Addiction can be extremely damaging to an individual in many different domains, including brain function. A new study published in Alcohol and alcoholism offers hope by suggesting that alcohol detox can improve cognitive impairment within weeks.
Many people struggle with a substance abuse disorder. This can lead to a host of problems with cognitive function, including lack of attention, impairments in executive function, memory loss, and more. Deficits in cognition have been linked to higher rates of relapse and more severe substance abuse disorder symptomology.
Despite this, there have been studies that suggest that some forms of cognitive function can improve upon cessation of use, but the factors that influence 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 used 32 participants who had severe alcohol use disorder and 32 healthy controls to serve as a sample. The alcohol use disorder group consisted of people admitted to a substance abuse program in a French psychiatric hospital between April 2018 and January 2019. Exclusion criteria for the alcohol use group were use of other drugs, other psychiatric diagnoses, use of psychotropic drugs, use of psychotropic drugs. and history of health problems, such as stroke, head trauma, epilepsy and liver fibrosis.
The drug addicts participated in a detoxification program that included treatment workshops and oral thiamine. The treatment lasted 5-9 days. The healthy controls were obtained from an online database and had no history of psychiatric disorders, neurological disorders, or serious illnesses. All participants completed measures on sociodemographic information, substance use and BEARNI neuropsychological assessments.
Neuropsychological assessments tested verbal episodic memory, verbal working memory, executive function and visuospatial abilities. Participants who had alcohol abuse were tested 8 days and 18 days after alcohol cessation.
The results showed that almost 60% of the patients with alcohol abuse showed cognitive impairments 8 days after stopping alcohol. Among those who showed impairments, 63% showed improvement in the deficit to reach normal levels of functioning after 18 days of cessation of alcohol use. Promising recovery rates were shown for working memory and episodic memory of 60 and 63%. 67% of participants who showed visuospatial impairments at the first data collection point showed normal levels at the second data collection point. In addition, the flexibility performance recovery was 100%.
“Caregivers should consider neuropsychological impairments prior to 18 days of abstinence, given that cognitive impairments are linked to treatment dependence outcomes,” the researchers said. “Eighteen days after alcohol withdrawal may represent a critical time to begin psychotherapies, such as cognitive behavioral therapy, which require intact cognitive function to be effective.”
This study took important steps to better understand how cognition can improve after detox from serious drug use. Despite this, there are limitations to note. One such limitation is that the sample size was limited. This was partly due to the strict exclusion criteria, which kept the sample homogeneous, but smaller samples show less power anyway. In addition, tobacco and nicotine use were not included in the exclusion criteria, which may have an effect on cognition.
“Further studies assessing cognitive improvements during abstinence, and particularly earlier in abstinence, are needed,” concluded Angerville and colleagues. “Additional studies should also assess the early course of social cognition, attentional bias, and inhibition deficits in alcohol use disorder patients early in abstinence, given their clinical efficacy.”
The study, “Early amelioration of neuropsychological impairment during detoxification in patients with alcohol use disorder”, was written by Bernard Angerville, Ludivine Ritz, Anne-Lise Pitel, Hélène Beaunieux, Hakim Houchi, Margaret P Martinetti, Mickaël Naassila and Alain Dervaux.