NATIONAL INDIGENOUS DRUG AND ALCOHOL CONFERENCE

Alcohol and other Drug-Related Brain Injury

Adelaide 16 June, 2010Nick RushworthExecutive OfficerBrain Injury Australia

members’ members

member organisations

BIA

“…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, near-drowning etc.) alcohol or other drug abuse

…alcohol marijuana/ cannabis petrol…

alcohol and other drug-related brain injury

nerve damage poor balance and coordination fatigue loss of sense of taste or smell vision and hearing disturbance speech impairment

PHYSICAL DISABILITY

COGNITIVE DISABILITY

= reduced ability

- to learn- to plan and - to solve problems

poor memory and concentration (2 in every 3)

“CHALLENGING BEHAVIOUR”

for 2 out of 3, the most disabling increased irritability

poor impulse control verbal and physical aggression paranoia, psychosis

(“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 1

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 2

“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 3

cerebellar atrophy

Wernicke's Encephalopathy

Korsakoff's [Amnesic] Syndrome (Wernicke–Korsakoff Syndrome)

hepatic encephalopathy

alcohol-related brain injury 4

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] 1

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.”

cannabis/ marijuana[-related brain injury] 2

60 deaths in the NT

2006 : 600 in Central Desert region “sniffing regularly”, 120 “with permanent brain damage”

petrol-[related brain injury] 1

(“…lack of verifiable data…”)

(“…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] 2

“…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?

petrol-[related brain injury] 3

results from external force applied to the

head

(ATSI = 3X) motor vehicle accidents assaults falls

TRAUMATIC BRAIN INJURY (TBI)

? “…excluding those in gaols

and correctional institutions”= 40%-80%

? homeless= 10% - 30%

? “…personal response…. people may

not have reported…because of the

sensitive nature of the condition… lack of

awareness…”

over 500,000 Australians have an acquired brain

injury? “…except for those living in

remote and sparsely settled

parts…”

“Cog State”Menzies School of Health Research)

assessment/ screening tools?

Kimberley Indigenous Cognitive Assessment

(KICA)

AUDIT: “not been validated foruse with Indigenous clients”

petrol?(Groote Eyland)

“2 years abstinence…improvement in neurobehavioural performance…

often normalised completely”

recovery?alcohol?

25% - complete recovery25% - significant recovery

25% - slight recovery25% - no recovery

www.braininjuryaustralia.org.au

nick.rushworth@braininjuryaustralia.org.au

1800 BRAIN1