AUGUSTA, GA — U.S. military veterans with traumatic brain injuries were more likely to develop alcohol-use disorder (AUD) and experience increased mortality, even after adjusting for demographic and clinical factors.
While the association between TBI and AUD is known, it has been unclear how much of a role TBI plays in the development of problematic use of alcohol, according to the report in the Journal of Addiction Medicine.1
To remedy that, a study team examined the association between TBI severity with subsequent AUD diagnosis and hazard for death due to alcohol, drug overdose or suicide.
The study was led by the Department of Pharmacy, Wellstar MCG Health at Augusta, GA, University, the study involved the VA Salt Lake City, UT, Healthcare System, the VA Portland, OR, Healthcare System, the VA Boston Healthcare System and related academic institutions, as well as the Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, both in Bethesda, MD.
The researchers used data from a national U.S. military/veteran cohort from October 1999 to September 2016 and followed the cohort until September 2020.
Results indicated that TBI severity correlated with an increased likelihood of an incident AUD diagnosis: mild TBI (hazard ratio [HR]: 1.25, 95% confidence interval [CI] 1.22-1.27), moderate-severe TBI (HR: 1.34, 95% CI 1.32-1.37), and penetrating TBI (HR: 1.90, 95% CI 1.86-1.94).
In veterans who developed AUD, TBI was associated with a higher hazard of death from specific causes such as alcohol, drug overdose or suicide HR: 2.47 (95% CI 2.03-3.02) for mild TBI, 4.25 (95% CI 3.49-5.17) for moderate-severe TBI, and 3.39 (95% CI 2.80-4.13) for penetrating TBI.
“Veterans with TBI were more likely to develop AUD and experience increased mortality, even after adjusting for demographic and clinical factors,” the authors concluded. “Care strategies that are sensitive to the cognitive and/or emotional impairments associated with varying levels of TBI may lead to better outcomes, reducing both AUD and mortality rates. Further research is needed to develop evidence-based methods for integrating TBI and AUD care.”
- Song K, Amuan ME, Adams RS, Kennedy E, et. Al. Diagnosis of Alcohol Use Disorder and Deaths Related to Alcohol, Drug Overdose, or Suicide among Post-9/11 Active Duty Service Members and Veterans Following Traumatic Brain Injury. J Addict Med. Am J Psychiatry
