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NATIONAL INDIGENOUS DRUG AND ALCOHOL CONFERENCE Alcohol and other Drug-Related Brain Injury Adelaide 16 June, 2010 Nick Rushworth Executive Officer Brain.

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Presentation on theme: "NATIONAL INDIGENOUS DRUG AND ALCOHOL CONFERENCE Alcohol and other Drug-Related Brain Injury Adelaide 16 June, 2010 Nick Rushworth Executive Officer Brain."— Presentation transcript:

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

2 BIA member organisations members’ members “…peak of peaks”

3 ACQUIRED BRAIN INJURY (ABI) any damage to the brain that occurs after birth

4 …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

5  …alcohol  marijuana/ cannabis  petrol… alcohol and other drug-related brain injury

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

7 COGNITIVE DISABILITY = reduced ability - to learn - to plan and - to solve problems poor memory and concentration (2 in every 3)

8 “CHALLENGING BEHAVIOUR” for 2 out of 3, the most disabling  increased irritability  poor impulse control  verbal and physical aggression  paranoia, psychosis

9  (“dose response”?)  NHMRC guidelines (2009) – “2 standard” per day ≠ “risk drinking”  National Drug Strategy Household Survey “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

10  National Aboriginal and Torres Strait Islander Health Survey ( consumption week prior to the survey) - 16% 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

11  “2 million Australians at risk of permanent brain damage”  6 standard drinks per day 3 drinks) X 8-10 years = “high risk of brain damage” alcohol-related brain injury 3

12  cerebellar atrophy  Wernicke's Encephalopathy  Korsakoff's [Amnesic] Syndrome (Wernicke–Korsakoff Syndrome)  hepatic encephalopathy alcohol-related brain injury 4

13 National Aboriginal and Torres Strait Islander Health Survey, : - 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 : 55% males, 13% females cannabis/ marijuana[-related brain injury] 1

14  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

15  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…”)

16  (“…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, : 4% in non-remote areas “had sniffed petrol” (4% had “used other inhalants”)? petrol-[related brain injury] 2

17  “…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“  70 communities  [drug use] migration? petrol-[related brain injury] 3

18 results from external force applied to the head (ATSI = 3X)  motor vehicle accidents  assaults  falls TRAUMATIC BRAIN INJURY (TBI)

19 ? “…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…”

20 “Cog State” Menzies School of Health Research) assessment/ screening tools? Kimberley Indigenous Cognitive Assessment (KICA) AUDIT: “not been validated for use with Indigenous clients”

21 petrol? (Groote Eyland) “2 years abstinence…improvement in neurobehavioural performance…often normalised completely” recovery? alcohol? 25% - complete recovery 25% - significant recovery 25% - slight recovery 25% - no recovery

22 BRAIN1


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