Social and Non-Social Cognitive Enhancement in Cocaine Users-A Closer Look on Enhancement Motives for Cocaine Consumption

Substance use-related alterations of social decision-making in a longitudinal cohort of young adults

BACKGROUND

Substance use disorders (SUD) are associated with severe negative social and health-related outcomes. Evidence accumulates that chronic substance use is associated with alterations in social interaction behavior, which likely contributes to the vicious circle of SUD. However, little is known if these social problems originate from contextual factors only or also from the substance use itself - in other words, if they are predisposed or substance-induced.

METHODS

We study the causation behind behavioral alterations of substance users over a 9-year period (from age 11 to 20) in an urban age cohort (n=1,002) with high prevalence of substance use at age 20. We identify common substance use patterns using toxicological hair analysis, examine behavioral alterations with incentivized games, and use teacher assessments across different ages to determine the causes and effects behind substance use-related impairments in social interaction.

RESULTS

We find that opioid and stimulant users reveal reduced prosocial behavior compared to nonusers, particularly in interpersonal trust and perspective-taking (e.g., they are ∼50 percent less likely to trust others). Our longitudinal analyses suggest a causal relationship between the non-medical use of prescription opioids and impaired social behavior, whereas impairments among stimulant users seem to be partially predisposed. Moreover, women tend to be more severely affected by opioid use than men. However, no behavioral alterations were found among young adult cannabis or ecstasy users.

CONCLUSION

Highly addictive substances such as opioids can impair users' social behavior by undermining fundamental human interaction fueling a vicious circle of substance use and social isolation.

Neurocognitive and substance use disorders in older adults: challenges and evidence

Purpose

This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.

Design/methodology/approach

Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.

Findings

Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.

Originality/value

This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.