Research Reports - Prevalence of traumatic brain injury in cocaine-dependent research volunteers

Am J Addict. 2015 Feb 6

Ramesh D(1), Keyser-Marcus LA, Ma L, Schmitz JM, Lane SD, Marwitz JH, Kreutzer
JS, Moeller FG

BACKGROUND: There is a high prevalence of traumatic brain injury (TBI) among
those with substance dependence. However, TBI often remains undiagnosed in these
individuals, due to lack of routine screening in substance use treatment settings
or due to overlap in some of the cognitive sequelae (eg impulsivity,
disinhibition) of TBI and cocaine dependence.
METHODS: The prevalence of self-reported mild to moderate TBI in a group of
cocaine-dependent (n = 95) and a group of healthy volunteers (n = 75) enrolled at
the same facility was assessed. Additionally, the relationship between TBI and
clinically relevant correlates, including impulsivity, cocaine use history, and
treatment outcome in the cocaine-dependent group was also examined.
RESULTS: A higher proportion of individuals with cocaine dependence (29.5%)
reported having suffered a TBI in their lifetime compared to controls (8%) on a
Closed Head Injury scale. Among cocaine users, the average age of sustaining TBI
was significantly lower than the age of initiating cocaine use. Presence of TBI
was not associated with higher impulsivity on the Barratt Impulsiveness Scale-11
or self-reported years of cocaine use. No differences were noted on treatment
outcome for cocaine dependence as measured by treatment effectiveness scores
(TES) between cocaine users with TBI and their non-TBI counterparts.
CONCLUSIONS: These results are the first to highlight the high prevalence of TBI
among individuals with cocaine dependence. This study underscores the possible
role of TBI history as a risk factor for onset of cocaine use, however, more
research is needed to determine the impact of co-morbid TBI as a complicating
factor in the substance abuse treatment setting.

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