Screening for Substance Abuse in Individuals with Traumatic Brain Injury (TBI).

Past Studies

Past Studies which have examined the various instruments available to screen for substance abuse disorders in individuals with TBI have been few. Some studies have suggested that substance abuse is under-identified in TBI rehabilitation settings. Use of self-reports by individuals as a method to obtain information about substance use and abuse versus use of data provided by clinicians (health professionals, hospital staff) has been found to be useful and reliable when done with the general population. Past studies report that self-reporting is rarely used with individuals with TBI .There is, however, a large body of literature on substance abuse which has shown that self-reporting (from interviews or questionnaires) of substance abuse is consistent with data collected from other sources (family and health professionals) who have observed the patient or from blood alcohol level testing.

This Study

This Study tested two groups of individuals with TBI to examine the accuracy, sensitivity and specificity of several instruments used to screen individuals for substance abuse. Additionally, information from self-reports was compared to information from clinical interviews. A number of tools were tested to see if they successfully screened individuals with TBI for substance abuse. Findings suggest that a tool called CAGE may be useful for screening for alcohol abuse and the Substance Abuse Screening Inventory (SASSI-3) may be useful in screening for drug abuse in individuals with TBI. The other tools tested did not prove useful. Use of self-reporting was found to be an inaccurate measurement tool for individuals with TBI.

Who May Be Interested In These Findings

Individuals with TBI, their family, caregivers, community providers, health providers and researchers. 

Caveats

One limitation of this study is that findings did not show clear reasons why the CAGE and SASSI-3 testing tools were the only tests that demonstrated acceptable sensitivity and specificity for use in screening for substance abuse. Another limitation may be the use of self-reporting as an accurate screening tool. The authors noted that patients may not be reliable reporters about their psychiatric history, although other studies suggest that patients’ reports are often consistent with those of their observers. .

Bottom Line

While use of self-reporting as a method of measuring substance abuse with the general population seems to be a valid tool, it does not accurately identify substance abuse with individuals with TBI as well as the CAGE and SASSI-3 tests.

Please take a moment to comment on the value of this abstract:
Click here to take a brief survey