Traumatic Brain Injury and Substance Use Disorder: A Clinic Based Exploratory Study

Background: Traumatic brain injury (TBI) and substance use disorders (SUD) are common co-occurring conditions that have been investigated in isolation over the past several decades. Research regarding the conditions in unison have yielded conflicting results; however, there is a clear correlation linking negative implications of one condition on the other. Objectives: To explore factors contributing to SUD among persons screening positive for a history of TBI and to validate the importance of screening for TBI as part of the SUD treatment program intake process. Setting: Outpatient SUD treatment programs across West Virginia. Design: Exploratory Study. Methods: Those who screened positive for history of TBI according to the OSU-TBI-ID were included in the study. The Mental Health Assessment by a Non-Physician (ASAM) was incorporated in the program admission process and used for data collection. Results: Data was analyzed from 183 SUD admissions who screened positive for a history of TBI. Most of the subjects were male (72.7%) and identified as white (87.9%). The most common referral sources were probation/parole (43%), court (21%), and self (27%). 91% of individuals had a criminal background. Participant SUD triggers were difficulty dealing with their feelings (76.5%), being in the wrong places (74.3%), and boredom (68.3%). Negative implications of drug and alcohol use were legal implications (90.7%), relationships (89.1%), finances (84.2%), and mental health (77%). Conclusion: The significant findings indicate a need to screen individuals for TBI upon admission to SUD treatment facilities to provide appropriate and holistic care to reduce relapse and readmission rates.