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Ehlert A, Zimmermann J, Johann D, Ribeaud D, Eisner M, Baumgartner MR, Shanahan L, Rauhut H, Quednow BB. Substance use-related alterations of social decision-making in a longitudinal cohort of young adults. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00172-1. [PMID: 39009135 DOI: 10.1016/j.bpsc.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/17/2024]
Abstract
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.
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Affiliation(s)
- Alexander Ehlert
- Institute of Sociology, University of Zurich, Andreasstrasse 15, 8050 Zürich, Switzerland
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - David Johann
- Institute of Sociology, University of Zurich, Andreasstrasse 15, 8050 Zürich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland; Institute of Criminology, University of Cambridge, Cambridge, CB3 9DA, United Kingdom
| | - Markus R Baumgartner
- Center for Forensic Hair Analytics, Institute of Forensic Medicine, University of Zurich, 8057 Zurich, Switzerland
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland; Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
| | - Heiko Rauhut
- Institute of Sociology, University of Zurich, Andreasstrasse 15, 8050 Zürich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland; Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland.
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Neurocognitive and substance use disorders in older adults: challenges and evidence. ADVANCES IN DUAL DIAGNOSIS 2022. [DOI: 10.1108/add-01-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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