Abstract:
Reported drug use at Years 1 and 2 following traumatic brain injury (TBI) is 6 to 8%, compared to 29% premorbidly. How drug use responses change over time in the same group is not known. This study investigates patterns of reported drug use and follow-up for individuals with TBI who received inpatient rehabilitation, and who were questioned annually about illicit drug use. The TBI Model System Database (n=1160) was used to perform a cross-sectional analysis on all successfully contacted and screened over a 10 year period. Responses to drug use at Year 1 were 37 yes, and 333 no, with no significant difference in yes/no responses across the years. However, analysis of the positive responses revealed those reporting drug use in Year 1 had poor follow-up and reporting in subsequent years. Of those who reported drug use at Year 1, 33% were not available for data collection at Year 2 and 11% were contacted but did not answer the question. There were also new reports of drug use at each follow-up interval. For example, of those who had reported drug use at Year 2, 47% had reported no drug use at Year 1. These findings parallel TBI alcohol research that suggests changes in function, transportation, finances, and socialization allows people to resume former activities. This study indicates that as time passes from injury, there may be individuals who are becoming drug users, and/or have been using drugs, but are now revealing that information. We may need better ways to track those with TBI and their drug use. If there is truly new drug use occurring each post-injury, this may need to be a clinical focus during the post-acute recovery phase, with more information needed about how to identify those at risk for drug use after TBI.