Addressing Drug and Alcohol Related Brain Damage - Counselor Training

I'd like to welcome everybody to today's presentation on alcohol and drug related brain damage. I'm your host, Dr. Donnelly Snipes. Today we're going to talk about a variety of disorders, starting from those or not starting, but including those that are induced by substance use, such as persisting amnesic disorder, psychotic disorder, mood disorder, sexual dysfunction, sleep disorder and persisting dementia, in addition to some other brain traumas or brain issues that are caused by substance misuse, including fasd, chronic traumatic encephalopathy and neurocognitive disorder. The prevalence of brain damage in people with substance use disorders is estimated to be between 30% and 80%. All right, so let that sink in. If you're working with somebody, even if their primary presenting issue is mental health, if they have substance use disorder, there's a really strong likelihood that they've got some level of brain damage as a result. Now can that heal? Possibly. Definitely can be stabilized in a lot of cases. These impairments can significantly impact symptoms and treatment outcomes. Physically. When we're working with somebody who is struggling with substance use issues and inflammation in the brain and systemic inflammation, they're likely going to have sleep problems, inflammation issues, pain, they can develop neuropathy, and hormone and neurotransmitter imbalances. Interpersonally. If they're struggling with substance use disorders, they may have issues with self efficacy and the ability to interpret non verbals in other people, which strains relationships emotionally. They'll have probably disregulation and potentially apathy. Cognitive deficits include difficulty with executive functioning, memory and resultant treatment compliance. And then environmentally, some people with substance related brain disorder end up needing assisted living due to physical or cognitive impairments. We do need to recognize that substance induced brain disorders can have long lasting and multifaceted effects on the people. Again, even if they're not presenting with that, if you know the person you are seeing is, let's say a quote, heavy drinker, then there's a chance, better than average chance, that they've got some level of substance related brain damage. Use of alcohol will cause systemic inflammation, causes inflammation in the gut, causes inflammation throughout the body, can cause brain inflammation over time and potentially slow recovery from other issues. This has its own slide because a lot of us work with people who drink and you know, I'm not saying that we need to have a goal for every person we work with to become abstinent. That's not realistic and that's maybe not their choice. However, we do need to realize the impact that alcohol has. We also need to realize that heavy drinking is considered anything more than one drink a day for women and two drinks a day for men. And when we talk about a drink, we're not talking about a drink, we're talking about a drink. So we need to be cognizant of the fact that when people report they have some wine every evening, is it 5 ounces of wine or is it half a bottle? There's a difference there. And not to be judgmental, but we do need to pay attention to the fact that half a bottle is considered very heavy drinking and likely is contributing to systemic inflammation. Just go over some brain regions really quick because these are the brain regions that are negatively impacted by subs. And when we start looking at substance induced brain disorders, we're going to see problems that correlate with the brain regions that are affected. The frontal lobe we always, Whenever I talk about executive functioning and wise mind, I talk about the prefrontal cortex and the frontal lobe, Motor control and movement, executive functioning, personality and social behavior, language and speech, emotion regulation and impulse control and memory storage. So again, even if your person is not presenting with substance use issues, if they have them, we may start seeing some of these problems. If they're we're seeing them for anxiety, for anger, and they're drinking a lot, then they may continue to have emotional regulation and impulse control issues, speak, speech and language issues and executive functioning issues as a result of the that alcohol use that's going on. The cerebellum, motor movements and coordination and balance, motor learning, and it contributes to speech and language processing. So the cerebellum is another area we don't talk about a lot. But when we consider motor movements, balance and learning, motor learning, the parietal lobe is involved in sensory integration and perception, being able to recognize what's going on, being able to smell, see, hear, integrate those senses that are coming in into something that our brain can interpret, Spatial awareness and navigation. A lot of people who have difficulty with their parietal lobe have difficulty with have a higher risk of falls because they have difficulty knowing where they are in space because of sensory integration and proprioceptive issues and have difficulty navigating in a particular space. Parietal lobe is also involved in mathematical reasoning and calculation, reading and writing, and visual attention and processing. So we do have some attention issues that come with damage to the parietal lobe. And then the limbic system we typically think of as the area that does all of the emotion regulation.