craigm,

Welcome to NeuroTalk. I'm sorry to hear about your son. Concussions can cause personality issues. I can see how these issues can cause one to self-medicate. Executive functioning can also be a problem resulting poor decision making.

A full Neuro Psych Assessment (NPA) could help you both understand his issues.

Intoxication during his early to mid teen years is know to cause long term changes in how the brain works. It can interrupt the maturing process that is so important later in life. These issues are not unresolvable. If he can learn to accept his poor decision making skills and ask for help with decisions, he can improve his future. It would be similar to many of us who have flat affect and do not express emotions or other relational issues naturally. We learn to use a mechanical thinking process to fill in for our other limitations.

The important issue is for him to recognize his failings and ask for help.

Here in Idaho, we have drug court to divert addicts away for the criminal system and give them an incentive to make better choices. A few nights in the med wing of the jail waiting for a judge to divert the case to drug court is often an good incentive to make better choices. The short leash the user is tied to including frequent drug testing has been very successful as an incentive to make better choices.

His brain condition can be an weak excuse for bad behavior or an incentive to ask others for help. I know a young man who spent his youth high on drugs. He lack of maturing and his final recognition of such lack caused him to rely on family to help with life decisions. He got himself into too many messes until he finally realized he needed the help of others for decisions.

Hopefully, he has come to a point where he can accept his limits and ask for help. The NPA may be a starting point. I had my first NPA in 2002. The report stated that I am prone to unreasonable outbursts. Seeing this diagnosis led me to let go of my 'right to be mad.' It has not been easy but it was the start of changes in my behavior. His choices to self-medicate are no different.

I suggest that you help him get onto a vitamin and supplement regimen. It can make a big difference in his clarity of thought. My regimen is posted in the Vitamins sticky at the top.

btw, It also makes a big difference if he can break all ties with his past social circle. Replacing his past behavior with new activities and responsibilities may help.

I hope you can find a good NeuroPsych to help him understand his need to rely on others for help with decision making.

My best to you both.