Key messages

  • There have been guidelines developed around the clinical treatment of people with an acquired brain injury and a substance abuse problem.
  • Acquired brain injury and substance abuse present differently in different patients and are thus hard to report on or study.

Victoria’s guidelines for the clinical treatment of people with acquired brain injury associated with alcohol and other drug use provide guidance for assessment and diagnosis, recommendations for clinicians, principles for treatment, and information regarding the relationship between substance use, brain injury and offending behaviour.

Relationships between brain injury and substance use

The impacts of acquired brain injury and substance use are often unique to the individual and meditated by complex interactions between:

  • individual differences in substance use
  • predisposing factors
  • pre-existing strengths and vulnerabilities
  • environmental and lifestyle factors.

This makes classification and codification of diagnoses, assessments, treatment approaches and outcome measures difficult.

It also makes it harder to conduct research with clearly defined experimental groups, levels of dysfunction or standard outcome measures.

Much of the evidence relating to acquired brain injury and alcohol and drug use comes from research into traumatic brain injury.

In addition, the focus in the past has been on alcohol, with very little research into the impacts of other drugs on acquired brain injury.

Guidelines for clinical treatment of people with acquired brain injury and alcohol and drug use

The Clinical Treatment Guidelines for Alcohol and Drug Clinicians: Co-occurring acquired brain injury/cognitive impairment and alcohol and other drug use disorders document focuses on treatment for people with co-occurring alcohol and drug issues and acquired brain injury.

The guidelines provide an overview of acquired brain injury, including consequences and prevalence.

As well as the cognitive impact of alcohol use, they also look at cognitive impairment caused by:

  • cannabis
  • psychostimulants
  • opiates
  • inhalants/solvents
  • benzodiazepines.

The guidelines provide:

  • advice for assessment and diagnosis
  • recommendations for clinicians working with people with acquired brain injury and alcohol and other drugs issues
  • principles for treatment
  • information about the relationship between substance use, brain injury and offending behaviour.