At the Ridge Policy Group, we often get to represent and advocate on behalf of organizations and causes that we personally feel passionately about. Each member of our team values that opportunity and enjoys sharing our personal interests with you. In the past month, you have heard from members of our team about the prevalence of brain injury (one of the most common causes of death and disability in the US) and also about the significant impact of the opioid epidemic in the United States. Today, we’d like to highlight the connection between opioid misuse disorder and brain injury, an incredibly complex issue.
The Centers for Disease Control and Prevention (CDC) most recent data shows that 2.53 million people are admitted to emergency rooms each year due to a traumatic brain injury (ranging from concussion to coma). That number is higher than the population of 15 states.
Among that staggering number, 70–80% of this group is discharged from the hospital with a prescription for opioids. Chronic pain, including headaches; back/neck pain; and musculoskeletal conditions are commonly reported by individuals with brain injury. These symptoms are regularly treated with opioid pain relievers.
In America, 21–29% of all individuals prescribed opioids will misuse them, as they are highly addictive. This rate of misuse is further amplified within the brain injury community as this population often struggles with impulsivity, depression, anxiety, and other symptoms that lend themselves to drug misuse and an inability to stop taking opioid pain medicines.
Our country’s opioid crisis has highlighted yet another connection between drug misuse/abuse and brain injury. In 2017, 11.4 million people misused opioids with 2.1 million people diagnosed with an opioid use disorder. For the first time since 1990, there has been a drop in opioid overdose deaths in the United States. This is all due to the introduction of naloxone, a nasal spray that, upon introduction to the body, begins to reverse the impact of overdose and often enables a victim to survive. The antidote can be administered in minutes, sometimes several minutes, after the overdose takes place, enabling the victim to regain consciousness and go home to heal. This drug is amazing, saving thousands of lives and giving second changes to humans across the world.
However, there can be long term side effects of the use of such “opioid antagonist” medications. What happens to individuals who have loss of consciousness for 10, 20 or even 30 minutes after drug overdose? They may have damage to the brain due to the absence of oxygen during the time it took for emergency personnel to arrive at the scene and administer the reviving antidote. Lack of oxygen to the frontal lobes of a human brain often results in a loss of executive function (problem solving, organizing, emotional control, and attention).
These individuals will now live a new normal and likely will not understand why. Yes, they are alive, but they are living with altered brains. They are in need of resources to help them understand why they may now have memory deficits, challenges with speech, sudden bursts of anger, or ringing in the ears. They need information about supports that are available to help them.
While there is a greater understanding among the public about the scale of the opioid crisis and therefore broad distribution and use of naloxone to save lives, there remains a lack of information available to opioid users to educate them about the potential for living with brain injury post-overdose.
The Ridge Policy Group has advocated to our federal partners, such as the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration, to create materials that are given to overdose survivors outlining symptoms of brain injury to be aware of, as well as local and national resources available to assist the individual who may be living with cognitive impairments.
The brain injured population continues to grow every day, in part due to the increased prevalence of overdose resuscitation. With the right supports and resources, people who have experienced a brain injury can live happy and productive lives. It is our goal to help get them the information to understand they may be living with deficits as well as available resources to support them. If we do that, we see a bright future for this community that is far too often forgotten in our public health debates.
Ridge Policy Group represents multiple clients in the public health space. Most notably related to this article is the Independence Blue Cross Foundation, which has run a successful Someone You Know Campaign referenced in our blog here to destigmatize opioid misuse disorder, and the National Association of State Head Injury Administrators.