Research continues to investigate the possible link between Traumatic Brain Injury and substance abuse. It is well documented that substance abuse can lead to accidents or violent acts that result in a traumatic brain injury (TBI). What is being explored is whether experiencing a TBI makes a person more susceptible to developing substance abuse in cases where they did not have one before the injury.
CDC TBI Definition
A TBI is caused by a bump, blow, or jolt to the head that disrupts the normal function of the brain. Not all blows or jolts to the head result in a TBI. The severity of a TBI may range from “mild” (i.e., a brief change in mental status or consciousness) to “severe” (i.e., an extended period of unconsciousness or memory loss after the injury). Most TBIs that occur each year are mild, commonly called concussions.
Understanding What Causes a TBI
From a 30,000-foot view, a TBI can either be penetrating or closed. A penetrating TBI is caused when a projectile or object penetrates into the brain. As you might expect, combat can create penetrating TBIs as can violent attacks or accidents. A penetrating TBI damages specific areas of the brain as opposed to large swaths.
A closed TBI occurs when the person suffers a blow to the head of sufficient force to damage the brain. Closed injuries can happen in sports (concussions are called “mild” TBIs), in vehicle accidents, in industrial/workplace accidents, in falls (54% of TBIs are the result of falls) where the head hits the ground or pavement, in crimes, and other situations.
A closed TBI can be more damaging than a penetrating TBI. The incident that causes a closed TBI damages the brain in a larger area on the side of the impact and may cause damage to the side of the brain opposite the impact. A non-medical description is the impact causes the brain to bounce off the other side of the skull, injuring that part of the brain.
The Frequency of TBI in America
Recent CDC (2013) statistics estimate that 2.8 million people suffer a TBI each year. Of those, 50,000 will die. Another 282,000 are hospitalized, and more than 80% are treated then released from the emergency room. What these statistics do not report are those people who receive a TBI and don’t seek help or treatment.
According to the CDC, the rates of TBI are increasing (47% between 2007 and 2013), but the rates of hospitalization are decreasing (2.5%). The rates of TBI among children 19 years and younger are also increasing (more than doubled between 2001 and 2012).
Are Traumatic Brain Injury and Substance Abuse Related?
So, the question is, “How much influence does a TBI have on an individual developing substance abuse where an addiction did not exist before?” Unfortunately, there is no definitive answer at this stage in the research. They are saying there are strong indications that a TBI can make an individual more susceptible to developing substance abuse. Clinical and other research continues to determine if this connection is real.
Substance abuse and TBIs both disrupt the normal functioning of the brain. Some evidence points towards a connection between the area of the brain injured and subsequent substance abuse. A TBI may affect the portions of the brain that manage an individual’s self-control, restraint, self-regulation, and critical thinking. In other words, certain TBIs may lead the individual to make poor decisions when it comes to overuse of an addictive substance.
Immediately following a TBI, there may be a “grace” period during injury recovery where the individual does not engage in substance abuse. This is particularly true for patients receiving care in a hospital setting. The reasons for this abstinence period vary and include reluctance to use while under hospital scrutiny or having time for self-reflection and starting the process of recovery.
Following this period, a person with an existing substance abuse problem may relapse into their old habits of overuse. People not having a substance abuse issue before the injury may develop one. This may come from having easy access to pain medications for the injury or due to other psychological effects of the TBI.
Watch for Signs of Addiction
A rapidly developing opinion is that people who suffer a TBI are at higher risk of developing a substance abuse problem where one did not exist before the injury. Best practice at this point is to treat TBI and substance abuse simultaneously for those individuals who had a substance abuse problem before their injury.
For individuals without a substance abuse issue before being injured, they should be monitored for signs of an addiction developing. The onset of a new addiction or relapse into an old one may take months, or even years, to occur. In the meantime, these people should be carefully monitored for the signs of new or recurring addiction.
The period of hospitalization is an ideal time to begin rehabilitation for people with an existing substance abuse situation. Being in a medical facility provides the trained staff and resources required to manage the potentially dangerous detoxification stage. It is also an excellent time for the same staff to monitor the patient without a pre-existing substance abuse history for the signs of a developing addiction. Before release, both individuals can be given the information needed to connect with addiction recovery/support resources and be sent home ready to stay on a path to recovery or avoid developing an addiction altogether.
Where to Turn for Help
If you, a loved one, or a friend, have suffered a TBI and are experiencing addiction personally or are seeing the signs of it developing, please reach out to CARUS Recovery. We are the premier residential recovery center in Southern California and can help. Call at 877-225-7724 or contact us today.