Concussion, sensation-seeking and substance use among US adolescents

Abstract

Background

No large-scale epidemiological survey of adolescents in the US has assessed the association between lifetime history of concussion, propensity toward sensation-seeking, and recent substance use. Methods: This study assesses the association between lifetime history of diagnosed concussions, sensation-seeking, and recent substance use (i.e., cigarette use, binge drinking, marijuana use, illicit drug use, and nonmedical prescription drug use) using the 2016 and 2017 Monitoring the Future study of 25,408 8th, 10th, and 12th graders. Results: Lifetime diagnosis of concussion was associated with greater odds of past 30-day/2-week substance use. Adolescents who indicated multiple diagnosed concussions (versus none) had two times greater odds of all types of recent substance use, after adjusting for potential confounding factors. Adolescents indicating multiple diagnosed concussions also had higher adjusted odds of cigarette use, binge drinking, and marijuana use) when compared to adolescents who only indicated one diagnosed concussion. Accounting for adolescents’ propensity toward sensation-seeking did not significantly change the association between substance use and multiple diagnosed concussions. Conclusions: This study provides needed epidemiological data regarding concussion and substance use among US adolescents. Exposure to a single diagnosed concussion is associated with a modest increase in the risk of substance use and this association increases with the accumulation of multiple diagnosed concussions. These associations hold when controlling for sensation-seeking. Substance use prevention efforts should be directed toward adolescents who have a history of multiple concussions.

Keywords:

• Concussion
• substance use
• adolescents

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

Philip T. Veliz conceptualized the study and discussed the study design with all coauthors. Dr. Veliz interpreted the data, drafted the initial manuscript and all subsequent drafts of the manuscript, and approved the final manuscript as submitted.

Sean E. McCabe reviewed and revised the manuscript, and approved the final manuscript as submitted.

James T. Eckner reviewed and revised the manuscript, added comments to the first draft, and approved the final manuscript as submitted.

John E. Schulenberg helped oversee collection of the data; he helped analyze and interpret the data, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Additional information

Funding

The development of this manuscript was supported by research grants from the National Institute on Drug Abuse [L40DA042452, R01DA031160, R01DA036541, and R01DA001411], National Institute of Child Health and Human Development [K23HD078502], and National Cancer Institute [R01CA203809], National Institutes of Health. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.