Cognitive Functioning During and After Detox

Recent studies recommend 18 days of alcohol detox prior to commencing further addiction recovery treatment.

There is no arguing that the effects of alcohol addiction extend to all areas of life, be it relationships, work, study or mental and physical health.

Brain function, especially, will bear the brunt of substance abuse, with common symptoms including the inability to focus, the ability to maintain attention for any length of time, memory loss and impaired executive functioning (i.e. the ability to make good decisions).

If not taken into consideration, cognitive deficits can impact a recovering alcohol-dependent person’s ability to engage effectively with treatment and hence reduce the probability of abstinence in the longer term.

However, a recent study published in Alcohol and Alcoholism explores the positive effects of alcohol detox can have on cognitive functioning. The study, “Early Improvement of Neuropsychological Impairment During Detoxification in Patients with Alcohol Use Disorder“, (B. Angerville, et al., 2023) suggests that a significant number of rehabilitation patients will experience cognitive improvements within weeks of beginning the detox process. Angerville et al. are taking a long-term approach in their observation, study and analysis of this phenomenon.

The study, conducted at a French psychiatric hospital between April 2018 and January 2019, included a total of 64 subjects, half of whom were suffering from severe alcohol use disorder, with the other half acting as the control group.

Approved patients participated in a 5-9 day detox program, incorporating treatment workshops and oral thiamine.

The group of alcohol users was limited strictly to admissions on grounds of alcohol addiction only; other substance abuse issues, psychiatric diagnoses, use of psychotropic medication and health issues including stroke, head trauma, epilepsy and liver fibrosis were considered disqualifying factors for participation.

Tobacco and nicotine use, however, were not part of the exclusion criteria, as they don’t impact cognitive functioning. The control group was put together from an online database and had no history of mental illness, neurological disorders, or serious illness; in addition, all of them completed assessments on sociodemographic information, substance use and BEARNI neuropsychological assessments.

The BEARNI assessment, which focuses on verbal episodic memory, verbal working memory, executive functioning, and visuospatial abilities, was given to the alcohol user group at 8 days and 18 days after they stopped using.

The results were encouraging. While almost 60% of patients from the alcohol use group exhibited clear signs of impaired cognitive functioning after eight days of treatment, by day 18 63% of affected patients showed significant improvements, verging on normal levels of functioning.

Working memory and episodic memory improved by 60-63%; visuospatial impairments improved to normal levels for 67% of participating patients; flexibility performance was recovered completely for all patients involved.

Considering this timeframe, the researchers suggest that 18 days post-cessation of alcohol use could represent an ideal time point to begin implementing other treatments, such as cognitive behavioural therapy, which can only be effective when a patient’s cognitive functioning has been restored.

The study acknowledges the small sample size of participants and the fact that additional studies are necessary to further investigate the cognitive improvements during abstinence, particularly the early stages of abstinence.

These future studies will ideally focus on social cognition, attentional bias and inhibition deficits, as these can have the greatest clinical impact on a patient’s recovery.

The better we understand the recovery process, especially in terms of cognitive functioning, the better we can design treatments to help patients on the road to reclaiming their lives.

The Hader Clinic Queensland is committed to constantly improving our treatment program and studies like this one are instrumental in allowing us to give our clients the best care available; but, perhaps more importantly, studies like this one are concrete proof of life and possibility after addiction.

While detox is a great starting point for recovery, it will be more effective if it is combined with a range of therapies, including cognitive behavioural therapy.

Going through detox in a professional setting will leave a person struggling with substance abuse disorder in a better place cognitively, which means they will be better equipped to address the long-term issues which can add fuel to the fire of addiction.

At Hader Clinic Queensland we take a dual diagnosis approach, resulting in holistic biopsychological addiction treatment plans tailored to our clients’ specific needs.

Reference Article:  Alcohol and Alcoholism, Volume 58, Issue 1, January 2023, Pages 46–53