Article
Substance abuse as a mediating factor in outcome from traumatic brain injury

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Abstract

A review of recent research addressed two questions: how common are problems of substance abuse in traumatic brain injury (TBI), and to what extent does alcohol and other drug use mediate outcome? Studies showed alcohol intoxication present in one third to one half of hospitalizations; data for other drug intoxication were not available. Nearly two thirds of rehabilitation patients may have a history of substance abuse that preceded their injuries. Intoxication was related to acute complications, longer hospital stays, and poorer discharge status; however, these relationships may have been caused by colinearity with history. History of substance abuse showed the same morbidity, and was further associated with higher mortality rates, poorer neuropsychological outcome, and greater likelihood of repeat injuries and late deterioration. The effect of history may be caused by subgroups with more severe substance abuse problems. Implications for rehabilitation are discussed, including the potential negative impact of untreated substance abuse on the ability to document efficacy of rehabilitation efforts.

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    Preparation of this manuscript was supported in part by grant H 235L20001 from the US Department of Education, Rehabilitation Services Administration, to the Ohio Valley Center for Head Injury Prevention and Rehabilitation.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organizations with which the authors are associated.

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