Stop the Party After Head Injury

Mild traumatic brain injury patients at risk of short term substance and alcohol abuse

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Head injuries can come with an unpredictable recovery process. Coping with the physical and mental stress of a traumatic brain injury may lead to short-term substance abuse.

A recent study looked at a group of injured military personnel to see if experiencing a mild traumatic brain injury increased the risk of developing any type of addiction.

The results of the study showed that substance abuse was common for the first 30 days after injury. Alcohol abuse was common for up to six months after injury.

The researchers recommend that healthcare providers screen for substance abuse the month after injury and alcohol abuse for another five months.

"Tell your doctor about any substance abuse."

Shannon C. Miller, MD, from the Veterans Affairs Medical Center and the Center for Treatment, Research and Education in Addictive Disorders at the University of Cincinnati in Ohio, led the study.

“Traumatic brain injury (TBI) is considered a signature injury in the wars in Iraq and Afghanistan. The prevalence of TBI among US troops is estimated to be between 23 percent and 30 percent (combat-exposed troops),” according to the background of the study.

For this study, the researchers looked through records in the Military Health System for military personnel injured between 2001 and 2008. A group of military personnel that were injured, but had no TBI, was used as a comparison group.

After sifting through over half a million personnel records, 5,065 mild TBI patients and 44,733 other-injury patients were compared for risk for developing an addiction-related disorder.

Mild TBI was considered to be transient confusion or disorientation, memory loss, and/or brief loss of consciousness.

Addiction-related disorders included:

  • Drug dependence
  • Non-dependent use of drugs and/or alcohol
  • Nicotine dependence
  • Opioid painkiller dependence or abuse
  • Caffeine abuse
  • Amphetamine dependence or abuse
  • Gambling disorder

The results of the study showed that 30 percent of the TBI group abused alcohol for the first 30 days after diagnosis.

Between 31 to 179 days after diagnosis, alcohol abuse rates lowered to 83 percent of the original 30 percent.

“Nicotine dependence and non-dependent abuse of drugs and alcohol demonstrated a similar pattern (to the above rates of alcohol abuse),” the authors said.

In the mild TBI group, there were only five total cases of drug dependence, opioid dependence or abuse and caffeine abuse.  

“Mild TBI was associated with an increased risk for alcohol dependence, non-dependent abuse of drugs or alcohol, and nicotine dependence in the first 30 days following mild TBI,” said the authors.

The researchers found that, with the exception of alcohol dependence, addiction-related disorders after mild TBI reduced over time and in most cases went away completely.

The authors said they were surprised to see that the risk for alcohol addiction in TBI patients was so high within the first 30 days after injury. They suggested that the physical and psychological stress from experiencing a TBI might contribute to the early onset of alcohol abuse.

Furthermore, other symptoms associated with mild TBI – depression, anxiety, aggression and poor impulse control – may factor into the increased risk for alcohol abuse.

The authors suggested healthcare providers screen for addiction-related disorders as part of routine care for the first 30 days after a patient had a TBI and again for alcohol abuse for up to six months after injury.

This study was published in February in The American Journal of Psychiatry.

No funding outside the involved Veterans Affairs and academic institutions were used for this project. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
March 13, 2013
Last Updated:
March 17, 2013