Carolyn Lemsky, Ph.D.,C.Psych  ABPP/ABCN

Clinical Director

Community Head Injury Resource Services (CHIRS)


Is it okay to drink alcohol after a brain injury?

There’s a lot of good reasons to think very carefully about using alcohol or other drugs after a brain injury.  Most people have been told not to drink for the first year or two by their doctor.  People often ask what they should do after that.  It’s a personal choice, but we usually tell people that it’s generally best to avoid alcohol.   Here’s a few of the good reasons not to use alcohol after brain injury:

  • A lot of people have problems with being impulsive after brain injury—saying and doing things that they later regret.  Alcohol seems to reduce inhibitions too.  We know people are generally more likely to get into trouble while they are drinking, add a brain injury into the picture and the problem is even worse.
  • Drinking and other drugs can interfere with medications you are taking.  Sometimes the combination of medications and alcohol is downright dangerous.  It isn’t safe to stop medications so that you can drink.  Talk to your doctor about this.
  • Alcohol can increase the likelihood of a seizure.
  • Alcohol can have a damaging effect on the brain—that can really slow down your rehabilitation progress
  • Alcohol often has the effect of making problems with speech and balance worse.   Using alcohol can put you at risk for a fall.
  • Alcohol is a depressant. That means it can make symptoms of depression worse.  It may seem like it helps with boredom, but in the long-run problems with mood will get worse if you use alcohol or other drugs.


Have a look at this interesting resource from the people at the Ohio Valley Center for Brain Injury Prevention and Rehabilitation:


Who is at risk of developing a substance abuse problem after a brain injury?

The research tells us that about 20% of people living with the long-term effects of brain injury will develop a new problem with substance use post-injury.  We also know that as many as a third of all people who have a brain injury had some problematic substance use before they got hurt.  It turns out that brain injury is a risk factor for misusing substances and misusing substances is a risk factor for having a brain injury.

Its not all about getting addicted to alcohol.  Sometimes the problem is when a person uses alcohol occasionally, but gets hurt or has problems other during the times that they are using.  Having said that, people who have the most consistent and severe problems after brain injury with substance use tend to be people who used alcohol before injury and/or have problems with self-regulation (being impulsive) following their injury.  Boredom and depressed mood also seem to play a role putting someone at risk for having problems with alcohol after injury.


Why is there such a high incidence of substance abuse among individuals with a brain injury?

It seems to be the combination of problems with self-control after brain injury and the fact that people often have trouble getting back to things that they find productive and interesting.  The best prevention and the best treatment is finding meaningful engagement.


How do I know if someone has a substance abuse problem?

The short answer is that someone is having a problem with substance use if something bad or unwanted happens when they use the substance.  I’ve known folks that after one beer become disinhibited  enough to do something someone found offensive and they later regretted.  They might get arrested or into an argument or fight.

If you’re worried about yourself or someone else’s substance then here’s a few good resources to look at.


What services are available in Toronto for people with substance abuse problems?

The Center for Addiction and Mental Health (CAMH)has a range of services.  They are partners in the Substance Use and Brain Injury (SUBI) project.  Getting an appointment will help you to get help.  Vist for more information.


What is involved in the treatment of a substance abuse problem?

There are a variety of programs out there.  There’s a limited number of inpatient rehabilitation programs (where you sleep in the treatment program).  There are group, self-help programs like AA, and professionally supervised programs that provide individual and group counseling.  There’s enough different types of programming that people who want services can often choose what they think would help the most.  The important thing is to make an appointment for an assessment if you have concerns.


How can family/friends/caregivers help?

GET INFORMATION.  It may seem backwards, but the first thing to do is to get help for yourself if you are worried about someone’s substance use.  That can help you to be more helpful to the person you care for.  The CAMH website is a great resource for that.  They can help you learn to express your concerns in a way that will be encouraging, avoid putting yourself at risk and do what you can to help your loved one get the care they need.