- Up to 32% of individuals with TBI are alcohol dependent within two years after injury, and up to 20% are dependent on an illicit substance7.
- About 21% of individuals maintained total abstinence from alcohol following a TBI8.
- Alcohol is the most heavily abused substance both prior to and following TBI9.
- For many individuals with TBI, it is more difficult to access and utilize substance use treatment due to other complications related to their injuries3. This may be related to a multitude of factors, including poor access to transportation, residual cognitive difficulties such as memory, language, or attention deficits, or financial limitations.
For those who are able to access treatment, critical aspects of successful treatment include:
- Identifying risk factors, use patterns, and obstacles to recovery
- Routine monitoring of substance use
- Involvement of family members and friends in treatment
- Education of patient and family members
- Emphasize prevention
- Avoid harsh treatment following relapses
- Promote learning through presenting material in a variety of modalities
- Praise incremental progress
- Recognize and prepare for relapses, which are inevitable for most people
- Access local resources such as AA
- Utilization of peer-based support
- Development of drug-free social and recreational activities
- Carefully weigh pros and cons of referring for outpatient and inpatient substance abuse treatment programs.6
References
- Kolakowsky-Hayner, S., Gourley, E., Kreutzer, J., Marwitz, J., Meade, M., & D. Cifu (2002). Post-injury substance abuse among persons with brain injury and persons with spinal cord injury, Brain Injury, 16, 583–592.
- West, S. (2011). Substance use among persons with traumatic brain injury: A review. NeuroRehabilitation, 29, 1-8.
- Taylor, L., Kreutzer, J., Demmand, S., & M. Meade (2003). Traumatic brain injury and substance abuse: a review and analysis of the literature, Neuropsychological Rehabilitation, 13, 165–188.
- Corrigan, J. (1995). Substance abuse as a mediating factor in outcome from traumatic brain injury, Archives of Physical Medicine and Rehabilitation, 76, 302–309.
- Kelly, M., Johnson, C., Knoller, N., Drubach, D., & M Winslow (1997). Substance abuse, traumatic brain injury and neuropsychological outcome, Brain Injury, 11, 391–402.
- Bogner, J., Corrigan, J., Mysiw, W., Clinchot, D., & L. Fugate (2001). A comparison of substance abuse and violence in the prediction of long-term rehabilitation outcomes after traumatic brain injury. Archives of Physical Medicine & Rehabilitation, 82, 5, 571-577.
- Hall, K., Karzmark, P., & M. Stevens (1994). Family stressors in traumatic brain injury: a two-year follow-up. Archives of Physical Medicine Rehabilitation, 75, 876-884.
- Ponsford, J., Whelan-Goodinson, R., & A. Bahar-Fuchs (2007). Alcohol and drug use following traumatic brain injury: A prospective study. Brain Injury, 21, 13-14, 1385-1392.
- Horner, M., Ferguson, P., Selassie, A., Labbate, L., Kniele, K., & J. Corrigan (2005). Patterns of alcohol use 1 year after traumatic brain injury: A population-based, epidemiological study. Journal of the International Neuropsychological Society, 11, 322-330.