Lininger Monica R, Anastario Michael P, Specht Aaron, Firemoon Paula
Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States.
Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ, United States.
Front Public Health. 2025 Aug 13;13:1588332. doi: 10.3389/fpubh.2025.1588332. eCollection 2025.
Traumatic brain injury (TBI) is a significant public health concern, with disparities in prevalence and care access among Native Americans. The syndemic relationship between substance use and TBI remains underexplored in Native Americans who inject methamphetamine, a population at high risk for both conditions. This study examines the association between self-reported TBI and substance use patterns in a sample of Native Americans who inject methamphetamine.
In this cross-sectional study, 60 Fort Peck Tribal members who reported injecting methamphetamine were recruited. Data collection included anthropometric measures, a structured questionnaire (lifetime TBI history, health conditions, and substance use characteristics), and portable X-ray fluorescence to measure tibial lead (Pb) concentrations. Logistic regression analyzes assessed associations between self-reported TBIs and substance use patterns stratified by gender.
Self-reported lifetime TBI prevalence was 42%. Among females, cumulative years of sedative (OR: 1.3, 95% CI: 1.0-1.5) and cocaine use (OR: 1.3, 95% CI: 1.0-1.5) were associated with increased TBI reports. For males, hypertension (OR: 754.6, 95% CI: 10.7-53,294.1) was a significant predictor. Elevated tibial Pb levels were associated with increased TBI risk in both females and males.
Findings highlight the syndemic burden of substance use and TBI in Native Americans who inject methamphetamine. Gender-specific risk factors suggest targeted interventions are needed. The study underscores the need for increased representation of Native Americans in concussion research and supports implementing TBI screening within substance use treatment programs.
创伤性脑损伤（TBI）是一个重大的公共卫生问题，美国原住民在患病率和获得医疗服务方面存在差异。在注射甲基苯丙胺的美国原住民中，物质使用与TBI之间的综合征关系仍未得到充分研究，这一人群同时面临这两种情况的高风险。本研究调查了注射甲基苯丙胺的美国原住民样本中自我报告的TBI与物质使用模式之间的关联。
在这项横断面研究中，招募了60名报告注射甲基苯丙胺的福特佩克部落成员。数据收集包括人体测量指标、一份结构化问卷（终生TBI病史、健康状况和物质使用特征），以及用于测量胫骨铅（Pb）浓度的便携式X射线荧光法。逻辑回归分析评估了按性别分层的自我报告的TBI与物质使用模式之间的关联。
自我报告的终生TBI患病率为42%。在女性中，镇静剂使用的累积年限（比值比：1.3，95%置信区间：1.0 - 1.5）和可卡因使用（比值比：1.3，95%置信区间：1.0 - 1.5）与TBI报告增加有关。对于男性，高血压（比值比：754.6，95%置信区间：10.7 - 53294.1）是一个显著的预测因素。胫骨Pb水平升高与女性和男性的TBI风险增加有关。
研究结果突出了注射甲基苯丙胺的美国原住民中物质使用和TBI的综合征负担。特定性别的风险因素表明需要有针对性的干预措施。该研究强调了在美国原住民脑震荡研究中增加其代表性的必要性，并支持在物质使用治疗项目中实施TBI筛查。
