Addiction in the context of personal injury claims

Addiction, such as increased alcohol consumption and substance abuse, following an accident is often reported. In theory, there is no reason why a negligent third party cannot be liable for losses resulting from trauma induced alcohol dependency or excessive alcohol consumption (1) or indeed other substance abuse.

It is also known that individuals suffering from a traumatic brain injury (TBI) are more likely to drink more alcohol post TBI than before (2). It is also well known that self-medicating with alcohol and/or drugs is a well-recognised symptom of Post Traumatic Stress Disorder. However, where an injured person is reporting such issues, causally linking them to the accident is not likely to be straightforward.

Any history of substance abuse or addictive behaviour before an accident is likely to make it extremely difficult to prove that a subsequent accident is the sole or main cause of current problems. A full and complete history of any pre-accident addiction issues will need to be taken.
Where a client has a previous history of on and off alcohol and/or drug dependency, it may be possible to identify a pattern of when excess alcohol consumption and/or illicit drug use tends to occur. This could be where a client is having relationship or family issues, is out of work, or unable to partake in their usual activities. Where this is the case, a psychiatric expert will be able to comment on whether the accident has caused a further relapse.
Generally, if a client has an active psychological condition, such as PTSD, or, alternatively, a brain injury then the development of problems with addiction or a relapse of pre-existing problems can be more easily explained.
Clients are likely to be embarrassed about such behaviours and will probably keep any addiction problems secret and not volunteer information. It is often the case that clients with these problems tend to go quiet for periods of time when it is difficult to establish contact to take instructions.
Medical records will need to be carefully reviewed. Substance abuse is not always picked up if incidents are not serious. Multiple attendances at A&E for minor injuries is often an indication that there are other issues at play.
It will be sensible to ask clients directly if they are experiencing any issues, as part of routine enquiries. If problems are identified, then good proactive case management with the right treatment could lead to recovery or stop things from escalating.
Picking up issues early in the claim will also help to establish a timeline of the onset of problems rather than matters only coming to light perhaps a year or more after the accident when causation may be harder to establish. It can be the case that the first notification of a problem is when matters have progressed to the point where the addiction can no longer be concealed.
If addiction problems are left untreated, then this is likely to reduce the level of compensation payable unless it is possible to show that they are entirely caused by the accident. If, for example, the brain injury improves or the underlying psychological issues are successfully treated, the addiction issues may continue if not also treated.
Addiction and the problems that go with it are likely to reduce the damages recovered unless they can be linked directly to the accident. For example, it will be argued that future employment prospects will be curtailed by addiction rather than ongoing injury symptoms.
A client with ongoing addiction issues is also likely to be more at risk of ending up with a criminal record from risky behaviours or being involved in other accidents. A reduction in life expectancy from addiction is also probable thus shortening working life in any event.
If a client had addiction problems before the accident, it may still be possible to deal these issues afterwards. This could potentially add substantial value to the claim if a successful recovery is made. In such a case, thought could be given to a general interim payment so that the client can enter a suitable rehabilitation programme, even if the cost of this treatment cannot be recovered as damages.
Thought should also be given to the problems that a seriously injured client may have if there is a history of previous addiction. Such clients are likely to have a heavier reliance on alcohol or illicit drugs as a form of pain management. They may experience an increase in pain if they try to suddenly decrease their use or stop. Such clients are also more likely to have problems with prescription medication. Close management of a pain programme by treating clinicians should be considered.

Those representing seriously injured clients will want to:

Be aware of existing addiction issues. Untreated addiction problems are likely to reduce the damages awarded unless it can be show that they are entirely related to the claim.
Keep medical records under close review for any signs of a problem with addiction from an early stage.
Try to engage directly and frankly with the client. Criminal convictions and future accidents, even if addiction issues are causative, will be problematic when trying to recover future losses.
Consider a holistic programme of rehabilitation where all problems are identified and treated.