Alcohol abuse after traumatic brain injury: Experimental and clinical evidence

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Article reviews the existing clinical and animal evidence indicating that traumatic brain injuries (TBIs), particularly those that occur early in development, increase the lifelong propensity for alcohol abuse and discusses the potential underlying neurobiological mechanisms. Substance abuse is a major problem in this vulnerable patient population and a greater understanding of the underlying biology has the potential to greatly improve outcomes. The evidence for modulation of drinking behavior after TBI and the costs of problem drinking after TBI from both a biomedical and economic perspective is examined. The authors also review the existing animal models of drinking after brain injury and consider the potential underlying psychosocial and neurobiological mediators of this phenomenon. In particular, the potential interactions among TBI, neuroinflammation, and alcohol abuse are highlighted. Brain injury survivors, particularly those injured early in life are very likely to abuse drugs and alcohol later in life. Alcohol abuse following TBI is associated with poorer rehabilitation outcomes and greatly increased chances of suffering future head trauma. Thus, substance abuse among people with brain injury reduces the chances for positive long-term outcomes and greatly increases the societal costs.

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