Comparative Effectiveness of a Brief Intervention for Alcohol Misuse Following Traumatic Brain Injury: A Randomized Controlled Trial

Purpose/Objective: Compare the effects of an adapted Screening, Education, and Brief Intervention (Adapted SBI) for alcohol misuse following traumatic brain injury (TBI) to a Screening and Education with Attention Control (SEA) condition. Study Design: A single-masked, parallel group, randomized controlled trial was conducted with 58 participants who were 18 and older, sustained a TBI requiring inpatient rehabilitation, had a history of alcohol misuse, were English-speaking, cleared posttraumatic amnesia, were free of language impairments precluding participation in the intervention, and who provided informed consent. Outcomes were collected at 3, 6, and 12 months postdischarge. The primary outcome was drinks per week at 12 months postdischarge. Results: Participants in both conditions reduced alcohol use following their injury. The number of drinks per week at 12 months did not differ between the treatment conditions; the number of drinks consumed across the entire sample was very low (median = 0). A lower percentage of participants in the Adapted SBI condition resumed alcohol use by 12 months postdischarge (32% vs. 62% in the SEA condition, p < .05). No significant differences were found on other outcomes (binging, facts recalled about the negative effects of alcohol, drug use). The inclusion of a booster session did not appear to alter the intervention effects. The interventions did not impact other healthy behaviors, however healthy eating and stress management practices were associated with abstaining from alcohol use at the 12-month follow-up. Conclusions/Implications: While alcohol misuse generally declines postinjury, by 12 months postdischarge many individuals resume alcohol use. Adapted SBI may slow the resumption of alcohol use. Impact and Implications One-third to one-half of individuals who have sustained a moderate-severe traumatic brain injury (TBI) have a history of alcohol misuse and are at risk for resumption of hazardous alcohol use postinjury. Screening and Brief Interventions (SBI) are the standard of care for preventing the resumption of alcohol misuse following traumatic injuries, however, prior studies indicated limited effectiveness when used with persons with TBI. While the current study did not find an effect for the primary outcome (amount of alcohol consumed each week), the study demonstrated that an Adapted SBI accommodated to cognitive problems can be effective in decreasing the likelihood that an individual will resume any alcohol use during the year following inpatient rehabilitation for TBI.

Automated summary

The adapted Screening, Education, and Brief Intervention (Adapted SBI) may help slow the resumption of alcohol use following traumatic brain injury (TBI), but did not significantly impact the amount of alcohol consumed each week.