"Compared to social drinkers," said Duka, "the alcoholics were impaired in all the tasks except for the color-naming task. The age that patients started drinking, and the amount of alcohol they used to drink up to the last six months before treatment, appeared also to play a role. Only measures of the delay task, the ability to wait before a response in order to receive a reward, appeared to depend solely on the number of detoxifications."
What should be emphasized about these findings, added Malcolm, is that they pertain to "mild to moderate alcoholics, not severe alcoholics. These were generally functioning people who, if they were seen in a clinician's office, would not appear to be cognitively impaired, but yet they are." Identification of the mild to moderate classifications of alcoholism was determined through questionnaires about alcohol use, severity of dependence, and expectations from alcohol.
"Another interesting finding of Dr. Duka's is an association between multiple withdrawals and higher levels of nicotine or cigarette smoking," said Malcolm, "which I think is a fascinating phenomenon and needs to be followed up on."
Duka said her findings have implications not only for individuals who have experienced multiple withdrawals from alcohol, but also the clinician who treats them. "These individuals might be more difficult to treat," she said. "When they are being helped to detoxify from alcohol, they may need extra support to prevent them from relapsing. It might even be sensible to wait a while before starting detox, if it helps to get the post-detox support organized."
'The truth of the matter," said Malcolm, "is that researchers really know very little about the effects of multiple withdrawals on cognitive function. This paper points out the relevance of clinicians asking patients about past withdrawals, the number of them, and how severe they were. Hopefully, it may influence clinicians to do further cognitive testing in order to get a sense of their patients' capabilities for rehabilitation and present and future functioning. In other words, these findings represent a clue that some patients who have had multiple withdrawals might be impaired and might have trouble with their work and in their personal lives because of their impaired thinking processes."
Part One: Multiple Detoxifications
