Addict -> TBI -> Addict no more?

I was very captivated by the group’s presentation on Traumatic Brain Injuries. One question that kept me up late at night is:

Would addicts who suffer a traumatic Brain injury be cured from their drug or compulsion?
-This is your brain on drugs ⇑

As I perused the literature on addiction and TBIs, I found multiple documents linking addicts to TBIs. In fact, more than 50% of all patients who experience traumatic brain injury concurrently have a problem with alcohol or drugs. It makes sense to me because drugs can inhibit senses and increase risk taking behavior, which can lead to disastrous injuries.
However, I was interested in finding what happens to these addicts after the TBI. Robert Katz (Ph.D. Program Director Brady Institute for Traumatic Brain Injury) reviewed literature on the topic. Here’s what he found:
The CDC estimated that 5.3 million Americans live with disabilities due to brain injury and that 67% of people in rehabilitation for brain injury have a previous history of substance abuse. 50% of these people will return to using alcohol and drugs after the injury. Another study found that 20-60% of TBI survivors were identified as preinjury problem drinkers, with 30-50% of these survivors continuing to have problems with alcohol postinjury. Similarly, a different study put preinjury alcohol abuse at 40-66%, and postinjury alcohol abuse between 27%-50% of TBI survivors. Furthermore,TBI survivors were found to have a significantly increased sensitivity to alcohol’s effects postinjury; 20% of persons with brain injuries who did not use alcohol or drugs prior to the injury, were vulnerable to alcohol and drug use after the injury.
So all in all, the future for addicts that suffer a TBI does not look very bright. The range of alcohol abuse appears slightly lower after injuries, but research is showing that drug abuse is highly underreported after traumatic brain injuries. Perhaps because the individuals are so ashamed of falling back into their unhealthy habits.

I leave you with one of my guilty pleasures- a True Life episode about three boys living post-TBI:

http://www.mtv.com/videos/true-life-i-have-a-traumatic-brain-injury/1638298/playlist.jhtml

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5 thoughts on “Addict -> TBI -> Addict no more?

  1. Hey Lia!

    I really like your post; I wouldn’t have thought two connect those two ideas. Because human studies are mostly correlational, I was wondering how the specific cause-effect interaction comes into play. For example, we could ask, “does a TBI directly influence GABAergic, dopaminergic, or endocrine systems such that the reward activation changes, leading to an increased risk of addiction?” But then again we could also ask, “does the TBI decrease the quality of life for the individual to the extent that they would actively try to find relief in whatever way possible?” I also like your statement that drug-seeking behavior could pre-empt the TBI as a result of the more risky lifestyle that ensues.” We might ultimately be able to shed light on this causality by using different lesioned animal models of TBI and a conditioned place preference test to understand the extent of reward system changes and the nature of the TBI related impairment in facilitating the high correlation between drug use and TBI.

    -Michael S.

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  2. Lia this is a really interesting post. I too would not have thought that alcoholism could be linked to addiction. In fact I usually think of children with TBI for some reason. It is interesting to look at it from an adult perspective. I wonder if alcohol could act in some ways as a coping mechanism for people post-TBI.

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  3. People with TBIs showed increased sensitivity to drugs of abuse… do you also think that people with addictions are more vulnerable to TBIs???

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  4. What an interesting idea – to look at both these topics! I was going to ask if people who sustain TBI’s that don’t have substance abuse addictions develop them after getting one, but they reported that 20% of people who do get TBI’s develop addictions. I would like to see more research done on this aspect, to see why these people fall into addictions after their brain injuries. Is it because they are depressed? Are they genetically susceptible? Or is there another reason behind it, due to their brain injury, that influences their addiction?

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