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Industry: Email Alert RSS FeedAlcohol abuse and traumatic brain injury
Alcohol Health & Research World, Spring, 1989 by Gregory A. Jones
FUTURE DIRECTIONS
The outlook for future development in the area of alcohol or other drug abuse and brain injury is mixed but hopeful. There remains a troubling avoidance of the problem on the part of clinicians who provide acute care to brain-injured persons. In a recent and quite revealing survey of 154 trauma centers in 43 States, only 55.2 percent regularly measured blood alcohol levels upon admission (Soderstrom and Cowley 1987). In a retrospective chart review of 379 trauma patients seen in the emergency room of an urban teaching hospital, Chang and Astrachan (1987) found that although 43 patients were suspected or known to have used alcohol or other drugs, none was referred for further evaluation.
Rehabilitation providers, on the other hand, have responded to the problem of alcohol abuse and brain injury with a positive initiative. In 1987, the Professional Council of the National Head Injury Foundation convened a Substance Abuse Task Force. The work of this group, though preliminary, has helped to define the problem from both an etiological and clinical perspective and to suggest potential solutions. A positive finding of the task force is that "50 percent of acute and 83 percent of the postacute rehabilitation programs surveyed are addressing alcohol and other drug abuse within their range of services (NHIF 1988).
Better identification and intervention strategies for those with traumatic brain injury will succeed only if a corresponding initiative is undertaken within the alcohol and other drug abuse treatment field. Recommendations for development of effective services for brain injury survivors include improvement in the following areas:
Research - The number of brain injury survivors being served within the current alcohol and other drug abuse treatment system is not documented. To determine the effectiveness of current programs and methods, it is essential that this population be profiled. While it may be reasonable to suppose that brain-injured persons who abuse alcohol or other drugs have a high incidence of discharge from treatment centers for failure to meet treatment goals and are more prone to relapse than those without brain injuries, this has not been established.
Education - Perhaps the greatest barrier to the effective identification and treatment of brain injury survivors with alcohol or other drug abuse problems is the continued lack of awareness among professionals. Medical and rehabilitation professionals would benefit from additional training in assessing alcohol and other drug abuse. Professionals treating clients who abuse alcohol and other drugs need more information about brain injury and its consequences. Alcohol and other drug abuse counselors should be encouraged to familiarize themselves with the brain injury rehabilitation programs and services in their communities.
Interdisciplinary dialogue and cooperation - Communication between the rehabilitation and alcohol and other drug abuse fields merits further development, especially where brain injury is concerned. Professionals in both fields have much to learn from each other.
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