Effects of the injury can also become more difficult to cope with under the influence of alcohol. For these reasons, drinking alcohol is generally discouraged after brain injury.
This page discusses how alcohol affects the brain after brain injury. It also offers tips for managing an alcohol-free lifestyle. Finally, it discusses the professional support available if you are affected by this issue.
The effect of alcohol after brain injury
Brain injury generally reduces a person’s tolerance to alcohol. This means that a brain injury survivor can become much more sensitive to its effects.
Even drinking a smaller amount than someone did before their brain injury can worsen effects of the injury such as memory problems, behavioural issues, depression or anger. This happens because the chemical processes that take place after drinking alcohol happen much faster in brain injury survivors than in non-injured people. They therefore may get ‘drunk’ a lot faster than others with no brain injury.
Possible complications of drinking alcohol
Increased risk of accidents
Alcohol can generally increase the risk of people having accidents, for example causing people to walk unsteadily and therefore being at risk of falling. It can also cause people to engage in more risky behaviour, such as jumping from a height. People may become more disinhibited after drinking alcohol, for example shouting or swearing more and possibly even getting into fights. Brain injury survivors can be at greater risk of having such accidents after drinking alcohol due to their reduced tolerance.
The effects of their injury may also cause them to be at increased risk of accidents, for example if they have mobility issues from the injury that are worsened under the influence of alcohol, causing them to be at greater risk of falling.
These types of accidents can also cause head injuries, potentially resulting in a second brain injury for survivors. In fact, research finds that many people admitted to hospital with a head injury were under the influence of alcohol at the time of the accident.
Interference with coping strategies
Many people learn to use coping strategies to manage the effects of their brain injury. Drinking alcohol might interfere with the ability to use these strategies effectively.
For example, a brain injury survivor who struggles to manage their anger might become unable to use their coping strategy of moving away from the triggering situation while under the influence of alcohol. They might therefore have an anger outburst that become difficult to manage.
Seizures
Heavy alcohol use has been found to cause seizures in some people. Alcohol can also lower the threshold for seizures in people who have developed post-traumatic epilepsy.
Seizures can also be caused by sudden withdrawal from regular alcohol use. This happens because the brain attempts to restore balance to its delicate chemical processes but ends up overcompensating. It is therefore very important to get professional support when attempting overcome alcohol dependence. More information on this is available in the section Getting professional help for alcohol after brain injury, below.
Mood disorders
Some people use alcohol to cope with mood disorders such as depression and anxiety, as alcohol can have a temporary relaxing effect. However, long-term use of alcohol has been found to cause mood disorders to develop and worsen existing mood disorders.
Unfortunately, mood disorders such as depression and anxiety can develop after brain injury for a number of reasons. Alcohol may therefore worsen these experiences in brain injury survivors.
Alcohol might also interact negatively with mood disorder medication that a brain injury survivor might be taking. It is always extremely important to check medication information sheets/labels before drinking alcohol.
“After sustaining my brain injury and spending over four months in hospital, doctors advised me not to drink alcohol. During this time I found I no longer needed to drink alcohol to make me feel good or enjoy myself. I certainly don’t need the headaches it causes.”
How to manage an alcohol-free lifestyle after brain injury
We understand that many people drink alcohol as part of their lifestyle for a number of reasons, and this can make it difficult to adjust to an alcohol-free lifestyle.
Below we share some tips for coping, many of which have been suggested by brain injury survivors themselves.
Explore non-alcoholic drinks - non-alcoholic sparkling drinks or juices might be a good substitute, while many places now serve non-alcoholic beers, ciders or ‘mocktails’.
Identify why you like to drink - consider the underlying reasons of why you like to drink alcohol. Is it part of a cultural celebration, for socialising or to feel more relaxed? Being able to identify why you drink might help you to find alternative strategies. For example, if you enjoy a quiet drink at the end of a busy day, find an alternative non-alcoholic drink to enjoy at this time.
Help others around you to understand why you are not drinking - share information about brain injury with others to help with removing any social pressures to drink. Many people assume that once a brain injury survivor has left hospital, they are ready to resume life ‘as normal’. Teaching people about the effects and impact of brain injury can help in situations where others may be expecting you to drink with them.
Ask others to support you - ask friends and others in your life to support you by offering non-alcoholic drinks when you visit, stopping drinking themselves or not drinking around you. Find new activities to enjoy together that do not involve drinking alcohol.
Stay positive - even if people in your life do not support you with not drinking, try to stay positive about your decision, as ultimately you know best about your brain injury and how you might feel if you give into pressure.
“There’s nothing wrong with ordering a fancy coffee or mocktail either.”
Tips for managing if you do still drink alcohol
Limit yourself - if you do decide to drink, limit yourself to one or two drinks a night. Ask family and friends around you to help with keeping track of this and encouraging you to stop.
Make travel arrangements - never drive after drinking, even if you think you are below the national alcohol limit. Remember that your brain will be more sensitive to the effects of alcohol, even if you have stayed within the legal drinking limit. Make travel arrangements in advance, for example getting a lift home from someone you trust or sharing a taxi with a friend.
Drink sensibly - if you do decide to drink, stick to one type of alcoholic drink rather than mixing drinks, and eat some food before you start. Food slows down the rate of alcohol absorption by lining the stomach. Meals containing healthy fats, such as fish, can be particularly good at slowing down alcohol absorption rates. Drink slowly, pace yourself, and drink glasses of water in between.
Don’t drink alone - avoid drinking on your own, as it can be difficult to keep track of how many drinks you have had and can cause you to feel even worse. Have people around you so that they can offer support if needed.
Keep a ‘drink diary’ - this way you can have a visual record of how much you drink, which can help with monitoring how much you can tolerate as well as how alcohol has made you feel. There are several apps and tools that are designed to help people with tracking how much they drink, which you might wish to explore.
Getting professional help for alcohol after brain injury
Some brain injury survivors may have a difficult time giving up entirely on alcohol, or they may be unable to understand that they have a reduced tolerance to it. In such cases, it might be necessary to get professional support.
If you are not sure whether you need professional support, you can take a simple online test on Drink Aware’s website. This test will assess your drinking behaviour and give you information about whether you should seek professional support. Do note however that the assessment does not factor a brain injury in, so you might still need to get expert input. You can also contact the national Drinkline helpline for advice on 0300 123 1100.
If you are drinking alcohol as a way to cope with the brain injury, it might be helpful to get professional support for dealing with the impact of your injury. Talk to your GP about getting a suitable referral.
There are a number of organisations that have been set up to support people with alcohol addiction issues, listed at the bottom of this page. Whilst these services can provide helpful information and support, it is important to remember that these will not necessarily specialise in supporting people with brain injury.
There may also be local alcohol addiction services in your area that can help. You can search for this on the NHS’ services directory.
Useful organisations
The following organisations can provide information, support or guidance on managing alcohol addiction, although do note that they may not be specialised in supporting people with brain injury, and advice may therefore need to be more carefully tailored to your personal circumstances. Headway does not endorse the following organisations and they are included for general awareness only.
The organisations listed below are provided for information purposes only. Their inclusion does not imply endorsement, recommendation, or approval by Headway. Users should make their own assessment of any organisation or service before engaging with them.
This information was produced with expert input from brain injury survivors, Dr Anya Topiwala, Senior Clinical Researcher and Consultant Psychiatrist at Oxford Health NHSFT and Dr Subha Vandabona, Consultant in Rehabilitation Medicine at Leicester General Hospital.
This information was last reviewed in 2026.
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