The relationship of spinal cord injury trauma to alcohol misuse: A study of monozygotic twins

Background: Substance misuse frequently is correlated with serious trauma such as spinal cord injury (SCI). Two hypotheses to this effect are (a) substance abuse predates injury and is a risk factor or trigger for serious injury such as SCI; or (b) substance abuse begins postinjury, and alcohol or other drugs are used to ameliorate the physical and emotional distress that result from SCI. Methods: To test these two hypotheses, 14 pairs of monozygotic twins, in which 1 of each pair had sustained an SCI, were studied. The twin without SCI was used as a control for preinjury substance misuse status for the twin with SCI. Results: No significant differences between SCI and non-SCI co-twins' substance use patterns were found. Conclusion: These findings suggest that drinking patterns might not be significantly affected by SCI and that substance misuse might precede injury.