Substance Use and Related Harms Among Adolescents With and Without Traumatic Brain Injury

J Head Trauma Rehabil. Sep-Oct 2015;30(5):293-301. doi: 10.1097/HTR.0000000000000101.


Objective: The relationship between self-reported lifetime traumatic brain injury (TBI) and drug and alcohol use and associated harms was examined using an epidemiological sample of Canadian adolescents.

Settings and design: Data were derived from a 2011 population-based cross-sectional school survey, which included 6383 Ontario 9th-12th graders who self-completed anonymous self-administered questionnaires in classrooms. Traumatic brain injury was defined as loss of consciousness for at least 5 minutes or a minimum 1-night hospital stay due to symptoms.

Results: Relative to high schoolers without a history of TBI, those who acknowledged having a TBI in their lifetime had odds 2 times greater for binge drinking (5+ drinks per occasion in the past 4 weeks), 2.5 times greater for daily cigarette smoking, 2.9 times greater for nonmedical use of prescription drugs, and 2.7 times greater for consuming illegal drug in the past 12 months. Adolescents with a history of TBI had greater odds for experiencing hazardous/harmful drinking (adjusted odds ratio [aOR] = 2.3), cannabis problems (aOR = 2.4), and drug problems (aOR = 2.1), compared with adolescents who were never injured.

Conclusion: There are strong and demographically stable associations between TBI and substance use. These associations may not only increase the odds of injury but impair the quality of postinjury recovery.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Brain Injuries / diagnosis
  • Brain Injuries / epidemiology*
  • Brain Injuries / rehabilitation
  • Cohort Studies
  • Comorbidity
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Ontario / epidemiology
  • Prevalence
  • Reference Values
  • Risk-Taking*
  • Self Report
  • Severity of Illness Index
  • Sex Distribution
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / rehabilitation