The natural history of drinking and alcohol-related problems after traumatic brain injury

Objective: To describe changes in drinking from before traumatic brain injury (TBI) to 1 year after TBI. Design: Inception cohort with 1-year follow-up. Setting: Level I trauma center. Participants: Adults (N=197) hospitalized with a broad range of head injury severity. Interventions: Not applicable. Main Outcome Measures: Alcohol consumption and alcohol-related problems. Results: Drinking and alcohol-related problems decreased substantially from preinjury to 1 year after TBI. However, about one quarter of the sample reported heavy drinking, significant problems, or both during the first year after TBI. Preinjury alcohol use and problems were highly predictive of heavy use and problems after TBI. Conclusion: Although drinking and alcohol-related problems decreased after TBI, there appears to be an ongoing need for prevention and intervention efforts. Screening for preinjury alcohol problems can be used to identify the vast majority of persons who will develop alcohol-related problems within 1 year after injury.