1546 - The Occurrence of Substance Use Issues and Post Traumatic Stress Disorder in Traumatic Brain Injury Patients

Objectives: Approximately 69 million incidences of traumatic brain injury (TBI) occur per year, mostly in older adults. Primary TBI is the initial head trauma, and secondary TBI results from neural destruction caused by primary TBI. Axonal damage and decreased neuroplasticity may cause emotional and cognitive dysregulation, potentially leading to post-traumatic stress disorder (PTSD). An increased rate of substance use disorders (SUD) has also been observed in TBI patients as compared to the general population. Although PTSD has been correlated to TBI in the past, the prevalence of SUD in TBI patients with PTSD has not been widely examined. Determining whether PTSD is associated with increased SUD in TBI patients is paramount in improving care for TBI patients.

Design: Deidentified patient data from the Traumatic Brain Injury Model Systems National Data and Statistical Center from 2019-2021 was used, which had 18590 patients in the raw dataset. Inclusion criteria included follow-up patients who had answered both questions regarding PTSD and SUD diagnoses, leaving a sample of 7284. Chi-square-test and independent-samples-t-test were used to compare SUD proportions/means between PTSD and non-PTSD patients, adjusting for sex, age, and cigarette use. A crude and adjusted binary logistic regression were conducted to calculate the likelihood for SUD when having PTSD.

Results: PTSD significantly increased the likelihood of SUD by 1.786-fold (95% CI: 1.527, 2.089) in TBI patients. After adjusting for age, sex, and cigarette use, PTSD significantly increased the likelihood by 1.683-fold (95% CI: 1.348, 2.101) in TBI patients. p < .001.

Conclusions: When TBI patients have PTSD, it almost doubles the likelihood that they will have SUD. Having all three diagnoses puts patients in an increasingly disadvantaged position. It would be prudent to monitor TBI patients with PTSD for SUD, and even promptly begin treatment to avoid further brain damage.