Theme: Clinical Research Year: 2024
Background: Several studies report cognitive impairment in populations with substance use. Few, if any, report on cognitive functioning in this population’s habitual state, namely while influenced by substances. Cognitive problems may precede and/or succeed substance use. Cognition plays a key role in everyday functioning and should be considered in every aspect of treatment and recovery.
Aims: To identify cognitive problems among people with severe substance use, and investigate associations between patterns of substance use and cognitive function.
Methods: Participants were recruited from the City of Oslo’s institutions for people with severe drug use and a specialist health service unit for substance use treatment, Oslo University Hospital. Demographics and substance use were mapped by questionnaires. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA 8.1.). We performed multivariate regression analyses on cognitive function and the substance use variables. Age, sex, and level of education were used as covariates.
Results: 171 participants (71% male) with a mean age of 40 were included in the study. 54% reported heroin as their main substance, 67% reported having injected drugs during the past 4 weeks. 58% had used alcohol regularly. Debut age for substance use was 14 years, and 17 years the mean debut age for regular substance use. Participants had on average used 5.5 substances on a regular basis. The cognitive assessment indicated that 75% had cognitive impairment. No associations were found between patterns of substance use and cognitive function.
Conclusions: The alarmingly high proportion of participants scoring below the cut-off for cognitive impairment should inform health and social care workers, policymakers, leaders, and researchers of the need to systematically screen for cognitive functioning in this population. The methods used in this study show that it is possible to collect large and comprehensive datasets from a population often deemed ‘marginalised’, ‘high-risk’, and/or ‘hard-to-reach’.