Journal of Addiction Medicine 2017 (in press). [doi: 10.1097/ADM.0000000000000372]
Efrat Aharonovich, PhD (New York State Psychiatric Institute, GNY Node), Aimee N. C. Campbell, PhD, MSW (New York State Psychiatric Institute, GNY Node), Matisyahu Shulman, MD (Columbia University, GNY Node), Mei-Chen Hu, PhD (Columbia University, GNY Node), Tiffany L. Kyle, PhD (Aspire Health Partners, FNA Node), Theresa M. Winhusen, PhD (University of Cincinnati, OV Node), Edward V. Nunes, MD (Columbia University, GNY Node).
This study is a secondary descriptive analysis that explores and compares the cognitive profiles of adults entering treatment at geographically diverse community-based substance use disorder treatment facilities. 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 (protocol CTN-0044, "Web Delivery of Evidence-Based, Psychosocial Treatment for Substance Use Disorders"). Microcog subtests were used to assess cognitive domains of attention and mental control, reasoning and cognitive flexibility, and spatial processing.
The average age of onset for a substance use disorder was early to mid-20s, with marijuana users reporting the earliest age of onset (mean 19.9, SD 7.5) and stimulant users reporting the latest (mean 25.2, SD 9.9). Among the total sample, half (49.7%) demonstrated impairment in cognitive flexibility and reasoning, and over one-third (37.3%) had impairment in verbal learning and memory. Stimulant (37.68%) and cocaine (34.31%) users showed significantly greater clinical impairment in attention and mental control compared with alcohol users (17.31%) and opioid (21.3%) users (stimulant subgroup only). Cocaine users showed the greatest overall impairment across total and proficiency subtest scores, although these were not statistically different from other subgroups.
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. (Article (Peer-Reviewed), PDF, English, 2017)
Keywords: Cocaine | CTN platform/ancillary study | Heroin | Marijuana | Prescription-type opioids | Stimulant abuse | Yount adults| Journal of Addiction Medicine (journal)
Document No: 1290, PMID: 29194102.
Submitted by the Aimee N. C. Campbell, PhD, 10/20/2017.