Co-Morbidity of Substance Abuse and Traumatic Brain Injury

Sacks, Amanda; Fenske, Cheree L.; A, Gordon; Hibbard, Abpp Mary R.; Perez, Ken; Casac, Susan Brandau; Cantor, Joshua; Ashman, Teresa; Spielman, Lisa

doi:10.1080/15504260903182755

Cited by 34 publications

(27 citation statements)

References 23 publications

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“…It is not surprising that level of education and cognitive impairment are related. Individuals with some cognitive impairment while younger are naturally less likely to complete school and other forms of education because of their inability to understand and participate in classroom education (Sacks et al, 2009). One warning though, individuals who did not complete much education might score lower on the ACE-R test due to their level of education rather than cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

“…The high prevalence of substance misuse problems among people with cognitive impairment has been well documented (e.g. Sacks et al, 2009). However, there has been considerably less research into the prevalence of cognitive impairment among the substance treatment population and consequently limited information available about specific treatment methods and approaches likely to be effective.…”

Section: Discussionmentioning

confidence: 99%

“…Rather, more general suggestions are made about needing to adapt and lengthen treatment to improve outcomes for people with cognitive impairment (e.g. Degenhardt & Hall, 2000;Sacks et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…Another study suggested that people with comorbid cognitive impairment and substance use disorders require extended length of substance misuse treatment as well as specifically tailored interventions to address the cognitive deficits the impairment causes (Sacks et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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The prevalence of cognitive impairment in a rural in-patient substance misuse treatment programme

Allan¹,

Kemp

Golden³

2012

Mental Health and Substance Use

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Cognitive impairment is one factor known to affect people's ability to participate in substance misuse treatment because of the range of cognitive, behavioural and emotional problems such impairment can cause. Some of the behaviours described as common features of cognitive impairment, such as impaired selfmonitoring and self-regulation and lack of initiative are seen in some treatment modalities to be causes and consequences of addiction thereby prescribing a moral rationale to behaviour that may have a physical cause. The aim of this study was to identify the prevalence of cognitive impairment in a rural Australian substance treatment in-patient population. The Addenbrook's Cognitive Examination -Revised (ACE-R) was used to screen consenting patients (n ¼ 50). Six (12%) scores were less than or equal to 82 (moderate to severe cognitive impairment), and 20 (40%) were less than or equal to 88 (mild to moderate cognitive impairment). Statistical techniques were used to determine if cognitive impairment was related to different demographic variables. The tests showed that cognitive impairment was not related to age or gender, weakly related to level of education and strongly related to Indigenous status. For example, 82% of Indigenous clients had a score indicating possible impairment, compared to 28% for non-Indigenous. A significant number of people attending in-patient drug and alcohol treatment have some form of cognitive impairment that may affect their ability to participate in the treatment. Indigenous people in rural substance treatment services appear highly likely to have some cognitive impairment. However, further work is required to ensure the screening tool is appropriate for use with Indigenous Australians. Substance misuse treatment providers need to ensure treatment programmes are suitable for people with cognition problems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The prevalence of cognitive impairment in a rural in-patient substance misuse treatment programme

Allan¹,

Kemp

Golden³

2012

Mental Health and Substance Use

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“…Structural and functional brain changes may occur after substance misuse (Broyd, van Hell, Yücel, & Solowij, in press;Caplan, Epstein, Quinn, Stevens, & Stern, 2007;Ersche & Sahakian, 2007;Gonzalez, 2007;Gruber, Silveri, & Yurgelun-Todd, 2007;Lorenzetti, Solowij, & Yücel, in press;Oscar-Berman & Marinkovic, 2007;Scott et al, 2007). Traumatic brain injury (TBI) is also highly prevalent in substance misuse populations, leading to significant complexities in the process of AOD treatment (Sacks et al, 2009;Solomon & Malloy, 1992;Walker, Cole, Logan, & Corrigan, 2007;West, 2011).…”

Section: Introductionmentioning

confidence: 99%

The Montreal Cognitive Assessment (MoCA) is Sensitive to Head Injury and Cognitive Impairment in a Residential Alcohol and Other Drug Therapeutic Community

Marceau

Lunn²,

Berry

et al. 2016

Journal of Substance Abuse Treatment

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The Montreal Cognitive Assessment (MoCA) is sensitive to head injury and cognitive impairment in a residential alcohol and other drug therapeutic community AbstractIntroduction: Retaining clients in residential alcohol and other drug (AOD) treatment is difficult and cognitive impairment has been identified as a significant predictor of treatment dropout. The application of extensive screening for cognitive impairment is cost-prohibitive for most AOD treatment services. The current study aimed to explore cognitive functioning and impairment-associated factors in a typical sample of residential AOD clients using a free brief screening tool that could be utilised by front-line AOD services. Methods: Residents of an AOD therapeutic community (n = 128) and a non-substance using control group (n = 37) were administered a brief cognitive screening measure, the Montreal Cognitive Assessment (MoCA). MoCA total and domain scores were compared between these groups and within the AOD group examined in association with primary substance of misuse, severity of dependence, gender, psychological distress, and history of head injury. Results: Almost half (43.8%) of the AOD sample were identified as cognitively impaired, compared to 16.2% of the control group. Furthermore, 67.2% of the AOD sample had sustained head injuries and 50% of the sample required hospitalization for head injury. History of head injury was a significant determinant of cognitive impairment, and associated with greater levels of psychological distress. Conclusions: There are high rates of inter-related cognitive impairment, head injuries, and psychological distress among clients in residential AOD treatment. Routine screening of clients at intake for cognitive impairment by means of a brief screening measure such as the MoCA, in combination with the assessment of history of head injuries and comorbid psychological disorders, could inform treatment modifications or adjunct interventions to increase retention and improve long-term outcomes. Abstract IntroductionRetaining clients in residential alcohol and other drug (AOD) treatment is difficult and cognitive impairment has been identified as a significant predictor of treatment dropout. The application of extensive screening for cognitive impairment is cost-prohibitive for most AOD treatment services. The current study aimed to explore cognitive functioning and impairmentassociated factors in a typical sample of residential AOD clients using a free brief screening tool that could be utilised by front-line AOD services. Methods Residents of an AOD therapeutic community (n = 128) and a non-substance using control group (n = 37) were administered a brief cognitive screening measure, the Montreal Cognitive Assessment (MoCA). MoCA total and domain scores were compared between these groups and within the AOD group examined in association with primary substance of misuse, severity of dependence, gender, psychological distress, and history of head injury. Results Almost half (43.8%) of the AOD sample were identified ...

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Ethics and Practice of Research with People Who Use Drugs

Allan

2017

Handbook of Research Methods in Health Social Sciences

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Co-Morbidity of Substance Abuse and Traumatic Brain Injury

Cited by 34 publications

References 23 publications

The prevalence of cognitive impairment in a rural in-patient substance misuse treatment programme

The prevalence of cognitive impairment in a rural in-patient substance misuse treatment programme

The Montreal Cognitive Assessment (MoCA) is Sensitive to Head Injury and Cognitive Impairment in a Residential Alcohol and Other Drug Therapeutic Community

Ethics and Practice of Research with People Who Use Drugs

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