Postinjury Alcohol Use Is Associated with Prolonged Recovery after Concussion in NCAA Athletes

Roger C. Chang, Michael Singleton, Sara P.D. Chrisman, Christopher C. Giza, Ami Z. Cuneo, Natalia Murinova, Steven P. Broglio, Michael McCrea, Thomas W. McAllister, Tara L. Sharma*, April Marie Hoy, Joseph B. Hazzard, Louise A. Kelly, Justus D. Ortega, Nicholas Port, Margot Putukian, T. Dianne Langford, Ryan Tierney, Gerald McGinty, Patrick O'DonnellKenneth Cameron, Megan Houston, Steven Svoboda, Joshua Goldman, Holly J. Benjamin, Thomas Buckley, Thomas W. Kaminski, James R. Clugston, Julianne D. Schmidt, Luis A. Feigenbaum, James T. Eckner, Jason P. Mihalik, Jessica Dysart Miles, Scott Anderson, Christina L. Master, Anthony P. Kontos, Jeffrey J. Bazarian, M. Alison Brooks, Stefan Duma, Steven Rowson, Christopher M. Miles, Brian H. Dykhuizen, Laura Lintner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective:To determine whether alcohol use leads to prolonged clinical recovery or increased severity of concussion symptoms in National Collegiate Athletic Association (NCAA) athletes.Design:Prospective observational study.Setting:Clinical institutions.Participants:Athletes from the NCAA Concussion Assessment Research and Education consortium who sustained a concussion from 2014 to 2021.Interventions:Athletes were divided into 2 groups, those reporting alcohol use postinjury and those reporting no alcohol use postinjury.Main Outcome Measures:Symptom recovery was evaluated as time (in days) from injury to clearance to return to unrestricted play (days until URTP). Severity of concussion symptoms was assessed using the Standardized Sport Concussion Assessment Tool (SCAT3) symptom severity, headache severity, difficulty concentrating, and difficulty remembering scores. These scores were taken a median of 6.6 [interquartile range (IQR) = 4.0-10] and 6 (IQR = 4.0-9.0) days after injury for those who did and did not consume alcohol postinjury respectively and compared with baseline SCAT3 scores.Results:Four hundred eighty four athletes from the data set had complete data for exposure and outcome. The adjusted mean number of days until URTP for athletes reporting alcohol use postinjury [23.3; 95% confidence interval (CI), 20.0-27.2; days] was incidence rate ratio (IRR) 1.32 (95% CI, 1.12-1.55; P < 0.001) times higher than for athletes who reported no alcohol use postinjury [17.7 (95% CI, 16.1-19.3) days]. Postinjury alcohol was not associated with severity of concussion symptoms (P's < 0.05).Conclusion:Self-reported postinjury alcohol use is associated with prolonged recovery but not severity of concussion symptoms in collegiate athletes. This may inform future clinical recommendations regarding alcohol consumption after concussion.

Original languageEnglish
Pages (from-to)30-37
Number of pages8
JournalClinical Journal of Sport Medicine
Issue number1
StatePublished - 1 Jan 2024
Externally publishedYes


  • Brief Symptom Inventory
  • Standardized Concussion Assessment Tool
  • alcohol use
  • anxiety
  • collegiate athletes
  • concussion
  • depression
  • headache
  • return to play
  • traumatic brain injury


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