There are multiple reasons why alcohol and other drug use after traumatic brain injury is not recommended. The substance abuse education series "User's Manual for Faster, More Reliable Operation of a Brain after Injury" (Ohio Valley Center, 1994) enumerates eight reasons:
There is mounting evidence about the adverse effects of alcohol and other drug use after traumatic brain injury. Several studies have observed an association between use and such unwanted outcomes as unemployment, living alone and feeling isolated, criminal activity and lower life satisfaction (Sherer et al., 1999; Corrigan et al., 1997; Kreutzer et al., 1996; Kreutzer et al., 1991; Corrigan et al., 2003). While these studies have observed associations, the causal links or processes have not been fully explained.
There are also studies suggesting an "additive effect" on brain structure and function for substance abuse and traumatic brain injury (Barker et al., 1999; Baguley et al., 1997; Bigler et al., 1996). One example is the study by Ian Baguley and colleagues from Australia (see graph below). Their 1997 study of event-related evoked potentials (an indication of how fast the brain detects new stimuli) showed a clear additive effect of heavy social drinking and traumatic brain injury requiring hospitalization. Those subjects who had either of these conditions were slower responding then people with neither; and those with both were slower still.
The answer to this question requires multiple considerations. First, there are many reasons why it is not safe to consume illegal drugs, including their interactions with prescribed drugs or other medical conditions, the potential for being arrested, the proven greater vulnerability to injury or being victimized, and last but not least the potential for additional brain damage from these uncontrolled substances.
Alcohol – because it is a legal substance for adults – presents a more complex question. Our starting point is that certainly no one should consume more alcohol after traumatic brain injury than would be considered safe for an adult who had not. Many people do not realize that for adult men under age 65 it is recommended that no more than two alcoholic drinks should be consumed each day. For men over age 65 and for women, the recommended maximum is one drink per day (reference NIAAA website).
So the question becomes after traumatic brain injury should an individual drink even these amounts? Based on information about how alcohol and traumatic brain injury add together to change brain structure and function, we believe that there is no safe amount. We suspect that especially during the early period of recovery – the first several years when the brain is attempting to spontaneously heal and otherwise accommodate the injury – alcohol can inhibit these natural processes.
This website has been funded with financial assistance from Grant #H133A120086 awarded by the U.S. Department of Education, National Institute on Disability Rehabilitation Research (NIDRR) to the Ohio Valley Center for Brain Injury Prevention and Rehabilitation for the current funding period of 10/01/2012 - 09/30/2017.