The National Head Injury Foundation (NHIF) appointed a task force in 1987 to study the role of substance abuse in head injury. The task force founda significant link between substance abuse (particularly alcohol) and the occurrence of head injury. Recent findings suggest that a significant number of head trauma survivors have been substance abusers and return to the use of alcohol and other drugs. The implications of preinjury history of and return to the use of substances following head injury are not now fully understood. Treatment issues are paramount, yet few treatment models exist. Training and education of both head injury and substance abuse professionals is needed.