My Brain After Drugs

“This is your brain on drugs” – that famous public service campaign brought to us by Partnership for a Drug Free America – always made me chuckle.

Of course MY brain wasn’t being fried by recreational drugs and booze! I was just doing what everyone else was doing. Maybe a bit more but still doing ok at school. I got really good at denial – to myself and others.

I first noticed I was having trouble holding things, and my hands and feet were numb, around 1994. I would trip a lot and break things. I had been drinking very regularly since about 1972, adding in other drugs since 1976, and by the early 90’s had begun hiding that I was having blackouts occasionally. I didn’t tell my doctors about my use of course – so a few MRIs that showed white matter hyperintensities later and I got an MS diagnosis.

Those “bright spots” increased over the years – because of course I was still drinking very heavily and not discussing it with my physicians. Since I wasn’t admitting how much I was consuming to them, it became easier to not acknowledge it to myself.

When I first got clean and sober I felt like I had dodged a bullet – or maybe a barrage of gunfire! My liver enzymes were back to normal within 60 days and my Doc from rehab referred to me as a “miracle”. I firmly believed I was going to be ok – that my brain would be OK. I had every reason to think that … it’s what everyone told me. You stop drinking and your brain heals … except that’s not really how it works. What normally happens is that a healing brain creates work arounds. Neurological rerouting basically. Unfortunately for me my brain had been doing this for years. Heavy drinking and drug use during adolescence already requires a lot of that neurological elasticity – I didn’t have a lot of spare brain tissue to reroute by the time I got sober!

The other factor for me is the endothelial lining of my veins and arteries … and in all those little microvascular vessels that feed the brain. Mine are lazy. Made less energetic by the years of poly drug use. I imagine that lining as saggy pantyhose. There – but doing a half assed job! I seem to have inherited a propensity for this problem, which booze exacerbated. So poor profusion at a microvascular level continues leading to cognitive impairment.

So what am I doing to slow down the progression? Nothing that exciting. There is no magic solution. No CBD Oil, coconut oil, MCT oil is going to lube my brain healthy again. We have found that eating a healthy diet and getting enough exercise has helped my function a bit. Part of that is that feeling good physically and getting the right nutrients reduces the stress on my body generally which is a good thing. Managing emotional stress has also improved function. If I get overwhelmed or upset my memory, executive function and verbal abilities deteriorate for days.

The most important thing I’m focusing on is just living. Being diagnosed as cognitively impaired, and that I will continue to decline, really floored me. Although I knew I had a problem, having it be official took the wind out of my sails. I’m having to redefine who I am now and how I want to fill my days. Rather than focus on things I can’t do I’m working on enjoying the things I can. For instance reading fiction is very difficult – all those plot details! However non fiction – topics rooted in facts I learned long ago? Still a huge pleasure! I’m playing with painting, sewing and needlework. All revisiting skills from my youth. Then there is hiking. Currently I’m planning another attempt at the AT – and all the physical prep that goes along with that. Hopefully with my brain and body active, a healthy lifestyle and reducing stress I get to be cognizant as long as possible

I still chuckle at that “This is your brain on Drugs” PSA.

Learning Curve


At the end of a long day seeing clients I was writing reports. The language had to be very specific to meet Medicaid billing requirements but I couldn’t find the words. Believing I was simply tired I pushed thru for several weeks, but the vocabulary didn’t return. Getting reports done on time became a huge chore. To ease the burden I created a buzz word cheat sheet to get the job done, but it niggled at the back of my mind that I was struggling with terms I had been using since 1990. 

That was six years ago and when we relocated to another city it was clear to me that my time in the substance use disorder field was over. Not willing to admit any deficit that information was something I kept to myself. 

Public speaking and educational seminars had been a feature of my work during my career. I loved it and continued those type of engagements after my “Retirement”. As time went on I went from using a basic frameworks of topics to be covered to very detailed outlines of content. During my final speaking engagement I found myself getting lost in that plan, repeating myself and not feeling comfortable with the flow. Where once there was an ease to speaking in public,  that had been replaced by nerves, disappointment with my “performance” and concern I wasn’t covering the topic adequately. Since a portion of those topics included my own story,  I was concerned about getting lost in my own life. Again vocabulary I had used professionally was slipping further away. Not willing to admit any deficit that information was again something I kept to myself.

Several years passed as my short term memory became increasingly poor. Forgetting appointments, losing track of important documents, repeating questions, difficulty following recipes or multitasking in anyway, not remembering conversations within hours or days and even getting lost on the way home from frequented destinations. Not willing to admit any deficit that information I kept to myself, but people began to notice and were frustrated.

The struggle finally became too much at the end of 2017 and I had no choice but to come clean.  Get lost in enough conversations, or forget enough of what is simply a part of everyday life and people will begins to worry. The stress of not admitting my difficulty also became increasingly oppressive.  I felt like I was drowning.

Since opening up about my cognitive loss life has changed dramatically. After some adjustment the family has been hugely supportive by helping me create coping strategies, talk about my fears and determine the underlaying cause.

There have been a lot of visits to the neurologist, internist and neuropsychologist. Even though I  was aware of a problem having the extent of my loss was a little tough to take. Knowing what I was capable of before,  and where I am now,  has been a grieving process. Being able to live with who I am today, rather than who I once was, has been one of the most difficult things I have faced in my lifetime. I’m still actively in that process. 

It’s funny how life can take you by surprise. I think we all have a concept of who we are and how our life will continue to unfold. It’s a jolt to have that path disrupted or veer completely off course. I can choose to waste the time I have worrying about the progression of my cognitive loss or choose joy. I’m working on the joy thing.