Influence of Mild Traumatic Brain Injury History and Mental Health Status on Alcohol and Cannabis Use in University Athletes

Objective:This study examined the relationship between mild traumatic brain injury (mTBI) history, mental health, and sex with single and polysubstance use in university athletes.Design:Observational study.Setting:University in Ontario, Canada.Participants:Participants were identified from a dataset of 416 university athletes ages 18 to 21. Participants were classified based on their substance use habits and, 153 met criteria for the nonsubstance group, 195 for the alcohol use (AU) only group, and 64 polysubstance use group [ie, a combined substance use (AU+) group].Independent Variables:Athletes received baseline assessments and completed self-reported questions regarding alcohol, cannabis, or other recreational substance use, the Patient Health Questionnaire-9, self-reported mTBI history, and self-reported anxiety, and/or panic disorder endorsement information.Main Outcome Measures:Comparison of mTBI history and mental health status between individuals in the alcohol only or polysubstance use group.Results:Mild traumatic brain injury history was a significant predictor of AU (P < 0.001) and AU+ (P < 0.001). Anxiety endorsement was also a significant predictor of polysubstance use (P < 0.001) and there was a small but nonsignificant association of polysubstance use in men (P = 0.057).Conclusions:University athletes who experience mTBI are more likely to engage in single or polysubstance use and athletes who experience anxiety are more likely to engage in polysubstance use. Consideration of mTBI history and mental health may inform clinical concussion management for identifying potential high-risk behavior such as polysubstance use in university athletes and tailoring intervention strategies (eg, incorporating education about substance use).