title: Examining the Relationship Between Traumatic Brain Injury and Substance Use Outcomes in the Canadian Population.
abstract: The literature has opposing views regarding the magnitude of the association between substance use and TBI. Most studies have examined clinical samples which are not representative of the entire head injured population. Clinical samples provide very limited insight into TBI patients whom do not seek care.
  
  
  
  This paper examines the associations between TBI and substance use/misuse. Its primary aim is to test whether or not individuals with a past-year TBI have higher rates of substance use/misuse than Canadians without a TBI or back and/or spine injury controls drawing on self-report population level data.
  
  
  
  Using the 2009-2010 Canadian Community Health Survey, a nationally representative cross-sectional survey of Canadians 12 years and older, this paper assessed substance use (i.e., illicit drug use; drinking and binge drinking; current smoking) among those with a TBI, as compared to two control groups: (1) individuals with a back or spinal injury (BSI); and (2) healthy noninjured controls. Multivariate regressions (logistic and multinomial), both unadjusted and adjusting for a range of injury and sociodemographic covariates, were used in hypothesis testing.
  
  
  
  Those with a past-year TBI demonstrated significantly elevated rates of illicit drug use relative to non-injured Canadians. Relative to the BSI group those with a TBI were less likely to drink alcohol, did not differ in binge drinking, cigarette smoking and illicit drug use.
  
  
  
  Health care professionals working with the TBI population should integrate screening, brief intervention, and referral programming as a means to reduce future harm related to substance misuse.
authors.affiliation: a Department of Community Health and Epidemiology , Dalhousie University , Halifax , Canada.
authors.forename: Stefan
authors.initials: S
authors.lastname: Allen
authors.affiliation: a Department of Community Health and Epidemiology , Dalhousie University , Halifax , Canada.|b Department of Psychology, Dalhousie University , Halifax , Canada.
authors.forename: Sherry Heather
authors.initials: SH
authors.lastname: Stewart
authors.affiliation: c St. Michael's Hospital , Toronto , Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Cusimano
authors.affiliation: a Department of Community Health and Epidemiology , Dalhousie University , Halifax , Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Asbridge
mesh_terms: D000428:Alcohol Drinking; D000070642:Brain Injuries, Traumatic; D002170:Canada; D003430:Cross-Sectional Studies; D006801:Humans; D012907:Smoking; D019966:Substance-Related Disorders
keywords: Canada; TBI; alcohol; cannabis; cocaine; coping; heroin; illicit drug; marijuana; smoking