A family shared to us that their son had survived several overdoses. Each time, they felt relief that he lived. But over time, they began to notice changes they couldn’t explain.
He became more irritable. He forgot conversations. He struggled to follow through on simple plans. When they raised concerns, they were told it was “just the addiction.”
What they didn’t realize—and what many families are never told—is that surviving an overdose can cause brain injury.
An overdose is one of the most traumatic experiences a person can face. Too many families have experienced the loss of loved ones from fatal overdoses. But even a non-fatal overdose can have serious lasting consequences – like brain trauma.
Additionally, individuals who suffer from a traumatic brain injury may be at increased risk of developing a substance use disorder.
Brain injury after overdose has been called a “hidden epidemic” that people are often unaware of.1 In a PBS News documentary about overdose and brain trauma, a mother said of her son: “I always used to say that he would either turn around or he would die. There were two options. I never thought of the middle option of him actually overdosing but surviving with a brain injury.”2
Educating yourself and your loved ones on the dangers of an overdose can help prevent them from happening, and understanding the complexities of a brain injury can help you and your loved ones heal.
An acquired brain injury (ABI) is an injury to the brain that happens after birth. It can be caused by an outside force, like a fall or car accident, or by a medical event, such as a stroke or overdose. Sometimes, more than one factor causes the injury.
Brain injury is one of the most common disabilities in the United States. It can lead to long-term health problems and a higher risk of early death.3
Research suggests that people who experience a traumatic brain injury (TBI)—especially during childhood or the teen years—may be more likely to develop a substance use disorder later in life.4 This higher risk may be linked to:5
Substance use can also increase the risk of accidents that cause brain injuries. One study found that nearly 47% of people hospitalized with a traumatic brain injury had substances in their system at the time of injury.6
Nonfatal overdoses—especially those involving opioids—can cause brain injury when the brain does not get enough oxygen. During an overdose, breathing may slow down or stop. This is called respiratory depression. When this happens, oxygen cannot reach the brain, and brain damage can begin in just a few minutes.7
Today’s drug supply increases this risk. Powerful substances like fentanyl and xylazine can slow breathing very quickly and for longer periods of time, raising the chance of overdose-related brain injury.8
Brain injury caused by overdose or toxic substances is often called toxic brain injury or neurotoxicity, rather than traumatic brain injury.9 This type of injury may be:
Many families don’t realize that repeated nonfatal overdoses can slowly damage the brain. Even if someone survives multiple overdose, repeated loss of oxygen puts ongoing stress on brain cells.
Over time, this can lead to:
These changes may happen slowly and are often mistaken for continued substance use or mental health disorders.
Short-term symptoms of toxic brain injuries may include:10
More severe, long-lasting symptoms include:
Brain injuries often affect the parts of the brain that control judgment, emotions, and self-control. Because of this, a person may:
For families, this can be confusing and painful. These behaviors may be caused by changes in the brain, not a lack of effort or caring.
Treatment depends on how severe the injury is, the person’s symptoms, and whether they have had previous brain injuries or behavioral health conditions.
Rehabilitation may involve several specialists, including:
The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends treating brain injuries in a whole-person way, including support for mental health and substance use disorders.11
It’s important to know that brain injuries can be hard to diagnose. Mild brain injuries do not always show up on scans, and symptoms may appear days or weeks later. About 75% of traumatic brain injuries are considered mild.12 This means that sometimes, someone with a brain injury might present with no or very light symptoms.
If your loved one has survived an overdose and continues to have changes in memory, mood, or behavior, further evaluation may help. This can include:
Keeping track of overdoses, head injuries, and hospital visits can help healthcare providers see the full picture.
Brain injuries can affect a person’s ability to:
Some people may need accommodations, job training, or disability services. Families often need to explain how brain injury affects their loved one’s behavior and functioning.
Many people don’t realize that surviving an overdose can result in brain damage. Helping your loved one reduce the risks of their substance use can prevent an overdose from happening in the first place. Some strategies include:
Caring for someone who has survived an overdose—and may have a brain injury—can be exhausting and heartbreaking. Many parents grieve about the changes they see while still hoping their loved one can heal.
You are not alone. Support is available.
If you’re worried about your loved one’s substance use or changes after an overdose and don’t know where to turn, please reach out to us. You may also need help to process your own emotions, especially if you witnessed your child’s overdose. Our trained and compassionate Helpline Specialists will listen to your concerns and help you think through next steps. Click here to connect with us.