It’s been generally accepted that the best methods of treating substance use disorders include behavioral counseling. This involves helping patients recognize, avoid, and cope with any situations in which they are likely to use or have a craving for drugs. Another popular method is called motivational interviewing, wherein patients consider their need to change and their reasons for wanting to do so. However, some studies suggest that – while these treatments are very effective for most – some people who have suffered cognitive impairments as a result of their substance abuse may not benefit from them.

Last year, a parliamentary inquiry (basically, a motion made by a member of an assembly – in this case the Parliament) to obtain information or to do something that requires permission from that assembly)  in New South Wales, Australia discussed methods of treating the cognitively-impaired.  Because behavioral therapies require the patient to analyze their thoughts and feelings, definite their motivations, and learn how to problem solve and deal with triggers and cravings, some people might not be mentally capable of participating.

Cognitive impairment as a result of substance abuse can run the gamut. For one example, apart from any direct effects that alcohol has on the brain, heavy drinking increases the chances of traumatic brain injury from injuries or falls. Substance abuse can also induce mental disorders. Chronic drug use causes problems with information processing, decision making, and understanding instructions.

One study published in the journal Mental Health and Substance Use found that 52 percent of people in residential treatment programs had a cognitive impairment, and for 12 percent of those it was a serious impairment. These people might not understand or be able to apply the things they’re being told during treatment, or they might not remember them afterward. As a result, many of them end up dropping out.

People who have pre-existing intellectual disabilities are also more likely to develop substance use disorders, which compounds the problem. They can have a low tolerance for drugs and sometimes take too much of a prescribed medication because they don’t understand the instructions. For example, among adults with fetal alcohol spectrum disorder, 35 percent have alcohol and drug problems.

Knowing all this, many treatment programs still do not take into a patient’s cognitive impairments. Many nurses and counselors may not even be able to recognize or know how to work with people with cognitive difficulties. So what needs to happen? Experts suggest that when a patient begins treatment, a quick cognitive screening is given. Staff need to be trained in the impact these difficulties can have on treatment and ways to work around them. There are existing tools to help people with cognitive problems, such as games that require concentration and memory, that could be employed by addiction specialists.

If you or a loved one need help with quitting drugs or alcohol, consider Asana Recovery. We offer medical detox, along with both residential and outpatient programs, and you’ll be supervised by a highly trained staff of medical professionals, counselors, and therapists. Call us any time at (949) 438-4504 to get started.




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