Postinjury Alcohol Use Is Associated With Prolonged Recovery After Concussion in NCAA Athletes

Chang RC, Singleton M, Chrisman SPD, et al. Postinjury Alcohol Use Is Associated With Prolonged Recovery After Concussion in NCAA Athletes. Clin J Sport Med. Published online 2023:1-8. doi:10.1097/JSM.0000000000001165

Take-Home Message

Collegiate athletes may experience prolonged concussion symptoms when they consume alcohol during recovery. Symptom severity may not differ in those who consume alcohol during recovery.


Concussions lead to immediate and variable symptoms impacting quality of life. Many collegiate athletes regularly consume alcohol, but no consensus exists regarding the effects of post-concussion alcohol intake on symptoms.

Study Goal

The authors used a prospective cohort to assess whether post-concussion alcohol consumption is related to concussion symptom resolution. The authors also evaluated the impact of alcohol consumption on symptom severity.


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 out of the 3,518 athletes with a concussion. An athlete who reported consuming at least one alcoholic drink 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 post-concussion outcomes.


Athletes who consumed alcohol post-concussion took an average of 22 days to return to full sport participation. This represents a 33% delay in return to play compared to those who consumed no alcohol post injury. On average, those who consumed alcohol after a concussion took approximately five additional days to return to full sports participation. Furthermore, the more alcohol consumed post-concussion, the longer symptom resolution took. Alcohol consumption did not impact symptom severity.


This study clarifies previous research exploring the relationship between post-concussion alcohol consumption and delayed symptom resolution. The delay in symptom resolution may contribute to deconditioning among those who consumed alcohol post-concussion, which could impede their readiness to contribute to team success. Interestingly, post-injury alcohol consumption, according to this study, plays no role in symptom severity. This suggests alcohol may slow the healing process rather than causing additional tissue damage. However, while these results are important, this study did not standardize a ‘drink’. Therefore, a possibility exists that different types and volumes of alcohol consumed per drink may impact symptom resolution. Furthermore, the authors focused on less than 15% of athletes with a concussion. Hence, it will be important to replicate these findings to see if they apply to the broader athletic population with a concussion.

Clinical Implications

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

Questions for Discussion

What strategies, if any, do you use to educate athletes on post-concussion alcohol consumption? Based on this study, what changes do you plan to make to patient education?

Related Posts

  1. Sex-Specific Predictors for Prolonged Concussion Recovery
  2. Proposed Answer to Most Common Concussion Question: How Many Days Until I Can Play?
  3. Concussions: Is Submaximal Exercise Medicine?

Written by Cade Watts
Reviewed by Jeffrey Driban

Evidence-Based Assessment of Concussion Course - 5 EBP CEUs