• Kolakowsky-Hayner SA, Gourley EV, 3rd, Kreutzer JS, Marwitz JH, Meade MA and Cifu DX (2002). Post-injury substance abuse among persons with brain injury and persons with spinal cord injury. Brain Inj. 16 (7): 583-92. Summary: PRIMARY OBJECTIVE: To identify the patient population at greatest risk for post-injury adjustment problems, the present study independently examines and compares alcohol and drug use rates in patients with traumatic brain injury (TBI) and patients with spinal cord injury. Research design: The two samples were matched with regard to age, gender and mechanism of injury. The study provides a description of post-injury use rates for each population, and describes similarities and differences between the two groups. Methods and procedures: Participants included 30 consecutive Model Systems spinal cord injury (SCI) patients seen for follow-up neuropsychological testing between October 1996-June 1999. An equivalent number of Model Systems TBI patients were matched from a larger sample comprised of 440 consecutive hospital admissions, that returned for a 1-year follow-up neuropsychological evaluation between February 1989-December 1998. All participants were treated in an urban Level I trauma centre and associated inpatient rehabilitation programmes. Information regarding patient demographics, as well as pre- and post-injury psychiatric, employment, academic, criminal, and medical history was obtained via the General Health and History Questionnaire. Main outcomes and results: With regard to post-injury alcohol use rates, persons with spinal cord injury were more likely to drink on a daily basis. Although not statistically significant, pre-injury drinking rates differed from post-injury rates for both groups. With regard to illicit drug use, persons with TBI differed significantly from persons with SCI. A significant difference was also noted between pre-injury drug use and post-injury drug use for both groups. CONCLUSIONS: Persons who drink post-injury are unlikely to be 'light' or social drinkers. Either people choose to abstain completely or appear to use alcohol frequently. Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia, USA.