Alcohol Use Disorder and Traumatic Brain Injury

Alcohol Research: Current Reviews, 2018 · DOI: · Published: January 1, 2018

Simple Explanation

Alcohol use and traumatic brain injury (TBI) are inextricably and bidirectionally linked. Alcohol intoxication is one of the strongest predictors of TBI, and a substantial proportion of TBIs occur in intoxicated individuals. An inverse relationship is also emerging, such that TBI can serve as a risk factor for,or modulate the course of,alcohol use disorder (AUD). Critically, alcohol use after TBI is a key predictor of rehabilitation outcomes, prognosis, and additional head injuries.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Alcohol intoxication is a strong predictor of TBI, with 30-50% of TBI patients intoxicated at the time of injury.
2
TBI can serve as a risk factor for developing AUD, especially if the injury occurs during childhood.
3
Alcohol use after TBI is associated with poorer rehabilitation outcomes, increased risk of subsequent head injuries, and higher mortality rates.

Research Summary

This review provides a general overview of the bidirectional relationship between TBI and AUD and a discussion of potential neuropsychological and neurobiological mechanisms that might underlie the relationship. TBI has long been closely associated with acute alcohol intoxication. Most studies estimate that between 30% and 50% of patients treated for TBI were intoxicated at the time of injury, with even greater intoxication estimates for patients injured in motor vehicle accidents and assaults. Tere are special considerations for treating co-occurring AUD and TBI. As already mentioned, people who have TBI may be disproportionately vulnerable to negative consequences of alcohol misuse.

Practical Implications

Screening and Intervention

The initial period of abstinence after TBI presents a 'window of opportunity' for screening and intervention for AUD.

Tailored Treatment Protocols

AUD treatment protocols must be tailored to address the cognitive deficits, impaired emotional regulation, and difficulty focusing attention that are common after moderate to severe TBI.

Comorbid Psychiatric Disorders

Treatment for comorbid psychiatric disorders, particularly addiction, is more challenging in patients with a history of TBI, but treatments targeting both PTSD and comorbid alcohol dependence produced greater reductions in symptoms for both disorders than treatments for either condition alone.

Study Limitations

1
Difficulties in establishing a causal relationship between adult TBI and AUD due to confounding factors.
2
Patients with AUD after TBI are more likely to be lost to follow-up in studies.
3
Limited research on the efficacy of drugs approved for AUD treatment in the TBI population.

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