Alcohol and traumatic disability.

Abstract

Corrigan (1995) reviewed the literature on alcohol and TBI and found that preinjury alcohol abuse or dependence ranged from 16 to 66%. The most rigorous studies and those conducted in rehabilitation settings produced the highest prevalence rates, between 44 and 66%. People with SCI reported greater than average preinjury alcohol consumption, and 35-49% reported a history of significant alcohol problems (Bombardier & Rimmele, 1998a).Much larger studies of preinjury alcohol problems have been conducted on general trauma patients. Rivara et al. (1993) found that 44% of consecutive trauma admissions scored in the "alcoholic" range on a brief screening measure. In another study, 24% of all admissions met diagnostic criteria for current alcohol dependence (28% for men and 15% for women; Soderstrom et al., 1997). Alcohol IntoxicationAnother indication of alcohol-related problems among people with TBI or SCI is alcohol intoxication (blood alcohol level greater than 100 mg/dL) at the time of injury. In the seven studies he reviewed, Corrigan (1995) found that rates of alcohol intoxication ranged from 36% to 51% among patients with TBI. Alcohol intoxication rates for SCI reported in the literature are 40% (Heinemann, Schnoll, Brandt, Maltz, & Keen, 1988) and 36% (Kiwerski & Krasuski, 1992). Among general trauma patients, Rivara et al. (1993) found that 47% had a positive blood alcohol level and that 36% were intoxicated.

Alcohol abuse history and adjustment following spinal cord injury.

“…Our results indicate that the MAST appears to be a useful instrument in SCI rehabilitation (Bombardier, 2000). Elevated scores on the MAST seem to be indicative of potential secondary complications among persons with recent-onset SCI (total scores Ͼ 11).…”

Professional standards of practice for psychologists, social workers, and counselors in SCI rehabilitation

“…risk of mental health problems and secondary medical complications. 20 Moreover, healthy adaptation to SCI often requires increased self-regulation and enormous behavior change. The person has to learn and maintain skin checks, pressure releases, vigilance to urinary tract infections and respiratory illnesses, exercise, dietary modifications and stress management.…”

“…The National Registry of Evidence-based Programs and Practices (http://www.nrepp.samhsa.gov) and the National Institute for Health and Care Excellence (http://www.nice.org.uk) maintain vetted lists of EBTs. Clinicians should consult sources of expert opinion regarding how to adapt EBTs to people with SCI, for example in the areas of coping with disability, 41 sexual dysfunction, 42 substance use, 20 and psychotherapy in general. 43 Psychologists, social workers, and counselors may also be responsible for the design, management, evaluation, monitoring and coordination of team-implemented psychosocial interventions.…”

Examining the Influence of Mild Traumatic Brain Injury and Posttraumatic Stress Disorder on Alcohol Use Disorder in OEF/OIF Veterans

“…Of Veterans seeking VA services during 2009, about 20% who had sustained a TBI also had a comorbid substance-disorder diagnosis.1 Regard less of civilian or Veteran samples, treatment recommenda tions are clear that using alcohol after a brain injury should be avoided because it can delay healing and increase the risks of seizures and additional brain injuries. 29 Because of the independent relationships between alcohol use and mTBI and PTSD, in addition to the high comorbidity between mTBI and PTSD, research has begun to examine the combined effects of PTSD and mTBI on alcohol use. Similar to other research on mTBI and PTSD, results are equivocal.…”