Abstract
Bombardier CH, Rimmele CT, Zintel H. The magnitude and correlates of alcohol and drug use before traumatic brain injury. Arch Phys Med Rehabil 2002;83:1765-73. Objective: To describe preinjury alcohol and drug use and opportunities for secondary prevention among persons with recent traumatic brain injury (TBI). Design: Survey. Setting: Acute inpatient rehabilitation program. Participants: A total of 142 (91%) of 156 consecutive admissions who met inclusion criteria and were screened. Interventions: Not applicable. Main Outcome Measures: Alcohol and drug use questionnaires, alcohol problem questions, toxicology results, readiness to change, and treatment preference questions. Results: Subjects were on average 37 years old, 80% were men, and 80% were white. Fifty-nine percent of the sample was considered “at-risk” drinkers and, as a group, subjects reported a high degree of preinjury alcohol-related problems. Thirty-four percent reported recent illicit drug use, and 42 (37%) of 114 cases with toxicology results were positive for illicit drugs. Motivation to change alcohol use correlated positively with greater self-reported alcohol consumption and problem severity. Most at-risk drinkers wanted to change on their own, whereas a minority were interested in treatment or Alcoholics Anonymous. Conclusion: Both alcohol abuse and drug use are common before TBI. Inpatient brain injury rehabilitation represents an important opportunity to identify and intervene in substance abuse problems. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
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