Date Presented 04/20/2023

This study explored drug and alcohol use among people with traumatic brain injury (TBI) in both rural and urban areas. Study findings suggest that people with TBI from families reporting unmet needs engaged in more frequent substance use.

Primary Author and Speaker: Steven Wheeler

Additional Authors and Speakers: Amanda Acord-Vira

Traumatic brain injury (TBI) is one of the leading causes of death and disability in the United States affecting millions each year. TBI occurs when an individual sustains a direct hit, blow, or jolt to the head that alters the normal functioning of the brain (Centers for Disease Control and Prevention [CDC], 2022a). The use of substances, including alcohol or illicit drugs, can be seen pre-injury, at the time of injury, or during recovery as a coping mechanism, and ultimately influence a person’s quality of life and ability to engage in appropriate roles and daily activities.

PURPOSE: The purpose of this study is to analyze the impact and frequency of substance use among persons with traumatic brain injuries and the various contextual factors which influence recovery and quality of life (Corrigan et al., 2012).

DESIGN: A non-experimental correlations research design was utilized for the study.

METHOD: Data was reviewed for 54 subjects. Individuals with TBI and their caregivers completed a series of surveys and questionnaires: 1) Demographic information; 2) the Family Needs Questionnaire (FNQ); 3) Satisfaction with Life Scale (SWLS); and 4) the Mayo-Portland Adaptability Inventory (MPAI). SPSS was used to determine descriptive statistics and differences among variables.

RESULTS: Persons with TBI whose family members / caregivers reported their needs as ‘not being met’ on the FNQ were significantly more likely to report substance use (both alcohol (p=.05) and drug use (p=.02)) at a level considered more than ‘occasional.’ Furthermore, individuals living in urban settings reported a non-significant increase in the number of needs ‘not being met.’

CONCLUSION: The findings of the study indicate that individuals from families reporting a greater number of unmet needs since injury, were also more likely to be engaged in coping strategies involving substance use.


Centers for Disease Control and Prevention. (2022). Injury prevention & control: Traumatic Brain Injury & Concussion. Retrieved June 6, 2022, from

Corrigan J. D., Adams, R. S., & Dams-O’Connor, K. (2012). At-risk substance use and substance use disorders among persons with traumatic brain injury. In: N. D. Zasler, D. I. Katz, R. D. Zafonte, D. B. Arciniegas, M. Ross Bullock, & J. S. Kreutzer (Eds.), Brain injury medicine: Principles and practice (3rd ed.). New York: Demos Medical Publishing.