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Traumatic brain injuries (TBI) have been linked with substantial behavioral and emotional outcomes like aggression suppression and impulse control, notable factors associated with offending. Of importance is understanding accentuating factors post-TBI, such as alcohol usage which potentially increases psychosocial deficits and offending risk, as limited research has analyzed compounding factors and their impact on post-TBI individuals. Implementing data from multiple waves of Pathways to Desistance study of 1,354 juveniles to young adults, this study seeks to understand the relationship of alcohol usage following head injuries on behavioral outcomes of suppressed aggression and impulse control as well as the rate of self-reported offending. Findings suggest that individuals who suffer a head injury and then engage in alcohol use have substantially worse impulse control and aggression suppression compared to those with either risk factor individually. Further, these deficits appear to indicate that head injury is mediated by alcohol and increases self-reported offending. The study contributes to research on the impact of alcohol and TBI in humans.