The Frontal Cortex Connection: TBI and Drug Abuse
The long-term effects of traumatic brain injury are at long last being acknowledged and researched in our society, partly due to the media’s attention to the severity and consequences of this injury to football players in the NFL. We are realizing the extent in which these injuries play a part in affecting the daily lives of the people who experience them. Although there is no way to totally prevent these injuries from occurring, research can help us understand how to treat and care for these patients in the long-term as well as possibly predict what effects each injury will have on a particular patient based on what area of the brain has been affected by the injury. In this article we will explore how the location of the brain injury may affect drug abuse.
According to the National Institute on Drug Abuse (National Institute on Drug Abuse National Institutes of Health, 2016), the “reward pathway” of the brain involves several areas which are highlighted in the image: the ventral tegmental area (VTA), the nucleus accumbens, and the prefrontal cortex. When this pathway is stimulated by things like food, sex, drugs, etc., information travels from the VTA to the prefrontal cortex and we feel the euphoric effects throughout the brain. PET imaging allows scientists to see which areas of the brain are more or less active after introducing a drug into our system.
The prefrontal cortex in the frontal lobe is the area of the brain that is most often damaged by both brain injury and substance abuse. This lobe of the brain controls problem solving skills, judgement, organization, attention, concentration, awareness, personality, emotions, planning, inhibition, and initiation. This lobe is highlighted in yellow in the second image.
Therefore, it is understandable when the brain is injured in this most susceptible area it may affect someone’s ability to have good impulse control and decision-making abilities. Any associated memory loss and mood swings may cause someone who has previously been addicted to drugs to continue to be use, and someone who has never been addicted to drugs to be more susceptible to using and ultimately abusing them. (Boucher, 2016)
What does this have to do with criminal cases?
Both drug use and traumatic brain injury are associated with criminal activity. A review of the defendant’s past medical records by a medical expert will assist in understanding their condition, as well as identify any markers for drug use and abuse. In some cases, examination by a forensic psychiatrist is also beneficial and will aid the attorney in litigating the case.
Boucher, C. (2016, January 27). NAADAC: The Association for Addiction Professionals. Retrieved November 25, 2019, from naadac.org: https://www.naadac.org/assets/2416/2016_01_27_treating_suds_in_brain_injury_survivors_v2.pdf.
National Institute on Drug Abuse National Institutes of Health. (2016, February). www.drugabuse.gov. Retrieved November 25, 2019, from National Institute on Drug Abuse (NIDA): https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/.