Abstract
Objective
To quantify the relationship between substance use behaviors before and after traumatic
brain injury (TBI), to identify populations that may benefit more from targeted interventions
to reduce the effect of substance use on TBI recovery, and to establish areas for
further study.
Data Sources
Studies were identified via literature searches using MEDLINE, PsychInfo, PsychArticles,
PubMed, and GoogleScholar (published before January 2019), as well as reference section
reviews and forward searches. Searches were conducted using search terms for TBI and
substance use behaviors.
Study Selection
Studies were included if they (1) contained both a measure of TBI and a measure of
substance use behaviors; (2) reported an effect size representing the relationship
between substance use behaviors before and after TBI, compared TBI vs non-TBI groups
on substance use behaviors controlling for pre-TBI substance use, or compared groups
with differing TBI severity on subsequent substance use behaviors controlling for
pre-TBI substance use; (3) were written in English; and (4) were human subjects research.
Studies examining effects of substance use intervention for people sustaining TBI
were excluded from this study.
Data Extraction
Study variables included substance use behaviors, TBI severity, time since TBI, military
status, age, race, and sex.
Data Synthesis
Substance use behaviors had a small but statistically significant decrease after moderate-severe
TBI. After moderate-severe TBI, there was a statistically significant decline in both
substance use (d=−0.29, P<.01) and negative substance use consequences (d=−0.67, P=.01). There was no significant change in substance use behaviors after mild TBI.
Conclusions
Substance use behaviors had a small decrease after moderate to severe TBI and no significant
change after mild TBI. Study findings suggest the need for accurate assessment to
identify those at greatest risk for problematic substance use behaviors after TBI.
Keywords
List of abbreviations:
TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 01, 2020
Footnotes
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
