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Citation |
Adams RS, Corrigan JD, Dams-O'connor K. J. Neurotrauma 2019; ePub(ePub): ePub. |
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Affiliation |
Icahn School of Medicine at Mount Sinai, 5925, Rehabilitation Medicine, One Gustave Levy Place, Box 1163, New York, New York, United States, 10029; kristen.dams-o'connor@mountsinai.org. |
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Copyright |
(Copyright © 2019, Mary Ann Liebert Publishers) |
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DOI |
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PMID |
31333067 |
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Abstract |
As the opioid epidemic continues to unfold and efforts to address the crisis are expanded, identifying subgroups at elevated risk for opioid use disorder (OUD) and its devastating consequences is of critical importance. Growing evidence suggests that individuals with traumatic brain injury (TBI) may be at elevated risk for OUD by virtue of a confluence of factors that converge for this population. Opioids are commonly prescribed for pain during acute care, and high rates of chronic pain after TBI set the stage for long-term use. Even as state and federal regulations attempt to curb prescribing practices, rates of prescription opioid use remain elevated among individuals with disabilities. Pre-injury substance use is not uncommon among people who have incurred a TBI, and can increase susceptibility to misuse of highly addictive medications. Some of the most common sequelae of TBI, including changes in cognition and mood, may confer additional vulnerability for medication mismanagement and misuse. Long-term use of opioids is associated with changes in health and cognition that can further exacerbate TBI-related sequelae. Access to substance abuse treatment is an ongoing challenge for people who have had a TBI, and the efficacy of OUD treatment practices in this population is unknown. The convergence of multiple risk and perpetuating factors in this population creates a perfect storm such that persons with TBI may be uniquely vulnerable to opioid misuse and its devastating consequences. Research is urgently needed to quantify and characterize the population of individuals with TBI and OUD, and to identify opportunities for prevention and tailored interventions. Language: en |
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Keywords |
ALCOHOL AND DRUG ABUSE; HEAD TRAUMA; TRAUMATIC BRAIN INJURY |