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Different Types of Cognitive Impairment Associated with Different Types of Substance Use Disorders

January 1, 2018
Aharonovich, E., et al.
Aharonovich E, et al. Neurocognitive Profiling of Adult Treatment Seekers Enrolled in a Clinical Trial of a Web-Delivered Intervention for Substance Use Disorders. Journal of Addiction Medicine 2017 (in press).
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  • A growing body of evidence suggests that chronic substance users have higher rates of cognitive impairment than the general population.

Impairment also seems to differ by type of substance use disorder (SUD), with different types of impairment (memory issues, learning problems, poor decision-making, e.g.) associated more strongly with the use of different substances (marijuana, cocaine, alcohol, e.g.).

A better understanding of the cognitive impairments associated with specific substances could help inform treatment by increasing clinicians’ awareness of the specific cognitive difficulties most likely to be experienced by an individual patient, making it easier to tailor profile-specific behavioral and pharmacological treatment.

To that end, this study aimed to identify a comprehensive profile of neurocognitive deficits related to 5 primary substances of abuse(alcohol, cocaine, stimulants, opioids, and marijuana).

Performance on cognitive measures at baseline was compared across 5 primary substance subgroups of individuals (alcohol=104; cocaine=102; stimulants=69; opioids=108; marijuana=114) enrolled in a web-based psychosocial treatment study conducted within the NIDA Clinical Trials Network (CTN-0044). Cognitive domains of attention and mental control, reasoning and cognitive flexibility, and spatial processing were assessed.

Results found:

  • Average age of onset for SUD: early to mid-20s.
    • Earliest age: Marijuana at 19.9 years
    • Latest age: Stimulants at 25.2 years
  • Cognitive impairment in the total sample:
    • 49.7%: cognitive flexibility and reasoning impairments
    • 37.3%: verbal learning and memory impairments
  • Cognitive impairment by substance:
    • Cocaine users: greatest overall cognitive impairment across all scores
    • Marijuana users: second greatest overall impairment across all scores
    • Opioid users: least impaired overall in cognitive flexibility and abstraction (but not on mental control and spatial processing)

Conclusions: These findings confirmed previous studies, indicating a high prevalence of significant cognitive dysfunction across all substance use categories among treatment-seeking adults, and found that cocaine use appears to be associated with the most impairment. Increasing knowledge of similarities and differences between primary substance subgroups can help guide substance use disorder treatment planning.

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