Addiction can be extremely detrimental to an individual in many different domains, including brain functioning. A new study published in Alcohol and Alcoholism provides hope by suggesting that alcohol detox can greatly improve cognitive impairments within weeks.
Many people struggle with a substance use disorder. This can lead to a plethora of troubles with cognitive functioning, including lack of attention, impairments in executive functioning, memory loss, and more. Deficits in cognition have been linked to higher rates of relapse and more severe substance use disorder symptomology.
Despite this, there have been studies suggesting that some forms cognitive functioning can improve upon termination of use, but the factors affecting these improvements are not well understood. This study seeks to take a longitudinal approach to studying these cognitive improvements.
For their study, Bernard Angerville and colleagues utilized 32 participants who had severe alcohol use disorder and 32 healthy controls to serve as their sample. The alcohol use disorder group consisted of people who were admitted to a substance use program in a French psychiatric hospital between April 2018 and January 2019. Exclusion criteria for the alcohol use group was use of other substances, other psychiatric diagnoses, use of psychotropic medication, and history of health issues, such as stroke, head trauma, epilepsy, and liver fibrosis.
The substance use patients participated in a detoxification program that included treatment workshops and oral thiamine. Treatment lasted 5-9 days. The healthy controls were pulled from an online database and had no history of mental illness, neurological disorders, or serious diseases. All participants completed measures on sociodemographic information, substance use, and BEARNI neuropsychological assessments.
Neuropsychological assessments tested verbal episodic memory, verbal working memory, executive functioning, and visuospatial abilities. Participants who had alcohol use disorder were tested at 8 days and 18 days after alcohol cessation.
Results showed that nearly 60% of patients with alcohol use disorder showed cognitive impairments 8 days after cessation of alcohol. Among those who showed impairments, 63% showed improvement in their deficits such that they reached normal levels of functioning after 18 days of discontinuing alcohol usage. Promising recovery rates were shown for working memory and episodic memory at 60 and 63%. 67% of participants who showed visuospatial impairments at the first data collection point displayed normal levels at the second data collection point. Additionally, the recovery of flexibility performance was 100%.
“Caregivers should take into account the neuropsychological impairments before 18 days of abstinence, considering that cognitive impairments are linked to the treatment addiction outcomes,” the researchers said. “Eighteen days after alcohol cessation could represent a critical timepoint to begin psychotherapies, such as cognitive behavioral therapy, which requires intact cognitive functioning to be effective.”
This study took important steps into better understanding how cognition can be improved following detox from severe substance use. Despite this, there are limitations to note. One such limitation is that the sample size was limited. This was in part due to the stringent exclusion criteria, which kept the sample homogenous, but smaller samples show less power regardless. Additionally, tobacco and nicotine use were not included in the exclusion criteria, which could have an effect on cognition.
“Additional studies assessing cognitive improvements during abstinence, and especially earlier in abstinence, are needed,” Angerville and colleagues concluded. “Further studies should also assess the early course of social cognition, attentional bias and inhibition deficits in patient with alcohol use disorder early in abstinence, given their clinical impact.”
The study, “Early Improvement of Neuropsychological Impairment During Detoxification in Patients with Alcohol Use Disorder“, was authored by Bernard Angerville, Ludivine Ritz, Anne-Lise Pitel, Hélène Beaunieux, Hakim Houchi, Margaret P Martinetti, Mickaël Naassila, and Alain Dervaux.
