Brain Injury and Opioid Misuse

In recent years, opioid misuse has become a significant public health challenge, with many unwanted consequences, including an intersection with brain injury. Opioid use disorder increases the risk for brain injury.

Individuals who are addicted to opioids and/or survive overdose can experience brain damage because of lack of oxygen to the brain. Those who misuse substances are also more susceptible to brain injuries caused by falls and violence. Additionally, growing evidence suggests that individuals with brain injuries may be uniquely susceptible to opioid use disorder as a result of their struggles with chronic pain, pre- and post-injury addiction, neurobehavioral challenges, medication mismanagement, and difficulty accessing effective treatment.

Brain injury impacts an individual’s ability to concentrate, remember, plan, problem-solve, and self- regulate. These neurocognitive challenges leave individuals with brain injury less equipped to participate in and benefit from conventional substance abuse treatment and more likely to experience treatment failures. In fact, research suggests that those with a history of brain injury need adaptations to their treatment as well as long-term support in order to succeed. They also benefit from being connected to specialized brain injury services and resources.


The Pennsylvania Department of Health is partnering with the Brain Injury Association of Pennsylvania (BIAPA) to raise awareness of the intersection of brain injury and opioid misuse and to provide training and consultation to substance abuse providers and professionals who work with individuals struggling with opioid misuse and/or addiction.


By increasing both knowledge and awareness of this issue, we hope to build the capacity of professionals who come into contact with individuals with both substance use disorder and brain injury to identify and treat both problems successfully. This program will also highlight statewide resources.


  • Raise awareness of the intersection of brain injury and substance misuse
  • Provide training to providers and professionals who work with individuals with substance abuse disorder and/or brain injury
  • Offer assistance to providers who want to develop their ability to identify, treat, and/or refer individuals with both brain injury and substance abuse disorder.


Contact: Tara DiGuilio 717-753-5619


Resource for Clinicians:

Substance Use and Brain Injury Client Workbook:

SUBI Client Workbook 2nd Edtion Parts 1 and 2

SUBI Client Workbook 2nd Edition Parts 3 & 4

SUBI Client Workbook 2nd Edition Closing and Appendix


SUBI Project Team Second Edition (2021)

Community Head Injury Resource Services of Toronto:

Carolyn Lemsky, PhD, CPsych, ABPP/ABCN, Clinical Director

Center for Addiction and Mental Health:

Tim Godden, MSW, RSW, Advanced Practice Clinician

National Association of State Head Injury Administrators (NASHIA):

Maria Crowley, MA, CRC-Consultation, Editing, and Design



In the video below, Chris, who received an anoxic brain injury from a Fentanyl overdose, and his mother, Andrea, share how their lives have changed as a result.