Put down the drink; Alcohol use after a concussion can prolong symptoms in collegiate athletes

Chang RC, Singleton M, Chrisman SPD, et al. Alcohol use after injury is associated with prolonged recovery from concussion in NCAA athletes. Clin J Sport Med. Published online 2023:1-8. doi:10.1097/JSM.0000000000001165

https://journals.lww.com/cjsportsmed/Abstract/9900/Postinjury_Alcohol_Use_Is_Associated_With.142.aspx

Take home message

Collegiate athletes can experience long-lasting concussion symptoms if they consume alcohol during recovery. The severity of symptoms may not differ among those who consume alcohol during recovery.

Background

Concussions lead to immediate and variable symptoms that affect quality of life. Many collegiate athletes consume alcohol regularly, but there is no consensus regarding the effects of alcohol consumption after a concussion on symptoms.

Study aim

The authors used a prospective cohort to assess whether alcohol consumption after concussion is associated with resolution of concussion symptoms. The authors also evaluated the impact of alcohol consumption on symptom severity.

Methods

The authors used data from the ongoing Concussion Assessment Research and Education (CARE) Consortium. The authors analyzed data from 29 different clinical sites and 484 of 3,518 athletes with concussion. An athlete who reported consuming at least one alcoholic beverage per week during concussion recovery was considered an alcohol user. The authors used the Sport Concussion Assessment Tool 3 (SCAT3) symptom score sheet to track outcomes after concussion.

Results

Athletes who drank alcohol after a concussion took an average of 22 days to return to full participation in sports. This represents a 33% delay in return to play compared to those who did not consume alcohol after injury. On average, those who drank alcohol after a concussion needed about five additional days to return to full-time sports. Additionally, the more alcohol consumed after the concussion, the longer it took for symptoms to resolve. Alcohol consumption had no influence on the severity of symptoms.

Viewpoints

This study clarifies previous research on the relationship between post-concussion alcohol use and delayed symptom resolution. The delay in symptom resolution may contribute to deconditioning among those who have consumed alcohol after a concussion, which could hinder their willingness to contribute to team success. Interestingly, alcohol consumption after an injury does not play a role in the severity of symptoms, according to this study. This suggests that alcohol may slow the healing process rather than causing additional tissue damage. While these results are important, this study did not standardize a “drink.” Therefore, there is a possibility that different types and volumes of alcohol consumed per drink could influence symptom resolution. Furthermore, the authors focused on less than 15% of athletes with a concussion. Therefore, it will be important to replicate these findings to see if they apply to the broader athletic concussion population.

Clinical implications

In practice, physicians should encourage athletes diagnosed with a concussion to reduce alcohol intake or, ideally, to abstain from alcohol consumption until symptoms resolve. Clinicians should also educate athletes about the role alcohol consumption after injury plays in prolonging concussion symptoms.

Questions for discussion

What strategies, if any, do you use to educate athletes about alcohol consumption after a concussion? What changes do you plan to make to patient education based on this research?

related posts

1. Gender-specific predictors of long-term recovery from concussion
2. Suggested answer to the most common question about concussions: How many days until I can play?
3. Concussion: Is Submaximal Exercise Medicine?

Written by Cade Watts
Reviewed by Jeffrey Driban