Screening patients with traumatic brain injuries for substance abuse

Substance abuse frequently accompanies and complicates serious traumatic brain injury (TBI). An important prerequisite to providing assistance to TBI patients is the ability to identify substance abuse accurately. The authors prospectively evaluated 10 consecutive admissions to a TBI program using four substance abuse screening tools: the CAGE questions, the Brief Michigan Alcohol Screening Test (BMAST), the Substance Abuse Subtle Screening Inventory, and the Addiction Severity Index. The CAGE questions and the BMAST were found to be easy to administer and very sensitive as well as specific for substance abuse in this population. The authors conclude that all patients with traumatic brain injuries should be screened for substance abuse by using either the CAGE questions or the BMAST.