No one knew how long he had been alone after the overdose, but by the time Andrew was found, he had stopped breathing altogether. Fortunately for his sake and his family, doctors were able to restore his breathing, but not before a combination of heroin and fentanyl had starved his brain of oxygen for a dangerous length of time. The fact that Andrew survived is miraculous, but the overdose had caused brain damage, leaving him unable to care for himself for as long as anyone cares to think.
Many people who abuse drugs assume a drug overdose either leads to death or, for the lucky ones who survive, another lease on life. That is just not true. What is clear is that as the number of drug overdoses continues to rise, an increasing number of patients are facing irreversible brain damage and other long-term health issues because of a decision gone horribly wrong.
An overdose is what happens when an excessive amount of a drug or a combination of substances causes a severe adverse reaction. In the most critical of responses, the body forgets to breathe. As such, a lack of oxygen then becomes the greatest threat to brain damage.
All drugs can lead to overdose including medications a doctor may prescribe. Combining drugs increases the chance of accidental overdose, which is often the case when illicit drugs are tainted with synthetic psychoactive substances, unbeknownst to the individual beforehand. Accidental overdoses can also be the result of taking the wrong medication or dosage.
Approximately one-quarter of those individuals who enter brain injury rehabilitation are seeking treatment because of drug or alcohol issues. Any time addictive drugs interfere with the way the brain sends, receives and processes messages can cause brain damage.
Once a drug enters the bloodstream following ingestion, its chemical components attach to proteins called receptors, which are located on nerve cells in the brain, spinal cord, and gastrointestinal tract and other organs in the body. Receptors in the brain influence pain and euphoric feelings. When illicit drugs overload these receptors, messages from the brain to essential organs are disrupted and body functions, such as heart rate and breathing, are slowed.
The heart pumps oxygen to the brain. During a drug overdose, not only do the lungs fail to take in enough air, a sedated heart cannot pump the appropriate amount of blood needed to feed brain cells with oxygen. If the brain doesn’t receive enough oxygen, cells begin to die, and the threat of unconsciousness, seizure or stroke elevates. Some brain cells start dying less than five minutes after their oxygen supply disappears. If the brain is deprived of oxygen for extended periods – typically, more than four minutes — damage from the overdose is likely to be permanent.
Effects on the brain will differ depending on the type of substance, the amount used, and the duration of use. The term anoxic brain injury means a total loss of oxygen. The greater the loss of oxygen to the brain, the more wide-spread and serious the damage will be. A partial loss of oxygen is called brain hypoxia, which can begin with a loss of consciousness, and lead to seizures, stroke, coma and possibly death.
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When oxygen is prevented from reaching the brain, an individual who has overdosed may experience:
A return to consciousness can include memory problems, abnormal movements, weakness in arms and legs, lack of coordination and visual problems.
If enough oxygen is depleted, even one overdose can cause brain damage. Sudden loss of oxygen has the most significant effect on parts of the brain that are critical to adult thinking skills, such as memory, learning, and problem-solving, and the ability to manage emotions and impulses.
The frontal lobe is highly susceptible to brain hypoxia. Damage to the frontal lobe can lead to potential loss of executive functions which are often required to participate, engage, and thrive in substance abuse treatment. This means that anyone who survives an overdose is more difficult to treat for substance abuse and susceptible to relapse. It also means brain damage – even after one overdose. It can put individuals without a history of substance abuse at risk of developing an addiction.
Any deprivation of oxygen is a medical emergency that requires immediate treatment. Severe loss of oxygen to the brain may require a ventilator to assist an individual who has overdosed with breathing. Other forms of treatment may include blood, fluids, and medications to restore blood pressure and increase heart rate.
Full recovery from severe brain hypoxia is rare. However, the brain is resilient. Individuals who suffer damage in less oxygen-dependent areas of the brain can hope for a full or partial recovery.
But, a problem arises when life-saving measures are concentrated toward treating the brain injury and issues leading up to the drug overdose are ignored. As a result, an individual who has overdosed is taken to recuperate at a brain injury treatment facility, where his or her substance abuse is often overlooked.
Evidence has shown that multiple overdoses increase the risk of brain damage and individuals who abuse alcohol and drugs will not recover as quickly as those who don’t from this type of injury. Because continued drug abuse use heightens the adverse effects of brain damage, a failure to treat the chemical dependency following discharge from a hospital or brain injury rehabilitation facility could be a predecessor to more dire outcomes.
Physical and mental recovery from brain damage takes time. And the continued use of alcohol and drugs can only make matters worse, especially in dealing with related problems with balance, walking, thinking or speaking. But, treating drug addiction takes time as well. In situations where addiction and brain damage have created troublesome issues, the gold standard of care involves treating both conditions.
Following treatment for a brain injury, withdrawal, by this time, will probably not pose a medical danger or intense physical discomfort.
However, individuals who have suffered a brain injury from an overdose are likely to feel sad or depressed and will have a high propensity to seek relief in the form of drugs or alcohol.
However, up until now, no part of your brain injury care has addressed your drug addiction.
For this reason, detoxification under the care of a medical professional is strongly recommended to eliminate relapse to substance abuse.
This type of safe detoxification can be conducted at a residential substance abuse treatment facility.
Here, doctors can prescribe medications to temper symptoms of anxiety, depression and the psychological cravings to abuse again, and licensed medical staff can monitor brain injuries and prevent any unnecessary health complications.
Following a brain injury, the effects of alcohol and drugs can be even more dangerous. At the very least, a return to alcohol or drug abuse will elevate the possibility of another brain injury and the risk of seizure. The sobriety you have achieved in detox should not be taken for granted. If you are serious about recovery and preventing any further brain damage, the next step in treatment should involve a stay at a residential substance abuse treatment facility. Here, you will find there is more to staying clean than you may have realized. Under the supervision of certified health and substance abuse professionals, issues surrounding your addiction will be addressed and an individualized recovery plan including one-on-one counseling, group therapy, and educational workshops will supply the tools needed to prevent relapse and increase the chances of continued sobriety.
Brain Injury Association of America. Retrieved from https://www.biausa.org/downloads/public-affairs/media/Research/BIAA%20Statement%20on%20Non-Lethal%20Opioid%20Overdose%20and%20Acquired%20Brain%20Injury%20June%202018%20(002).pdf
Maryland Department of Health. Retrieved from https://bha.health.maryland.gov/Documents/The%20Intersection%20of%20Opioids%20and%20Brain%20Injury-%20Addressing%20Addiction%20Through%20a%20Brain%20Injury%20Informed%20Lens.pdf
National Institute of Drug Abuse. Retrieved from https://www.drugabuse.gov/related-topics/addiction-science
Harvard Medical School. Retrieved from https://www.health.harvard.edu/newsletter_article/how-addiction-hijacks-the-brain