 falls
over 500,000 Australians have an
acquired brain injury
? “…except for
those living in
remote and
sparsely settled
parts…”
? homeless
= 10% - 30%
? “…excluding those in
gaols and
correctional
institutions”
= 40%-80%
? “…personal
response…. people may
not have reported…
because of the sensitive
nature of the condition…
lack of awareness…”
assessment/ screening tools?
AUDIT: “not been validated for
use with Indigenous clients”
Kimberley Indigenous Cognitive
Assessment
(KICA)
“Cog State”
Menzies School of Health Research)
recovery?
alcohol?
25% - complete recovery
25% - significant recovery
25% - slight recovery
25% - no recovery
petrol?
(Groote Eyland)
“2 years abstinence…improvement in
neurobehavioural performance…often
normalised completely”
www.braininjuryaustralia.org.au
[email protected]
1800 BRAIN1