Related Experiment Video
Updated: May 29, 2025
Author Spotlight: Developing Precise and Clinically Relevant Models for Studying Secondary Degeneration in Traumatic Optic Neuropathy
Published on: November 29, 2024
Diagnosis of Alcohol Use Disorder and Deaths Related to Alcohol, Drug Overdose, or Suicide Among Post-9/11 Active
Kangwon Song1, Megan E Amuan, Rachel Sayko Adams
1Department of Pharmacy, Wellstar MCG Health, Augusta University, Augusta, GA (KS); Informatics, Decision-Enhancement, and Analytic Sciences Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, VA (MEA, MJP); Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (MEA, EK, MJP); Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA (RSA); Informatics, Decision-Enhancement, and Analytic Sciences Center of Innovation (EK); Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT (AJG, JC); Informatics, Decision-Enhancement, and Analytic Sciences Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT (AJG, JC); Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR (KFC); Oregon Health and Science University, Portland State University School of Public Health, Oregon Health and Science University, Portland, OR (KFC); Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA (TKP); Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA (TKP); Uniformed Services University of the Health Sciences, Psychiatry, Bethesda, MD (EGM); and Walter Reed National Military Medical Center, Georgetown University School of Medicine, Bethesda, MD (CS).
Objectives:
The association between traumatic brain injury (TBI) and alcohol use disorder (AUD) is known, but the extent of TBI's role in developing AUD remains unclear. This study examines the association between TBI severity with subsequent AUD diagnosis, and hazard for death due to alcohol, drug overdose, or suicide.
Methods:
Data from a national US military/veteran cohort (October 1999-September 2016, followed until September 2020) were analyzed using Fine-Gray competing risk models to investigate the relationships between TBI exposure, subsequent AUD, and hazards of death due to specific causes (alcohol, drug overdose, or suicide).
Results:
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). For those 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.
Conclusions:
Veterans with TBI were more likely to develop AUD and experience increased mortality, even after adjusting for demographic and clinical factors. 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.
Related Concept Videos
01:27Post-traumatic Stress Disorder
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...
01:24Substance Use Disorders Affecting Sleep
Understanding the concepts of physical dependence,...
01:27CNS Depressants: Alcohol and Nicotine
01:27Diagnostic and Statistical Manual of Mental Disorders (DSM)