Given that alcohol can itself cause brain damage, it should come as no surprise that abstinence from alcohol is believed to be an important component in optimising recovery following brain injury. Whilst there is a paucity of studies examining the impact of alcohol use after traumatic brain injury (TBI) on outcomes, there are many reasons to expect that continuing alcohol misuse post brain injury is likely to be detrimental. As well as alcohol’s directly neurotoxic effect, it is generally accepted that alcohol use after brain injury can contribute to:
- Increased risk of seizures.
- Increased risk of further head injury.
- Diminished ability to benefit from rehabilitation.
- Exacerbation of cognitive impairments.
- Behavioural difficulties.
- Increased risk of depression (Kolakowsky-Hayner 2002).
The good news is that TBI often encourages individuals to address their alcohol problem: one year after TBI 30% of individuals were completely abstinent from alcohol compared to only 8.4% reporting abstinence pre-injury (Ponsford 2007) Unfortunately the effects appear to be transient and consumption generally increases again with time. Young males are most likely to return to drinking (Ponsford 2007, Kreutzer 1990). It is therefore crucial that brain injury rehabilitation services prioritise the identification and treatment of alcohol problems, capitalising on this tendency for the experience of a major life event such as a brain injury to trigger reflection on alcohol consumption and behavioural change. It should be emphasised that consumption levels which would be considered relatively low risk in the general population may be very detrimental following brain injury as explained above. Abstinence should be the ultimate goal although any reduction is beneficial.
Alcohol Consumption: How to Foster Behavioural Change
References
Kolakowsky-Hayner S, III EVG, Kreutzer JS, Marwitz JH, Meade MA, Cifu DX. Post-injury substance abuse among persons with brain injury and persons with spinal cord injury. Brain Injury. 2002;16(7):583-92.
Kreutzer JS, Doherty KR, Harris JA, Zaster ND. Alcohol use among persons with traumatic brain injury. J Head Trauma Rehabil. 1990;5(3):9
Ponsford J, Whelan-Goodinson R, Bahar-Fuchs A. Alcohol and drug use following traumatic brain injury: A prospective study. Brain Injury. 2007;21(13-14):1385- 92.