title: Use of psychoactive substances in persons with spinal cord injury: a literature review.
abstract: OBJECTIVE
  To undertake a critical review of literature on use of legal and illegal psychoactive substances (PAS) in persons with spinal cord injury (SCI) before and after trauma.
  
  
  METHODS
  Hundred and five articles published between 1980 and 2014 on alcohol and drug use in persons with SCI before and after trauma were retrieved from the PubMed and PsycInfo search engines.
  
  
  RESULTS
  Before injury, 25% to 96% of people with SCI reported using alcohol, while 32% to 35% had used illegal drugs. At the time of injury, 31% to 50% of individuals with SCI were intoxicated with alcohol, 16% to 33% with drugs and 26% with a combination of drugs and alcohol. Among those reporting PAS use before injury, up to 50% stated that they had reduced their use during active rehabilitation, during which time only 6% consumed psychoactive substances for the first time. A variety of risk factors are associated with consumption subsequent to spinal cord injury: personality alteration (impulsiveness, aggressiveness), posttraumatic depression, poor coping skills, lack of social support and pain. PAS use can affect the process of rehabilitation, diminish the effectiveness of medication and result in various medical complications.
  
  
  CONCLUSIONS
  Few studies have explored the use of alcohol, drugs and psychoactive medications before SCI and during active rehabilitation. To our knowledge, no study has analyzed the evolution of PAS use after hospital discharge, even though return home is associated with new stressors that may trigger risky behaviors. It should be a priority, as early as possible during rehabilitation, to detect persons at risk of developing PAS abuse.
authors.affiliation: Centre de réadaptation en dépendance de l'Estrie, 1930, rue King Ouest, Sherbrooke (Quebec) J1 J 2E2, Canada. Electronic address: mtetrault.crde@ssss.gouv.qc.ca.
authors.forename: M
authors.initials: M
authors.lastname: Tétrault
authors.affiliation: Université du Québec à Montréal, CP 8888, succursale centre ville, Montréal, Québec, H3 C 3P8 Canada.
authors.forename: F
authors.initials: F
authors.lastname: Courtois
mesh_terms: D006801:Humans; D015995:Prevalence; D011619:Psychotropic Drugs / Q000009:adverse effects; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology
chemical_list: D011619:Psychotropic Drugs
keywords: Active rehabilitation; Facteurs de risque; Home return period; Lésion médullaire; Prevalence; Prévalences; Retour à domicile; Risk factors; Réadaptation fonctionnelle; Spinal cord injury; Substance use disorders; Troubles liés à l’utilisation d’une substance