Alcohol Use After Traumatic Brain Injury

      Alcohol use and traumatic brain injury (TBI) are closely related:
      • Nearly two-thirds of all people with TBI have a history of alcohol abuse or risky drinking.
      • Almost half of all people with TBI were injured while they were drunk.
      After TBI, your brain is more sensitive to alcohol. Even 1 or 2 drinks can put you in danger for negative health outcomes. Many people wisely stop drinking or cut down after a TBI.

      Facts about TBI and alcohol

      Alcohol and brain recovery

      • Recovery from TBI can continue for many years.
      • Alcohol slows down or stops your brain's recovery.
      • Not drinking is one way to give your brain the best chance to heal.

      Alcohol, brain injury, and seizures

      • TBI puts survivors at risk for developing seizures (epilepsy).
      • Alcohol can trigger seizures.

      Alcohol and the risk of having another brain injury

      • Having had 1 TBI increases your chances of having another TBI.
      • Alcohol, which affects coordination and balance, increases the risk of re-injury even more.
      • Not drinking can reduce the risk of having another TBI.

      Alcohol and mental functioning

      • Alcohol magnifies cognitive problems, like poor memory and inflexibility of thinking, caused by TBI.
      • The negative cognitive effects of alcohol can last from days to weeks after your last drink.
      • Not drinking is one way to keep your cognitive abilities sharp.

      Alcohol and mood

      • More than half of survivors of TBI will become depressed within 1 year of injury.
      • Alcohol is a depressant. It can worsen symptoms of depression and make antidepressants less effective.
      • Not drinking can improve mood or prevent depression.

      Alcohol and sexuality

      • Lowered sexual desire commonly occurs after TBI.
      • Alcohol use reduces sexual performance and satisfaction in men and women.
      • Alcohol reduces testosterone in men.
      • Not drinking can improve sexual functioning.

      Alcohol and medications

      • It is dangerous for you to drink when you are taking certain prescription medications, especially medications for anxiety or pain.
      • Overdose and death can occur if you drink alcohol while on certain medications.

      What should you do?

      There is no safe level of alcohol use after TBI. We recommend that you stop drinking to be safe and promote recovery. The next best thing is to cut down on your drinking as much as possible. If you don't want to stop or cut down, you can still take steps to reduce harm from drinking.

      How to stop or cut down

      Most people who stop drinking or cut down do so by themselves. Don't underestimate your ability to change if you want to do so.
      The key ingredients to changing your drinking habits are:
      • 1.
        Find people to support your efforts.
      • 2.
        Set a specific goal for reducing your drinking.
      • 3.
        Make concrete plans to meet that goal.
      • 4.
        Identify situations or emotions that can trigger drinking. Plan ways to avoid or cope with those triggers.
      • 5.
        Reward yourself for meeting your goals.
      If you have questions or concerns about your drinking, there are many ways to get help:
      • Take a confidential online drinking assessment (
      • Talk to your physician about your alcohol use.
      • Psychologists or other counselors in your TBI program can help you start to change.
      • Alcoholics Anonymous (AA) has helped millions of people. There are meetings in most towns and cities (
      • Moderation Management ( and Smart Recovery ( are alternatives to AA that do not use the 12-step model.
      • The Substance Abuse and Mental Health Services Administration (SAMHSA) is a federal program that can help you find a treatment facility (; 1-800-662-4357).

      How to reduce the harm from drinking

      • Eat food and drink water before you drink.
      • Avoid hard liquor; mix drinks with water rather than soda.
      • Never drink and drive.
      • Sip your drinks slowly and have no more than 1 drink per hour.
      • Drinking in bars slows some people down because of the expense.
      • Take vitamins B1 (thiamine), B12, and folate to reduce the chances of brain damage.
      • Keep your drinking to no more than 2 drinks per day, or cut back during certain times of the week, such as weeknights.
      • Take drinking holidays during which you don't drink at all; this can remind you of the benefits of sobriety.

      How family and friends can help

      No one can force another person to stop using alcohol, but family and friends can still have a positive influence. This is what they can do:
      • Seek support from others by attending Al-Anon Family Groups meetings.
      • Learn about an effective, positive approach to motivate loved ones to seek treatment called Community Reinforcement and Family Training (
      • Plan a meeting where family and friends tell the drinker about their concerns.


      This information is not meant to replace the advice of a medical professional. You should consult your health care provider regarding specific medical concerns or treatments.


      Our health information is based on research evidence and represents the expert consensus of the TBI Model System directors.


      Alcohol Use After Traumatic Brain Injury was developed by Charles Bombardier, PhD, in collaboration with the Model Systems Knowledge Translation Center. Copyright © 2011. May be reproduced and distributed freely with appropriate attribution.