One for the road: The role of substance misuse on outcomes from traumatic brain injury

Abstract

s / Drug and Alcohol Dependence 156 (2015) e102–e182 e109 use factors, personality, psychopathology and problems related to MJ use. Methods: To that end, we used multiple correspondence analysis to identify relationships between MJ use motives (Marijuana Motives Measure) and age, age of onset of MJ use, frequency of MJ use, personality traits (NEO Five Factor Inventory), depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), stress (Perceived Stress Scale), and, indicators of problematic MJ use (Marijuana Problem Scale) in 90 current, heavy MJ users (mean age=26.25, 62 males, mean duration of use =11.86 years). Bootstrap confidence intervals were calculated to determine significance. Results:The results indicatedfive significant components. Component 1 differentiated older (>30 years old), casual users from younger users with CUDs and who use MJ to cope with stress. Component 2 differentiated introverted users who use MJ to be social from thosewho useMJ to expand their creativity and awareness. Component 3 differentiated educated, introverted females who have social problems associated with MJ use from social, less educated males who use MJ to conform. Component 4 differentiated social users who have trouble fulfilling responsibilities from those with MJ withdrawal symptoms and who use MJ to cope with depression and anxiety. Component 5 differentiated older, educated women who started using MJ in their late teens from casual male users who started before the age of 13. Conclusions: These results demonstrate clear distinctions between various factors that promote MJ use and the effects that result from MJ use. In conclusion, effective treatment strategies should take into account individual factors that surround MJ use, including MJ use motives, age, age of onset, gender, personality, education, and mood. Financial support:NIDA K01 DA021632, awarded to Dr. Filbey. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.301 One for the road: The role of substance misuse on outcomes from traumatic brain injury Lori A. Keyser-Marcus2, Leroy Thacker3, Angela Starkweather3, Divya Ramesh1, F. Gerard Moeller4 1 Pharm Tox, VCU, Richmond, VA, United States 2 Psychiatry, VCU, Richmond, VA, United States 3 School of Nursing, VCU, Richmond, VA, United States 4 VCU IDAS, Richmond, VA, United States Aims: The relationship between substance use and TBI has been well established. Substanceuse is often implicated as a causal factor of TBI, with rates of intoxication at hospital admission ranging from 33 to 50% (Chen et al., 2012). Althoughmuch attention has focused on the relationship between TBI and comorbid substance misuse, fewer studieshaveexamined the relationshipbetweenpre-existing substancemisuse and outcomes. The present study seeks to further elucidate this relationship. Methods: Data for the present sample were abstracted from a trauma registry of individuals admitted to an urban, university based, Level I trauma center ED (N=2686). Inclusion criteria consisted of: ICD-9 diagnosis of TBI, between 18 and 65 years, and available alcohol and drug toxicology information (N=1872). Binary logistic regression and Poisson regression analyses, adjusting for age, gender, race, and general medical trauma severity, were run to compare TBI subjects with positive (TBIPOS) to TBI subjects with negative drug toxicology (TBINEG) on TBI outcome measures. Results: Individuals with TBI who screened positive for illicit drugs or alcohol on ED admission (TBIPOS, n=762), and those with negative screens (TBINEG, n=1110) were compared. The majority were male (67%), Caucasian (56%), and mild TBI (86%). Results of the regression analyses noted significant differences between groups on proportion of ICU admissions (p=0.0024), and TBI severity (p=0.0011), with TBIPOS subjects exhibiting worse outcomes. Further, results of the Poisson regression analyses revealed TBIPOS subjects had greater ICU lengths of stay (p= .009). No significant differences were noted between groups regarding hospital length of stay. Conclusions: Study findings demonstrate the negative impact of pre-existing substancemisuse on TBI outcomes. The lownumber of treatment referrals supports the need for a standardized system of screening and referral for this high-risk group. Financial support: Supported by VCU IDAS, U54DA038999. http://dx.doi.org/10.1016/j.drugalcdep.2015.07.302 Childhood parental incarceration and HIV-related drug and sex risk over the young adult life course Maria R. Khan1, Susan McGorray2, Joy D. Scheidell 1, Krishna Vaddiparti 2, Laurie M. Brotman1 1 Population Health, New York University, New York, NY, United States 2 Colleges of Public Health & Health Professions and Medicine, University of Florida, Gainesville, FL,