How can drug and alcohol use after TBI impact sexuality and intimacy?
[Glenn Parkinson] I would say probably two of the most common things that we see
following a traumatic brain injury in our setting on the outpatient side
are irritability—sense of increased irritability—and sleep disorder.
While in general I think military culture is very averse to medication—
people talk about not wanting to be on meds—
there is much more openness to alcohol.
Alcohol is in some sense—well, you know, it's also in some sense the domain
of kind of the young male in our culture.
Alcohol is sort of pervasive in the 18-24 set, in terms of people's experimentation
with being independent and all of that.
So I think it is a much more comfortable and familiar way for people to manage
some of their—whether it's physical pain,
whether it's anxiety, whether it's difficulty sleeping.
You drink enough you can crash, black out, and fall asleep.
There is a sense, I think, of sort of this disconnect in terms of thinking
about what is a substance, but I think that there is an increase in substance use
sometimes because it's more familiar, it's more available,
it seems more socially, culturally acceptable way of managing a lot of the symptoms
that go along with a brain injury.
In military culture it's interesting because people get drug screens all the time,
and so there is sometimes a service member who has a history of substance abuse
prior to their service and then a long period of being clean,
and then if they have an injury which involves the use of narcotics, a lot of pain,
or even just kind of the more psychological pain associated with feeling like
you're not yourself, feeling ashamed because you can't remember stuff,
you can't take care of yourself, that there can be a renewal of substance use—
a relapse of sorts.
In terms of sexual health and intimacy, the other thing that was new to me
is sometimes we find people abusing things like Viagra.
I mentioned previously that sometimes for people having sex is the one time
they really feel good.
If they can feel good, they want to feel good.
Sometimes they're using substances to help them be more sexual
because it makes them feel good in that sense as well.
When people use substances like alcohol, or they're on pain meds,
it has an incredible impact on their sexual functioning,
their ability to become aroused, their ability to be intimate with someone
because if they're impaired cognitively because of the use of substances.
They can't really build a significant relationship with someone.
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Produced by Victoria Tilney McDonough and Erica Queen, BrainLine.
Glenn W. Parkinson, MSW, MA, Glenn Parkinson, MSW, MA works as the psychotherapist on the Traumatic Brain Injury service at Walter Reed National Military Medical Center. She works with active duty and retired military personnel and their families specializing in combat-related injuries.
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