Traumatic brain injury (TBI) occurs around 1.7 million times every year in the United States. Almost 80 percent of the people who endure a TBI are treated and released from hospital emergency departments. An unknown number of Americans experience TBI, but do not seek medical treatment.
Rates for TBI are higher for males than for females in every age group. The age groups in which TBI is most common are ages 15 to 19 and ages 75 and older. Sports-related TBIs are the most common type, and many service members serving in Iraq and Afghanistan suffer TBI after encountering improvised explosive devices (IEDs), like roadside bombs.
Protective gear, such as that worn for athletic activities and during military exercises and combat offer some protection against injury, but there are some cases in which the brain cannot be protected. For example, blast waves from IEDs can cause damage even to people wearing helmets and body armor.
What Happens During and After Traumatic Brain Injury?
During a TBI, the skull is struck, penetrated, or thrust out of place due to falls, car accidents, launched or falling objects hitting the head, or bodily contact, as in a contact sport. A TBI may be caused by either blunt or penetrating trauma, which damages or destroys brain tissue through tearing or shearing. Secondary effects can include internal bleeding, brain swelling, oxygen deprivation, or other processes that result in the death of brain cells. Sometimes TBI affects a specific region of the brain, but other times, TBI effects can be diffuse throughout the brain.
As for symptoms, TBI generally causes cognitive effects, such as difficulty in thinking efficiently, problems with multitasking, or difficulty persevering at a task without mental exhaustion. The brain’s executive functions (cognitive processes necessary for cognitive behavior control) may be affected, and sensory functions may be affected too. Sensory difficulties can make normal sounds seem too loud and normal lighting seem too bright. People with TBI may have problems regulating emotions.
Many TBI symptoms are also characteristic of psychiatric disorders, and even trained counselors may have difficulty teasing apart which symptoms are due to psychiatric illness and which are due to TBI or other conditions such as addiction. Addiction treatment specialists must be particularly cognizant of the effects of TBI.
Are TBI and Addiction Linked?
Traumatic brain injury and addiction are linked in several ways. For one thing, addiction raises a person’s risk of TBI due to impaired reflexes and judgment. Alcohol is the most-reported misused substance prior to TBI, and nearly 75 percent of TBI patients have measurable alcohol in their blood when admitted to hospitals. In addiction treatment programs, typically a significant portion of patients report a history of head injury with lost consciousness when they are interviewed during intake. Unfortunately, a history of addiction is associated with worse outcomes for TBI, because each issue compounds the negative effects of the other.
At the same time, however, TBI is associated with abstinence or reduced consumption of alcohol and drugs afterward. This may be attributed to intense clinical monitoring, decreased access to substance, or decreased tolerance. These effects may be temporary, however, because a history of substance abuse before TBI increases the chances of resuming substance use after TBI.
Addiction Treatment for People with TBI
Addiction treatment for people with TBI must be tailored with the patient’s medical history in mind. For the addiction treatment specialist, this may involve assessing the person’s ability to read, write, and comprehend spoken language. Careful observation of a TBI patient’s attention span is also crucial, as is finding out which environmental characteristics are most conducive to good communication.
Some people with TBI absorb information better if they are allowed to take notes, and many benefit from the use of a calendar or planner. Perhaps most importantly, the counselor should not presume that patient non-compliance results from resistance or lack of motivation, because it may be the TBI itself that is behind such behaviors.
Traumatic brain injuries have been diagnosed for nearly 100 years, and since the 1970s, researchers have physically examined brains of people with suspected brain injuries, particularly professional athletes and combat veterans.
Physical changes in the brain due to TBI are both short- and long-term, but that does not mean that addiction treatment does not work in people with TBI. Addiction treatment that considers a person’s medical history, including a history of brain injury, can be successful and can help people with TBI gain significant control over their lives. If you or any of your loved ones are trying to cope with addiction, with or without accompanying TBI, we encourage you to contact us today!