ONE MAN'S DAMAGED BRAIN: WHAT STATISTICS DON'T SHOW

At first Frank Fabiani's family thought he was sleeping. Then they
noticed his lips had turned blue and they called an ambulance. Surely
a shot of Narcan would have him up and bounding around?

Nearly three years after he overdosed on heroin, Mr Fabiani's
35-year-old limbs are gripped with spasticity. He can hardly
communicate, and sometimes his eyes water - difficult to tell whether
it's the effort of trying to make a point or the pain of reliving the
day he suffered serious, debilitating brain injury.

His mother, Gemma, 61, dabs his eyes while his son, Ricky, 4, climbs
over his wheelchair-bound body, rubbing his head against his father's
chest.

He has listened while Gemma Fabiani explained how her son, a talented
junior squash player, started smoking marijuana in his late teens,
progressed to harder drugs, developed a mental illness and then, in
the middle of 1998 when they thought he was clean, took a near-fatal
dose of heroin.

If he had been upstairs at the time he would almost certainly have died.

"Maybe a good angel was looking after him," Mrs Fabiani said.

The occupational therapists who work with Mr Fabiani believe there is
a growing number of heroin overdose survivors with severe brain
injury, who don't show up in the statistics or reports on Australia's
drug problem. "People think you get high or you die," therapist
Michelle Tehan said. "There's no understanding among people who take
drugs that this could be a consequence."

Her colleague, Michelle French, runs a small occupational therapy
practice in North Fitzroy that sees one or two new overdose survivors
with bad brain injuries every month. At the moment they have a dozen
such clients aged between 20 and 43.

Ms French hopes a national accreditation program for occupational
therapists, launched in Brisbane yesterday, will encourage more OTs
to work with these victims of the heroin crisis.

"Most of the time it means they can't walk and they have severe
communication problems. With one client it has taken two years to
develop an eye-blink, just to say yes," Ms French said.

In Mr Fabiani's case, it is all he can do to utter the word "van". A
few days ago he and his mother waited for five hours for a maxi-taxi
to arrive to take them home after a doctor's appointment. The family
is desperate for funding to buy their own van, having "fought tooth
and nail" for State Government money to adapt a downstairs bedroom.
Before then Mr Fabiani had spent months in a nursing home and two
years in the living room at the family's Epping home.

The 71 hours a week of funded attended care recommended for Mr
Fabiani (to get him dressed, showered, fed and for rehabilitative
treatment) has been cut to less than 30 hours a week.

Brain damage can follow heroin overdose because of a rapid rise in
blood pressure, sometimes causing the veins at the base of the brain
to explode and depriving the brain of oxygen.

Ms French said the survivors were mainly young men. Often they had to
manage their addictions as well as cope with the massive physical
disabilities associated with brain damage.

There were few community options for young victims of acquired brain
injury, she said, which meant they often lived in nursing homes
ill-equipped to meet their special needs. For Mr Fabiani, the load is
carried by his ageing parents, Gemma and 71-year-old Tony.