Prevalence and correlates of traumatic brain injury amongst heroin users

The study aimed to determine the prevalence and severity of traumatic brain injury (TBI) amongst heroin users, and its associations with cognitive functioning and drug use histories. TBI and drug use histories were taken from 175 heroin users enrolled in maintenance or residential treatment, and neuropsychological tests administered measuring executive function, working memory, information processing speed, verbal learning and non-verbal learning. A TBI had been suffered by 55%, 37% had suffered multiple injuries, and 15% had suffered a moderate-severe injury. Males were significantly more likely to have had a TBI (odds ratio [OR] 2.59) and to have experienced multiple TBIs (OR 3.04). Maintenance patients were significantly more likely than therapeutic community clients to have experienced a TBI (61.6 vs. 40.0%). A higher number of TBIs was associated with poorer global cognitive performance, as well as poorer executive functioning, information processing speed and verbal learning. Treatment providers should be aware that a large proportion of those they treat have experienced TBI. TBI should be considered as one of the harms likely to accompany the transition into heroin use.