These abilities are often impaired by an acquired brain injury and therefore when people use alcohol or other drugs they are likely to experience even greater problems with alertness, memory, problem-solving and controlling their behaviour and emotions. Individuals who previously used alcohol and other drugs as a strategy for coping with stress or during social interaction are likely to return to using this strategy following the injury to cope with stress and to maintain social relationships. Alternatively, people may increase their use of these drugs as a means of coping with the enormous grief, stress and social isolation that they experience.

Taking illegal drugs after an acquired brain injury can have a number of implications in addition to the legal and financial issues. Firstly, the person may need to take prescription medication for pain, Epilepsy or mood disturbance. The illegal drugs may interact with this medication and cause serious complications. Secondly, similar to alcohol, many illegal drugs have an adverse effect upon a person’s ability to control behaviour, emotions and thinking. One particular concern relates to the risk of sustaining a further brain injury due to risk taking, distorted sensory perception and slow reaction time which are exacerbated by the use of alcohol and other drugs.

A common question asked is whether the use of alcohol and other drugs after an injury can cause further brain complications. Studies have suggested that the use of even ‘normal’ amounts of alcohol for people with a mild brain injury may be associated with poor neurological outcomes as indicated by brain scans, performance on neuropsychological tests and increased behavioural problems.

With regard to alcohol it is important that people initially spend time recognising changes in their Cognitive, emotional and behavioural functioning before testing how alcohol affects them after the injury. Many specialists recommend that people abstain from alcohol for at least one year after their injury. If people decide to have some alcohol it is suggested that they only drink a very small amount until they become aware of how alcohol now affects them and learn to recognise their personal limit, or the level that may be consumed without any risks or negative consequences, such as coordination problems, becoming aggressive or socially disinhibited. It may be beneficial to ask a close friend or family member to provide tactful feedback on what they observe. However, alcohol use can often become a sensitive issue where a person may not appreciate being told how much they should drink or whether they should drink at all.
Some people are strongly advised not to drink or take drugs at all after their injury due to particular medical conditions or the use of prescribed medication e.g. alcohol can lower the Seizure threshold for a person with epilepsy. For safety considerations people are encouraged to ask their doctor for advice on alcohol and drug use. Additionally, people may require an intervention or programme from alcohol and drug support services.

In making a decision on whether to keep drinking or using recreational drugs, consider the following points:

Someone with an ABI may have an alcohol or drug dependency for a number of reasons. They may have already had a dependency before acquiring the brain injury. The dependency may have arisen from trying to cope with depression and frustration during the recovery process. Or personality changes arising from impulsivity may mean the controls are lifted on what was once a safe usage.

Tell your loved one’s friends of the dangers of continued drinking or drug use after a brain injury. Get them to work with you on reducing or eliminating the problem. If the family member with a brain injury is still in a rehabilitation programme, advise the team and work with them to:

Be aware that since brain injury may lead to decreased judgment, poor memory, and difficulty in concentration, your family member may not listen to your advice. Sometimes the best way to prevent use of alcohol and other drugs is to make sure your family member has enjoyable activities and relationships to fill the day. Avoid the social isolation that can lead to substance abuse.

Talk with your family member about what he or she will do when friends offer alcohol, tobacco, or other drugs to him or her. Discuss ways of coping with stress and other problems in a positive way. Go over ways to have fun without drinking, smoking or taking other drugs.

Remove alcohol, tobacco, and other drugs from the house. If that isn’t possible, at least keep them away from the person with an acquired brain injury. Also keep an eye on over-the-counter drugs and substances that could be inhaled. Ask one doctor to take responsibility for all medications to prevent your family member from misusing or abusing prescription medications.

If drinking or using drugs is causing problems for someone you care about, you are not alone. Help your family member take charge of his or her life. You can talk with rehabilitation specialists and health educators, or attend support groups like Al-Anon and Nat-Anon. A good place to start is your State Brain Injury Association.


Copyright Brain Injury Association of Queensland, Inc, Australia, 2007. This is one of a range of fact sheets made available by the Brain Injury Association of Queensland. While all care has been taken to ensure information is accurate, these fact sheets are only intended as a guide and proper medical or professional advice and information should be sought. The Association will not be held responsible for any injuries or damages that arise from following the information provided in these fact sheets. You can visit the Association’s website at www.braininjury.org.au or send emails to This email address is being protected from spam bots, you need Javascript enabled to view it