Research Reports - Alcohol and drug use before and during the first year after traumatic brain injury

J Head Trauma Rehabil. 2017 Sep 18. doi: 10.1097/HTR.0000000000000341. [Epub
ahead of print]

Beaulieu-Bonneau S(1), St-Onge F, Blackburn MC, Banville A, Paradis-Giroux AA,
Ouellet MC.

OBJECTIVES: To compare individuals with mild and moderate/severe traumatic brain
injury (TBI) on alcohol and drug use and substance use disorders before and in
the first year post-TBI; to explore sociodemographic and injury-related variables
associated with substance use disorders.
PARTICIPANTS: A total of 225 adults hospitalized in a level I trauma center after
DESIGN: Observational cohort study with retrospective (pre-TBI) and prospective
(4, 8, and 12 months post-TBI) assessments.
MAIN MEASURES: Mini International Neuropsychiatric Interview for Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
RESULTS: The percentage of participants using alcohol or drug declined shortly
after the injury (4 months) but increased closer to preinjury levels by the end
of the first year. Post-TBI alcohol use was higher after mild than
moderate/severe TBI, but drug use was similar. About 11% of participants met
criteria for a substance use disorder in the first year after TBI. Younger age,
not being in a relationship, and suspected substance intoxication at the time of
TBI were associated with the presence of a post-TBI substance use disorder.
CONCLUSION: Individuals with milder injuries return to alcohol use earlier than
those with more severe injuries. Given that substance use may alter recovery,
preventive recommendations and systematic follow-ups are warranted regardless of
injury severity and access to rehabilitation. 

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