The Collateral Brain Damage of the Opioid Epidemic

As the opioid crisis ravages New England in general, and New Hampshire in particular, the seismic, disruptive effects are felt even all the way up on Crotched Mountain. The epidemic is one of staggering collateral damage, and when it comes to the specialty of Crotched Mountain Hospital--brain injury—this plays out on a weekly basis. 


“Every week we’re getting patients referred to us who have sustained a brain injury as a result of opioid use,” says Dr. Frederick Bruch, Chief Medical Officer at Crotched Mountain. 


There are three types of brain injury related to heroin use that Crotched Mountain sees: anoxic brain injury, strokes related to endocarditis, and traumatic brain injury resulting from an accident due to drug impairment. Anoxic brain injury results in a lack of oxygen to the brain, which can follow a significant length of unconsciousness due to an overdose. Endocarditis presents when bacteria—typically from “dirty needles” used with intravenous drug injections—makes its way through the bloodstream to attack the heart, sometimes producing strokes. Lastly, brain injury can happen from any traumatic incident, like a car accident or violent fall, because of drug-influence. 


The added wrinkle to treating patients who arrive via a drug encounter is the co-morbidity (i.e., the simultaneous presence of two conditions in a patient) of the new injury and the existing addiction. Because opioids like heroin is virulently addictive, Crotched Mountain has responded with an increased tactic to treat the addiction. Emily Robbins, a clinical mental health counselor who specializes in substance abuse, has joined the staff. 


Regardless of how a patient arrives at Crotched Mountain, the common denominator is always the brain injury. That means everyone accesses the suite of therapies the hospital offers--occupational, physical, speech and recreation—with the ultimate goal a return to the community. Crotched Mountain currently sees 80% of patients return to the community.









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