Cognitive impairment after multiple alcohol rehab detoxifications

Complete abstinence from all drugs and alcohol is promoted in a non 12 step approach to alcohol recovery. This article provides information regarding the importance of complete abstinence during alcohol rehab, and the possible benefits associated with greater lengths of alcohol recovery.

Animal studies show that repeated alcohol withdrawals are correlated with impaired cognitive and learning abilities. The cessation of chronic alcohol consumption during withdrawal may lead to increased excitotoxicity in the brain, which can affect frontal lobe function. Researchers from the University of Heidelberg in Mannheim, Germany examined the effect of multiple alcohol rehab detoxifications on cognitive performance and decision making (Loeber et. al., 2009).

The researchers recruited 48 alcohol-dependent participants from an inpatient alcohol rehab and detoxification program. Cognitive function of the participants was compared to that of a control group of 36 healthy individuals. Participants were divided into two groups: 27 individuals with less than two previous detoxifications, and 21 individuals with two or more previous detoxifications. Prefrontal function, memory function, and intelligence were assessed. Assessments included the Reduced Wechsler Intelligence Scale, auditory verbal learning test, Benton Visual Retention Test, Trial Making Test Part B, Wisconsin Card Sorting Test, and IOWA Gambling Task.

Results showed that both groups of participants recruited from alcohol rehab performed worse than healthy controls with regard to executive function. Cognitive impairment was most robust in recently abstinent individuals. With regard to attention and executive function, there were no significant differences between the two groups of participants. However, individuals who had two or more previous detoxifications performed more poorly in the IOWA gambling task; they had more difficulty learning to choose cards from more advantageous decks.

This study provides ample evidence that alcohol dependency impairs cognitive function and that abstinence is important for the recovery of cognitive function. However, the study provides little evidence that repeated alcohol withdrawals impair prefrontal function. The authors also suggest that executive function is affected early in alcohol dependency.

The researchers conclude, “Our results provide additional evidence for cognitive impairments in frontal lobe functions in alcoholics compared to healthy controls and initial evidence is found for an effect of repeated withdrawals on decision making in a gambling task, suggesting an inability to adjust behaviour to newly learned rules in patients with two or more previous detoxifications compared to alcoholic patients with less than two previous detoxifications. In addition, the present study has shown that cognitive impairment is especially pronounced in early abstinence and might recover with longer duration of abstinence.”

The study stresses the importance of alcohol rehab and abstinence early in the development of alcohol dependence. Cognitive impairments may develop quickly in alcohol dependence, but successful alcohol rehab may reverse these impairments, and sustained alcohol recovery will prevent further cognitive impairment.

In an alternative to AA, individualized treatment plans can be created for people who would are seeking complete abstinence from all drugs and alcohol. Although cognitive impairment may occur from alcohol abuse, there is a great possibility that one might recover with greater lengths of alcohol recovery.

References

Loeber S, Duka T, Welzel G, Nakovics H, Heinz A, Flor H, Mann K. Impairment of cognitive abilities and decision making after chronic use of alcohol: the impact of multiple detoxifications. Alcohol and Alcoholism. 2009; 44(4): 372-381.
http://alcalc.oxfordjournals.org/cgi/content/full/44/4/372