At-risk substance use and substance use disorders

Rehabilitation professionals working with people who have incurred a traumatic brain injury (TBI) cannot avoid the issue of alcohol and other drug use. This chapter provides a review of past and current research on TBI and the use of alcohol and other drugs. It describes injury-related characteristics with implications for later rehabilitation including pertinence for prognostication. The chapter summarizes the research on TBI and at-risk substance use in rehabilitation patients and describes the impact on long-term outcomes. It presents a brief summary of what is known about these co-occurring conditions in other treatment settings and at-risk populations. The chapter reviews the treatment studies that have specifically addressed substance use disorders following TBI is followed by presentation of a theoretical model for conceptualizing treatment goals based on severity of the conditions and settings for intervention. It discusses the best practices for clinical use in rehabilitation using the model as a framework.