Addiction can be extremely damaging to an individual in many different areas, including brain function. A new study published in Alcohol and alcoholism offers hope by suggesting that alcohol detox can significantly improve cognitive impairment in a matter of weeks.
Many people struggle with substance use disorders. This can lead to a number of cognitive functioning issues, including inattention, impaired executive function, memory loss, and more. Cognitive deficits have been linked to higher relapse rates and more severe substance use disorder symptoms.
Even so, there are studies suggesting that some forms of cognitive functioning may improve upon discontinuation of use, but the factors contributing to these improvements are not well understood. The present study aims to take a longitudinal approach to studying these cognitive improvements.
In their study, Bernard Angerville and colleagues used 32 participants with severe alcohol use disorders and 32 healthy controls as a sample. The group of people with alcohol use disorders consisted of people who had been admitted to an addiction program in a French psychiatric hospital between April 2018 and January 2019. The criteria for exclusion from the group of people abusing alcohol were: use of other substances, other diagnoses psychiatric disorders, use of psychotropic drugs, and a history of health problems such as stroke, head injury, epilepsy and liver fibrosis.
Substance-using patients participated in a detoxification program that included therapy workshops and oral thiamine. The treatment lasted 5-9 days. The healthy controls were retrieved from an online database and had no history of mental illness, neurological disorders, or serious illnesses. All participants completed measures of sociodemographic information, substance use, and BEARNI neuropsychological ratings.
Neuropsychological assessments assessed verbal episodic memory, verbal working memory, executive function, and visuospatial abilities. Participants who had an alcohol use disorder were tested after 8 days and 18 days after stopping drinking.
The results showed that nearly 60% of patients with alcohol use disorder showed cognitive impairment 8 days after alcohol withdrawal. Among those who showed impairments, 63% showed an improvement in their deficits, so that they reached a normal level of functioning after 18 days of stopping alcohol consumption. Promising recovery rates have been shown for working memory and episodic memory at 60 and 63%. 67% of the participants who showed visuospatial impairment at the first data point had normal levels at the second data point. In addition, the restoration of elasticity efficiency was 100%.
“Carers should consider neuropsychological impairment prior to 18 days of abstinence, given that cognitive impairment is linked to the effects of addiction to treatment,” the researchers said. “Eighteen days after alcohol withdrawal can be a critical time point to start psychotherapy, such as cognitive behavioral therapy, which requires cognitive functioning to be intact to be effective.”
This study took important steps towards a better understanding of how cognition can be improved after detoxing from heavy substance use. Nevertheless, there are limitations to note. One such limitation is that the sample size was limited. This was partly due to stringent exclusion criteria that maintained sample homogeneity, but smaller samples show less power regardless. In addition, the exclusion criteria did not include tobacco and nicotine use, which may have affected cognitive function.
“Additional research is needed to evaluate cognitive improvement during abstinence, and especially in earlier abstinence,” concluded Angerville and colleagues. “Further research should also evaluate the early course of social cognition, attention bias, and inhibitory deficits in a patient with alcohol use disorder in early abstinence, taking into account their clinical impact.”
The study “Early improvement of neuropsychological disorders during detoxification in patients with alcohol use disorder” was developed by Bernard Angerville, Ludivine Ritz, Anne-Lise Pitel, Hélène Beaunieux, Hakim Houchi, Margaret P Martinetti, Mickaël Naassila and Alain Dervaux.