There are nearly 2 million traumatic brain injuries (TBI) that occur in the U.S. every year. Substance Abuse and Mental Health Services Administration (SAMSHA) had this to say about TBI:
- 52,000 people die per year.
- 275,000 will be hospitalized.
- 80% receive treatment and are released from emergency rooms.
This is an illustration of how few people will seek out medical treatment for a head injury if they don’t feel it’s serious. They may go to the emergency room but many symptoms will not arise until later. Quite often, a traumatic head injury and substance abuse will coincide. Usually, the substance abuse that occurs after will go unnoticed.
The brain injury symptoms can intermingle with intoxication of substances. For people with this type of co-occurrence disorder, they will often not get help. Most people aren’t even aware the two can go hand-in-hand.
There have been studies linking addiction and TBI, also known as traumatic brain disorder. Substance abuse disorder increases the risk of traumatic brain disorder and makes the road to recovery much longer.
Types of Brain Injury
In a traumatic head injury, impact of an object will destroy brain tissue by shredding it. The effects can cause the brain to swell or internally bleed. The person can then be deprived of oxygen and neurochemical responses can be interrupted. The worst case scenario includes death. These are the types of brain injury:
- Open head injury
- Closed head injury
- Deceleration injuries
- Chemical/toxic injuries
Brain Injury vs Brain Damage
When it comes to brain injury vs brain damage, they are similar in some ways. Mainly, they both disrupt the normal functioning of the mind. A traumatic head injury occurs when an external force causes the brain to move inside the skull. It can actually damage the skull which damages the brain. Alternatively, the brain may bump into the skull and bruise which causes the brain to become injured.
Brain damage affects brain cells. It is often related to head trauma or a serious accident. A brain injury refers to an insult to the brain that leads to damage sometimes. This can come from being hit in the head by something. It can also be a penetrating head injury that gets in the way of normal brain function. So when comparing brain injury vs brain damage, the injury is a less severe form of brain disruption.
Various Types of Brain Injury
A traumatic brain injury can be caused by many things. There are open head injuries and closed head injuries. Here are the types of head injuries that can occur:
- Closed head injury – indicates that the person received a hard blow to the head from an object. In the process, the object did not break the skull. The most common type of closed head injury is a concussion.
- Open head injury – also known as a penetrating head injury, it indicates that the object hitting the head broke the skull and entered the brain. This is often the case in car accidents or gunshot wounds. High speed objects are more likely to penetrate the skull.
- With an acquired brain injury, this happens at a cellular level. A tumor may put pressure on the brain internally. It can also occur from a neurological illness, like a stroke.
- Head injuries are a little different. They are any trauma to the scalp, skull, or brain. The degrees of how serious the injuries are will vary. There may just be a minor bump or there could be serious brain injury.
Traumatic Brain Injury Symptoms
Symptoms of a traumatic head injury can occur immediately or develop slowly over a few days. The skull may not have been damaged but the brain may have hit the skull, which causes bruising. The problem with head trauma is the head may look fine so people won’t get immediate help.
It’s what a person can’t see that may cause damage. There may be inner bleeding or brain swelling. This is extremely dangerous and should be monitored. Some head injuries can lead to brain damage which is defined by a change in brain function. A concussion is considered a mild TBI which ranges from mild to severe.
Links Between TBI and Substance Abuse
There are many links between addiction and TBI. Sadly, when someone abuses substances during their head trauma injury, the recovery takes much longer. For someone who’s been abusing substances, they show a higher risk for traumatic brain injury. In fact, 1 out of 3 people hospitalized for TBI have a history of abusing drugs or alcohol. Alcohol is more common. Many patients will become injured with a traumatic brain disorder while they’re intoxicated.
Alternatively, studies that occurred in substance abuse treatment centers found that up to 63% of addicts in recovery suffered from traumatic brain disorder. One study involved 8,000 addicts in state-funded substance abuse treatment programs. One in three of those had one or more head injuries in the past. The head injuries were severe enough that the person had to be hospitalized for a night or lead them to become unconscious.
Negative Effects of Substance Abuse and TBI
Testing on the brain indicates that substance abuse and TBI feed off each other, resulting in negative effects. Brain function and structure are disturbed by both traumatic brain disorder and substance abuse. Abusing substances result in a worse outcome for traumatic brain injuries. It increases:
- The likelihood of death.
- Increases chances of ongoing complications.
- Makes it less likely that the person will be discharged.
- A more likely chance of disability and non-productivity.
Negative Effects a Head Injury Has on Substance Abuse
While there is no solid proof as of yet, it is believed that TBI can increase the risk of substance abuse directly. If traumatic brain injury is related to alcohol use, it increases the risk of further brain injury. The risk will exist for many years after the first injury occurred.
The changes in the brain after an injury are believed to create further risk of addiction. Some evidence is suggesting that parts of the brain affected by a head injury can be the culprit. An injury can cause negative cognitive effects. This includes self-regulation and mental control. The thought is that TBI can cause people to make bad choices.
Reduced Substance Abuse for Patients with TBI
Sometimes a head injury will be the intervention the patient needed. For the short-term, the patient will stop using substances. This is an excellent window of opportunity. If not tended to, it may worsen or prompt substance abuse.
Here are some reasons that someone suffering from TBI will abstain from alcohol:
- When the head trauma occurs, there is a time where substance abuse does not occur. This is when the patient is in the hospital and recovering from injury.
- The opportunity for the patient to get the help they need may become present while in the hospital. Many addiction signs may be overlooked while a patient is being monitored for their TBI, some symptoms may be present.
- It’s possible that a medical intervention could take place. Staff may recommend outpatient treatment from drug or alcohol abuse.
- The patient may feel less inclined to abuse substances as they are under scrutiny. They may decide that it’s time to make lifestyle changes. This will often be a temporary revelation for the patient but the opportunity to recovery is there.
Research has found that patients will begin or resume drinking within a year of the injury. For patients with a history of substance abuse prior to a traumatic head injury, they’re at higher risk of heavy drinking. Stimulants and painkillers are often abused too. Patients will have great access as painkillers are used to treat the brain disruptions along with pain.
Traumatic Brain Disorder Awareness
For people that are close to the person who has suffered a brain injury, there are some things to be aware of.
- Patients with a history of substance abuse may need continuing care on relapse prevention after a TBI.
- Care for traumatic brain injury and substance abuse should be concurrent. The recovery from a traumatic head injury will take time. So does recovery from substance abuse.
- Patients may have to re-learn things, depending on the brain injury. It may take some time to become physically strong again as well as to function mentally.
- Medication and therapy may treat traumatic head injury symptoms. This includes pain, seizures, insomnia, anxiety, and depression. With this in mind, if the patient is already an addict, these medications can be a drawback. That’s why addiction rehabilitation treatment may work in conjunction with the brain injury.
Motivational counseling has been shown to help patients who are recovering from the co-occurrence of TBI and substance abuse. Support-group participation has also been useful in recovery of both disorders. There are even groups that specifically focus on those who have suffered from a traumatic head injury. The mind and the body are extremely resilient in their ability to heal. When all parts of the TBI are cared for, there is the possibility of a full recovery.
NCBI, Am J Psychiatry (April 2014) When Addiction Co-occurs with Traumatic Brain Injury. Retrieved from,
NCBI, Ann N Y Acad Sci. (Oct. 2011) Effects of psychological and biomechanical trauma on brain and behavior. Retrieved from,
NCBI, J Neurotrauma. (July 2009) Does Traumatic Brain Injury Increase Risk for Substance Abuse? Retrieved from,