Traumatic brain injury (TBI) and substance use disorders (SUDs) frequently co-occur. Individuals with histories of alcohol or other drug use are at greater risk for sustaining TBI, and individuals with TBI frequently misuse substances before and after injury. Further, a growing body of literature supports the relationship between comorbid histories of mild TBI (mTBI) and SUDs and negative outcomes. Alcohol and other drug use are strongly associated with risk taking. Disinhibition, impaired executive function, and/or impulsivity as a result of mTBI also contribute to an individual’s proclivity towards risk-taking. Risk-taking behavior may therefore, be a direct result of SUD and/or history of mTBI, and risky behaviors may predispose individuals for subsequent injury or continued use of substances. Based on these findings, evaluation of risk-taking behavior associated with the co-occurrence of SUD and mTBI should be a standard clinical practice. Interventions aimed at reducing risky behavior among members of this population may assist in decreasing negative outcomes. A novel intervention (Substance Use and Traumatic Brain Injury Risk Reduction and Prevention (STRRP)) for reducing and preventing risky behaviors among individuals with co-occurring mTBI and SUD is presented. Areas for further research are discussed. 1. Introduction Traumatic brain injury (TBI) and substance use disorders (SUDs) frequently co-occur. Individuals with histories of alcohol or other drug use are at greater risk for sustaining TBI, and individuals with TBI frequently misuse substances pre- and post-injury [1–6]. Research suggests that members of general population who consume alcohol are at four times the risk of sustaining a TBI than those who do not [2]. Up to 75% of TBIs are incurred when individuals are intoxicated [2, 7]. These figures are not surprising given that alcohol use is implicated as a risk factor for injury resulting from motor vehicle accidents, falls, and/or violence. Further support for the link between intoxication and serious injury exists due to factors such as poor motor control, impaired decision making, vulnerability to victimization, or propensity toward belligerent/aggressive behaviors secondary to substance use. Moreover, prior history of a SUD, regardless of the presence of intoxication at time of injury, is a risk factor for morbidity and excessive use following injury [8]. Postinjury substance using behaviors are also problematic [9–11]. While a decrease in alcohol and other drug use and higher rates of abstinence have been observed immediately after
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