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A Comparison of Alcohol and Drug Use Rates

Individuals with Traumatic Brain Injury and Individuals with Spinal Cord Injury

Categories: Substance Abuse

The Question

How do alcohol and drug use rates compare for individuals with traumatic brain injury and individuals with spinal cord injury?

Past Studies

Past Studies show that alcohol and drug use are both a risk factor and an obstacle to rehabilitation for individuals with traumatic brain injury and individuals with spinal cord injury. Researchers have identified higher rates of pre-injury alcohol and drug use and abuse for individuals from both injury groups compared to the general population. An increasing number of studies document the negative effects of alcohol and drug use after traumatic injury. For individuals with traumatic brain injury, continued alcohol and drug use is associated with increased rates of psychiatric disorders, arrest, aggression, and decreased return to work rates. Individuals with spinal cord injury that continue alcohol and drug use after injury are at increased risk for medical complications, death, depression, and less life satisfaction. At the time of this study, researchers had not compared post-injury alcohol and drug use patterns among individuals with traumatic brain injury and individuals with spinal cord injury.

This Study

This study included 30 individuals with traumatic brain injury and 30 individuals with spinal cord injury that had similar characteristics. The participants were from the Traumatic Brain Injury Model Systems and the Spinal Cord Injury Model Systems inpatient rehabilitation sites. The participants and/or their family members completed the General Health and History Questionnaire at their one-year follow-up appointments. The General Health and History Questionnaire is a tool used to obtain information about pre- and post-injury psychiatric, employment, criminal, and medical history. The researchers also obtained information about the individual’s alcohol and drug use.

The researchers found that 50% of the individuals from both injury groups did not use alcohol after their injury. However, the results show that individuals with brain injury and individuals with spinal cord injury are at high risk for alcohol abuse. The researchers found that 43% of individuals with brain injury and 41% of individuals with spinal cord injury were moderate or heavy drinkers. Individuals with spinal cord injury reported drinking on a daily basis; whereas, individuals with brain injury reported drinking three or four times per week. The rates of moderate and heavy drinking in both populations exceed that of the general population, which is 25%. Pre-injury, the individuals from both groups had higher rates of moderate and heavy drinking compared to the general population.

The rate of drug use after injury was alarmingly high for individuals with spinal cord injury. One in five individuals with spinal cord injury reported using drugs within the past year. In comparison, only one in twenty individuals with brain injury admitted to using drugs during that time period. Another major difference between the two groups was the rate of employment after brain injury. Only 25% of the individuals with traumatic brain injury were unemployed at their follow-up evaluation. In comparison, almost 90% of the individuals with spinal cord injury were unemployed. While the difference in employment rates may be explained by differences in injury characteristics, the reasons for the different rates of drug use between the two groups is unclear.

Who May Be Affected By These Findings

Individuals with traumatic brain injury, individuals with spinal cord injury, significant others, rehabilitation personnel, substance abuse specialists, researchers

Caveats

The researchers found that 50% of the individuals from both injury groups did not use alcohol after their injury. In comparison, only about one third of the general population does not use alcohol. These figures are the same as previously reported rates of post-injury drinking for individuals with brain injury, but higher than those usually reported for individuals with spinal cord injury. Of importance, a greater number of individuals that used alcohol before their injury did not drink alcohol after their injury. Evidently, the individuals followed their physicians’ advice and did not use alcohol after their injury.

Bottom Line

Fifty percent of individuals with traumatic brain injury and individuals with spinal cord injury did not drink alcohol after their injury. The rate of drug use after injury was alarmingly high for individuals with spinal cord injury. One in five individuals with spinal cord injury reported using drugs within the past year. In comparison, only one in twenty individuals with brain injury admitted to using drugs during that time period.

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Find This Study

Kolakowsky-Hayner, S. A., Gourley, III, E. V., Kreutzer, J. S., Marwitz, J. H., Meade, M. A., & Cifu, D. X. (2002). Post-injury substance abuse among persons with brain injury and persons with spinal cord injury. Brain Injury, 16, 583-592.

 

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