Overdose Risk and Brain Injury (Traumatic Brain Injury/Acquired Brain Injury), A Commentary.

Publisher: Informa Healthcare Country of Publication: England NLM ID: 9602153 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2491 (Electronic) Linking ISSN: 10826084 NLM ISO Abbreviation: Subst Use Misuse Subsets: MEDLINE

Publication: London : Informa Healthcare
Original Publication: Monticello, NY : Dekker, 1996-

Brain Injuries*/complications ; Brain Injuries*/diagnosis ; Brain Injuries*/epidemiology ; Brain Injuries*/prevention & control ; Drug Overdose*/complications ; Drug Overdose*/diagnosis ; Drug Overdose*/mortality ; Drug Overdose*/rehabilitation ; Opioid-Related Disorders*/complications ; Opioid-Related Disorders*/diagnosis ; Opioid-Related Disorders*/mortality ; Opioid-Related Disorders*/rehabilitation ; Risk Assessment* ; Analgesics, Opioid*/administration & dosage ; Analgesics, Opioid*/adverse effects ; Analgesics, Opioid*/therapeutic use; Humans ; Brain Injuries, Traumatic/complications ; Brain Injuries, Traumatic/diagnosis ; Brain Injuries, Traumatic/epidemiology ; Brain Injuries, Traumatic/prevention & control ; Naloxone/pharmacology ; Naloxone/therapeutic use ; Racism/statistics & numerical data ; Social Stigma ; United States/epidemiology

Objective: This commentary seeks to evaluate existing knowledge about the relationship between brain injury (BI) and overdose (OD), to unify distant bodies of literature, and to enhance prevention and treatment for opioid OD among individuals with BI.
Background: There is a hidden epidemic of undiagnosed BI in the United States. Due to lack of screening, the vast majority of BI sufferers do not know they have a BI. Not only are those with BI at elevated risk for opioid use, misuse, and opioid use disorder, but also they are at elevated risk for OD. Conversely, those with OUD and those who experienced an OD, are more likely to sustain BI. Key Findings/Conclusions: The existing literature suggests that primary strategies to reduce ABI (Acquired Brain Injury)/TBI (Traumatic Brain Injury) harms involve addressing: screening, stigma, racial disparities, and popular misconceptions about OD. The association between TBI and OD is an underexamined public health issue, exacerbated by the bidirectional nature of the relationship. Not only is TBI a risk factor for opioid OD; opioid OD was also found to be a major cause of ABI, which can have lifelong effects similar to Alzheimer's disease. Screening tools for BI were underutilized and inconsistently implemented across reviewed studies. Enhanced screening population wide is a promising intervention, complemented with expanded treatment and research. Black individuals face worse outcomes in BI and treatment outcomes. Anti-racist strategies must fight inequity while addressing social and structural drivers of overdose and BI within the opioid and opioid overdose crises.

Keywords: ABI; Brain injury; OD; TBI; opioid use disorder; screening

36B82AMQ7N (Naloxone)
0 (Analgesics, Opioid)

Date Created: 20240528 Date Completed: 20241118 Latest Revision: 20241118

20250114

10.1080/10826084.2024.2359722

38803022