A typology of alcohol use patterns among persons with recent traumatic brain injury or spinal cord injury: implications for treatment matching.

OBJECTIVE: To describe empirically valid and clinically meaningful types of alcohol use among persons with recent traumatic brain or spinal cord injury.

DESIGN: Cross-sectional cohort survey.

SETTING: Acute inpatient rehabilitation program in a level I trauma center.

PARTICIPANTS: A total of 218 (87%) of 250 consecutive initial admissions who met inclusion criteria and completed interviews.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Alcohol and drug use questionnaires, alcohol problem questions, admission toxicology results, readiness to change, and treatment preference questions.

RESULTS: Participants were on average 37 years old, 84% were men, and 82% were white. Four types were identified by using k-means cluster analysis based on preinjury alcohol consumption, alcohol problems, and alcohol dependence. Cluster groups differed on extrinsic variables such as drug use, readiness to change, and interest in treatment or in attending Alcoholics Anonymous. The 4 types corresponded to those with a history of (1) alcohol abuse; (2) alcohol dependence; (3) alcohol dependence in remission, partial remission, or relapsed; and (4) normal or nondrinkers.

CONCLUSION: More effective care may be possible if clinicians match common patient types to specific interventions such as education, motivational interventions, formal substance abuse treatment, and relapse prevention.