Traumatic Brain Injury and Substance Abuse

Article excerpt

This article provides an understanding of the causes and effects of a traumatic brain injury (TBI) in relation to substance use and abuse (alcohol, pharmaceutical drugs and illegal (illicit) drugs). For background information on TBI, its co-occurring conditions and other related topics, refer to prior articles in the TBI-ROC series, including the article "Understanding Traumatic Brain Injury: An Introduction".

The following article is the final and eleventh in a multi-part series on traumatic brain injury (TBI). This series is written by the Traumatic Brain Injury-Resource Optimization Center (TBI-ROC) and its Advisory Group, which is facilitated by JBS International, Inc, and has been published by Exceptional Parent Magazine. The TBI-ROC aims to be a recognized source and leader for advancing national attention to the myriad of policy, research, practice, and service needs supporting both civilian and military individuals who incur TBI and their families.

Every year in the United States (US), approximately one in five adolescents, between the ages of 12 and 17, engage in abusive/dependent or problematic use of illicit drugs or alcohol. According to the most recent National Survey on Drug Use and Health, more than 25% of underage drinkers are binge or heavy drinkers. Studies have found that substance use disorders precede the onset of trauma for many adolescents. Research suggests that adolescents and young adults who incur a TBI engage in "risky behavior" more often when under the influence of a substance. For example, one in five reported driving while under the influence during the past year, according to the most recent National Survey on Drug Use and Health.

The terms substance abuse, substance use, substance misuse, dependence, or addiction are often mistakenly used interchangeably. Substance use is the casual, recreational consumption of alcohol or illicit drugs. For instance, using on weekends. Substance misuse refers specifically to an incorrect dosage of a prescribed drug. For example, taking 4 tablets of an opiate every 2 hours in order to reach an intoxicated state, instead of the prescribed 2 tablets solely for pain relief. Substance abuse is the excess use of alcohol or drugs-either prescribed or illicit. Substance abuse is also used to describe the misuse of prescription drugs. Once substance use or misuse becomes excessive, an individual may become dependent on the substance in order to prevent experiencing withdrawal symptoms. Substance abuse is also described as having a Substance Use Disorder (SUD).

Substance Abuse as a Cause of TBI

It is common for adolescents and young adults to experiment with one or more drugs. 29% of adolescents have experimented with illicit drugs by the time they complete 8th grade, and 41% have consumed alcohol. How is this linked to a TBI?

Substance use is a risk factor for TBI. A risk factor is a characteristic or behavior that is associated with an increased likelihood of disease, condition, or injury. Substance use can affect cognitive skills, or information-processing skills, and psychomotor skills, or hand-eye coordination. It has been shown that large percentages of individuals hospitalized for TBI have histories of substance abuse, and are intoxicated when admitted to the hospital at the time of the TBI. In a study of 262 people with TBI, 43% had a history of problem alcohol use or worse, 29% had a history of illicit drug use and 48% had a history of either. When an adolescent incurs a TBI, it is recommended that they are screened for substance use.

Substance Abuse as a Result of Self-Medication for TBI

An adolescent or young adult may abuse substances in order to self-medicate after incurring a brain injury. Although it is unclear exactly how many adolescents and young adults' abuse substances have also experienced a head injury, numerous studies identify a correlation between substance abuse and head injury in adolescents. …