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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Updated: Oct 21, 2025

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Scoping Review of Opioid Use After Traumatic Brain Injury.

Amy J Starosta1, Rachel Sayko Adams, Jennifer H Marwitz

  • 1Division of Rehabilitation Psychology, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle (Drs Starosta and Hoffman); Institute for Behavioral Health at the Heller School for Social Policy & Management, Brandeis University, Waltham, Massachusetts (Dr Adams); Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, Colorado (Dr Adams); Division of Rehabilitation Psychology and Neuropsychology (Dr Kreutzer), Department of Physical Medicine and Rehabilitation (Ms Marwitz), Department of Rehabilitation Medicine, University of Minnesota, Minneapolis (Dr Monden); Brain Injury Research Center of Mount Sinai, Departments of Rehabilitation Medicine and Neurology, Icahn School of Medicine at Mount Sinai, New York City, New York (Dr Dams O'Connor).

The Journal of Head Trauma Rehabilitation
|September 7, 2021
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Summary

Research on opioid use in individuals with traumatic brain injury (TBI) is limited. Opioid receipt is linked to psychological symptoms, and more studies are needed to explore interventions for TBI patients.

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Public Health

Background:

  • Traumatic brain injury (TBI) can lead to chronic pain and increased risk of opioid use.
  • Understanding opioid receipt and use patterns in TBI populations is crucial for patient care.
  • Existing literature on this topic requires comprehensive summarization.

Purpose of the Study:

  • To review existing research on prescription and nonprescription opioid use in adults with TBI.
  • To identify research methodologies employed in studying opioid use post-TBI.
  • To ascertain current knowledge regarding opioid use patterns and associated factors in TBI survivors.

Main Methods:

  • A systematic literature search was conducted using keywords related to opioids and TBI.
  • Inclusion criteria focused on English-language studies of adults with stable TBI and opioid use.
  • Data extraction involved multiple reviewers assessing study design, population, TBI/opioid assessment, and findings.

Main Results:

  • The review identified 21 eligible studies, primarily using administrative and electronic health records from the Department of Veterans Affairs.
  • Most studies focused on prescription opioid use and were published between 1987 and 2019.
  • Preliminary findings indicate a strong association between prescription opioid receipt and psychological symptoms like depression, anxiety, and PTSD.

Conclusions:

  • Current research on opioid use following TBI is limited despite growing awareness.
  • There is a lack of studies investigating interventions to mitigate opioid use in TBI populations.
  • Future research should broaden patient populations and focus on developing and evaluating interventions.