ArticlesThe magnitude and correlates of alcohol and drug use before traumatic brain injury☆,☆☆,★
Section snippets
Participants
Subjects were drawn from 203 consecutive inpatients with recent TBI. One hundred fifty-six persons met our inclusion criteria. Forty-seven were excluded for the following reasons: too cognitively impaired (n=18), non–English speaking (n=15), severe psychiatric disorder (n=6), younger than 18 years of age (n=3), not the initial rehabilitation admission (n=3), and discharged to homeless shelter or to prison (n=2). Of the 156 persons who met inclusion criteria, 144 (92%) were successfully
Definition of at-risk drinkers
This research is part of an ongoing treatment study. The treatment study has specific inclusion criteria that were devised to identify persons whose preinjury drinking pattern might place them at risk for alcohol-related problems generally.25 The inclusion criteria were as follows: (1) being a current drinker and scoring in the “alcoholic” range on the SMAST; (2) being intoxicated at the time of admission to the emergency room (BAL, ≥99mg/dL); or (3) having a recent history of “risky drinking,”
Discussion
The results of the present study are consistent with previous research on people who sustained TBI as well as on trauma survivors more generally. Both groups have high rates of alcohol use and alcohol-related problems before injury. In our sample, approximately one third were intoxicated at the time of injury. This rate of intoxication is slightly below the range reported in other studies of persons with TBI, that is, 36% to 51%.1 Alternatively, it is quite similar to the rate of intoxication
Conclusion
The results of the present study highlight the need for universal screening for drug and alcohol problems in acute rehabilitation settings. The data also describe the opportunity that exists for secondary prevention programs. Surgeons and other trauma specialists are recognizing the need to address the fact that alcoholism is the most common health problem among those who sustain trauma.30 Rehabilitation professionals are enjoined to recognize this silent epidemic as well and to consider
Acknowledgements
We thank Kristin Knight, for her help with data collection, as well as Susan Pilcher and the Harborview Trauma Registry.
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Cited by (0)
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Supported by the National Center for Injury Prevention and Control and the Disabilities Prevention Program, National Center for Environmental Health (grant no. R49/CCR011714-01). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Center of Injury Prevention and Control.
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No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
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Correspondence to Charles Bombardier, PhD, Dept of Rehabilitation Medicine, Box 359740, Harborview Medical Ctr, 325 9th Ave, Seattle, WA 98104, e-mail: [email protected]. Reprints are not available.