Traumatic Brain Injury and Addiction in the Military

The Centers for Disease Control and Prevention (CDC) defines a traumatic brain injury (TBI) as a disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury. Everyone is at risk for a TBI, especially children, and older adults. It’s also a common injury in the military. 

Traumatic brain injury as a battlefield wound was unheard of not too long ago. As explains, “Before modern-day medical advancements, speedy battlefield treatments, and advanced armor were developed, most people who suffered these types of injuries rarely survived. Today, however, TBI is becoming a more common injury among military members as well as the general public. Most reported military TBI cases are related to improvised explosive devices or IEDs.” 

There are different types of TBI: focal and diffuse. A focal injury occurs in a specific location, while a diffuse injury occurs over a more widespread area of the brain. There are mild, moderate, and severe TBIs and symptoms can be cognitive, physical, or behavioral. Symptoms of posttraumatic stress disorder (PTSD) trauma and TBI trauma can be very similar. A TBI often closely mimics PTSD, with the exception of nightmares and intrusiveness. 

The military screens anyone suspected of a TBI:

  • Who has been in a vehicle that was damaged by a blast
  • Within 50 meters of a blast
  • Within a structure hit by an explosive device
  • Who sustained a direct blow to the head or experienced a loss of consciousness
  • Who is directed to be screened by their command

There is only limited evidence that TBI can increase drug or alcohol use in persons with no histories of significant substance misuse prior to the injury. However, repetitive head trauma has been associated with depressive symptoms, worsening cognitive function, and suicide.  

A 2019 study, co-authored by Brandeis University scientist Rachel Sayko Adams, shows that soldiers with traumatic brain injuries often endure unbearable emotional suffering after returning from Afghanistan and Iraq. “Traumatic brain injury (TBI) has been called the ‘signature injury’ of combat veterans returning from the Iraq and Afghanistan wars,” reported Brandeis Now. “As many as 23 percent of veterans of these conflicts return home with a TBI as a result of an explosion, objects hitting their heads, falls, or other causes.” The Brandeis study suggested that veterans with moderate or severe TBI are more than twice as likely as those without a TBI to die by suicide. 

TBI is frequently not the only battlefield injury. PTSD, witnessing or participating in extreme acts of violence, and chronic pain caused by serious physical injuries may induce the urge to self-medicate these wounds with drugs and alcohol. As with civilians, trauma, depression, and anxiety are strongly correlated with substance use disorder (SUD).    

Due to the nature of their profession, our men and women in uniform face an elevated risk of developing mental health conditions or a SUD. Multiple deployments, combat exposure, and related injuries such as TBI can be extreme stressors increasing the risk of misusing addictive substances. Due to a high incidence of physical injury, members of the military are at risk of addiction to opioid pain relievers. Nearly one in four active-duty service members had at least one prescription for an opioid at some point in 2017, according to Defense Department data. 

The Farley Center at Williamsburg Place proudly helps our men and women in uniform who struggle with substance use disorders. Members of the US military who develop health problems can rely on a healthcare program known as TRICARE. Farley has a lot of experience working with the command structure and healthcare provisions of the US military. A significant percentage of Farley patients have TRICARE coverage. That is quite different from many other addiction treatment centers that don’t take TRICARE at all or are unable to handle TRICARE cases directly—mostly because they are unfamiliar with the provisions of the program.

If you or someone you know is struggling with substance use and could benefit from addiction treatment services, please contact The Farley Center at 800.582.6066 or fill out our admissions request form.




See also Moral Injury and Addiction in the Military