Deficits in Memory and Cognition due to Chronic Substance Abuse

Running head: FINAL PROJECT SUBMISSION 1
(7-2) Final Project Part I Submission:
Research Investigation
Alexandra Perkins
Southern New Hampshire University

FINAL PROJECT SUBMISSION 2
Literature Review
Deficits in memory and cognition due to substance abuse raise concerns for at-risk youth,
current addicts, and recovering addicts. Understanding the link between cellular communication
and pharmacology is pertinent to the biopsychology of substance abuse. The purpose of this
literature review is to display how substance use disorders incite cognitive deficits in individuals
with chronic addiction history. This knowledge will assist mental health professionals in creating
treatment plans to mediate loss in memory and attention while the affected individual is pursuing
recovery.
Article One
Platt, B., O’Driscoll, C., Curran, V. H., Rendell, P. G., & Kamboj, S. K. (2019). The effects of
licit and illicit recreational drugs on prospective memory: a meta-analytic review.
Psychopharmacology, 236(4), 1131–1143.
https://doi.org.ezproxy.snhu.edu/10.1007/s00213-019-05245-9
The researchers in this study analyze the magnitude of prospective memory impairments
in recreational drug users. In an analysis of 27 studies, it was determined that all drug using
groups showed moderate-large impairments in event and time-based prospective memory (PM).
Prospective memory is the ability to remember to carry out intended actions in the future (Platt et
al., 2019). This article reveals that chronic substance abuse results in deficits in prospective
memory. This information elucidates that regular users of alcohol, cannabis, ecstasy, and opiates
performed significantly worse than controls on event- and on time-based PM tasks. Additionally,
it was emphasized that there was “a marked reduction in the heterogeneity of effect sizes in time-
based PM performance amongst studies of heavy drinkers, as well as nearly halving the overall
effect size” (Platt et al., 2019). This study was an archival research design that explored

reputable literature including searches of MEDLINE, EMBASE and PsycINFO. This was the
most effective was to evaluate an accumulation of studies without the burdens of time, finances,
or ethics. All resources are cited in APA formatting with approval received for use in this study.
Article Two
Parrott, A. C., Lees, A., Garnham, N. J., Jones, M., & Wesnes, K. (1998). Cognitive performance
in recreational users of MDMA of “ecstasy”: evidence for memory deficits. Journal of
Psychopharmacology, 12(1), 79–83. Oxford: England.
MDMA users experienced cognitive performance deficits compared to controls when
tasked with a battery of cognitive tasks. Researchers note that MDMA use leads to serotonergic
neurodegeneration, particularly in the hippocampus and frontal cortex, which may be the catalyst
for these cognitive deficits. In the task of immediate word recall and delayed word recall,
MDMA groups recalled significantly less words than controls. This study analyses performance
regarding speed and vigilance through cognitive tasks. Performance measured by simple reaction
time, choice reaction, and number vigilance explicate data that shows the deficits incurred
because of MDMA use. The degeneration of serotonergic axons, particularly in the hippocampus
and frontal cortex, results in changes in mood, motor, sensory, autonomic, and cognitive
functions. This study follows an experimental research design. Three groups of 10 participants
were used. 10 participants stated that they had taken ‘ecstasy’ on 10 or more occasions. 10
participants had used MDMA between one and nine times and 10 participants had never used
MDMA. The participant population was 13 females and 17 males between the ages of 18-30.
Participants would then perform a variety of tasks, such as choice reaction time, immediate word
recall, simple reaction time, number vigilance, and the Sternberg task. Participants were
evaluated on accuracy and latency. Parrott et al. explicitly states, “before being accepted into the

study therefore, each subject was required to sign a written informed consent form”. All
participants were above the age of 18 and able to participate.
Article Three
Halpern, J. H., Sherwood, A. R., Hudson, J. I., Yurgelun-Todd, D., & Pope, H. G., Jr. (2005).
Psychological and cognitive effects of long-term peyote use among Native Americans.
Biological Psychiatry, 58(8), 624–631.
The authors claim that no evidence was found to suggest that psychological or cognitive
deficits among Native Americans can be attributed to using peyote in a religious setting.
Researchers emphasize that these findings are not reflective of recreational illicit hallucinogen
use. This study emphasizes the relevance of cultural sensitivity in neuropsychology and
addiction research. Peyote, a hallucinogen used in religious setting for some Native Americans,
was not significantly related with deficits in neuropsychological performance. Therefore,
legislation and stigma discriminating against the use of peyote was determined to have no
evidential basis. This experimental research design included three groups of Navajo Native
Americans: (1) 61 church members ages 18-45, (2) 36 chronic alcoholics but currently sober for
two months, and (3) 79 individuals reporting minimal use of peyote, alcohol, and other
substances. Ten standard tests evaluating neuropsychological functioning of memory and
attentional/executive functions were conducted. Results were compared in a statistical analysis to
effectively show the insignificance of peyote in causing psychological or cognitive deficits. This
study was performed on the reservation of Navajo Nation and following a complete description
of the study given to the subjects, informed consent was obtained. A baseline evaluation was
established by a mental health professional.
Article Four

Beatty, W. W., & Borrell, G. K. (2000). Forms of knowledge, cognitive impairment and drug
abuse: A demonstration. Progress in Neuropsychopharmacology & Biological
Psychiatry, 24(1), 17–22. https://doi-org.ezproxy.snhu.edu/10.1016/S0278-
5846(99)00086-X
Beatty & Borrell (2000) offers a contrasting explanation for cognitive deficits in
substance abuse users. Authors support that the acquisition of different forms of knowledge than
non-drug users may influence performance on cognitive assessments. This analysis focuses that
"these deficits are usually attributed to drug-induced brain dysfunction or to familial factors that
depress performance independent of drug abuse" (Beatty & Borrell, 2000). While previous
studies analyze the impact on the individual, this study looks at the progression of cognitive
deficits in individuals with a history of familial drug use. Using a musical based assessment,
Researchers found no evidence of differences in simple identification tasks, but there were
disparities when asked about what the task was referring to. Drug abusers were more likely to
note that the song was related to substance abuse.
Article Five
Fitzpatrick, R. E., Rubenis, A. J., Lubman, D. I., & Verdejo-Garcia, A. (2020). Cognitive deficits
in methamphetamine addiction: Independent contributions of dependence and
intelligence. Drug and Alcohol Dependence, 209. https://doi-
org.ezproxy.snhu.edu/10.1016/j.drugalcdep.2020.107891
Researchers in this study focused on the specific consequences of methamphetamine use
on cognitive performance. It was unclear whether these deficits were caused by
methamphetamine dependence or by other factors such as mental health or other drug use.
Fitzpatrick et al. (2020) depicts that "methamphetamine dependence was associated with poorer

performance in decision-making and disinhibition over and above other predictors, while IQ
better explained performance in episodic and working memory." This inhibition may carry over
to offspring and further analysis of the long-term consequences of drug abuse is necessary.
Article Six
Tang, W. K., Lau, C. G., Ungvari, G. S., Lin, S.-K., & Lane, H.-Y. (2019). Recovery of
cognitive functioning following abstinence from ketamine. Addictive
Behaviors, 99. https://doi-org.ezproxy.snhu.edu/10.1016/j.addbeh.2019.106081
This unique study analyzed whether the cognitive impairments incurred from ketamine
use could be reversed. The longitudinal study showed that significant improvements in
immediate recall and delayed recall were noticed at the 12-week follow-up. This evidence
supports that cognitive function lost to use of ketamine can be reversed following periods of
abstinence. Similar studies conducted with other substances could reveal whether cognitive
deficits from substance abuse can be reversed.
Article Seven
Lopes, B. M., Gonçalves, P. D., Ometto, M., dos Santos, B., Cavallet, M., Chaim-Avancini, T.
M., Serpa, M. H., Nicastri, S., Malbergier, A., Busatto, G. F., de Andrade, A. G., &
Cunha, P. J. (2017). Distinct cognitive performance and patterns of drug use among early
and late onset cocaine users. Addictive Behaviors, 73, 41–47. https://doi-
org.ezproxy.snhu.edu/10.1016/j.addbeh.2017.04.013
Authors explore the impacts of early-onset and late-onset cocaine use on cognitive
functioning. Lopez et al. (2017) found early-onset users performed worse in attention span,
working memory, sustained attention, declarative memory, and general executive functioning.
Late-onset users displayed deficits in divided attention and general executive functioning in

relation to the control group. The increase of deficits as cocaine use increased is evidence of
cognitive impairment by chronic cocaine use. Investigation into the relation between early-onset
drug abuse and the progression of cognitive deficits in families with chronic substance abuse will
be the focus of my research gap.
Technology
The psychological and cognitive deficits of drug abuse are significant to contemporary
psychological research. Parrott et al. (1998) depicts the influence of chronic substance abuse on
cognitive function. Individuals with a history of chronic hallucinogen abuse showed deficits in
areas of performance functioning. They were slower at completing tasks and had decreased
accuracy compared to controls. These deficits are evidence for the cognitive profile of MDMA
users and “therefore of impaired memory combined with unchanged information processing
speed” (Parrott et al., 1998). Similarly, Platt et al. (2019) depicts similar evidence of deficits
among substance abusers. This meta-analysis revealed heavy drinkers and regular drug users
performed worse on event and time-based prospective memory tasks. Deficits in prospective
memory results in forgetting to perform a planned action or recall a planned intention at some
future point in time. These deficits in memory may result in truancy from treatment, forgetting to
take medication, neglecting hygiene, etc. Furthermore, Fitzpatrick et al. (2020) highlights that
methamphetamine dependence impacts inhibitory control and decision-making. In contrast,
researchers Halpern et al. (2005) and Tang et al. (2009) propose evidence that cognitive deficits
do not accompany all substance abuse or that these deficits can be reversed.

Historical Views
Platt et al. (2019) is historically significant because no recent studies had focused on
prospective memory impairment in recreational drug users. Lab-based acute drug studies are
unable to capture whether prospective memory deficits extend beyond an acutely or sub-acutely
intoxicated state. Therefore, researchers used a population that was not currently intoxicated, but
had used licit and illicit drugs in the past. Parrott et al. (1998) is historically significant in that
experimental populations had not focused on the unique effect of MDMA. Isolating the
substance to MDMA and its unique impact on cognitive processes was the focus of this study.
Fitzpatrick et al. (2020) also isolates a single substance, methamphetamine, to examine the
relationship between dependence and intelligence. Likewise, Halpern et al. (2005) is significant
because this analysis focuses specifically on the impact of drug use within Navajo Native
Americans. This population had shown increased vulnerability to substances and investigating
this population had not been addressed before. Lopes et al. (2017) proposes that cognitive deficit
severity corresponds to early and late onset cocaine users. Examining the patterns of drug abuse
in cocaine users is unique to this study. In contrast, Tang et al. (2019) offers another perspective
of substance abuse related cognitive deficits in exploring if these deficits are reversed following
periods of abstinence. Similarly, Beatty & Borrell (1999) incorporates contrasting evidence with
suggestions that these deficits are not the result of cognitive ability but rather “that some
neuropsychological deficits of drug abusers arise because they acquire different forms of
knowledge from non-drug abusers.”
Conclusions in Biopsychology
The results of these study convey that use of illicit substances, especially hallucinogens,
cause cognitive impairment. Platt et al. (2019) reveals that several substances including alcohol,

cannabis, MDMA, methamphetamine, and tobacco affect cognitive functioning. Memory is less
accurate and increases in latency. Parrott et al. (1998) depicts that chronic MDMA use
specifically results in psychological and cognitive deficits; Fitzpatrick et al. (2020) cites the same
of methamphetamine. However, attention to peyote is the focus of Halpern et al. (2005) who
emphasizes that use of this religious hallucinogen does not result in significant cognitive
impairment. Contrasting evidence presented by Halpern et al. (2005), Beatty & Borrell (1999),
and Tang et al. (2019) suggest that factors not related to substance abuse also impact the
cognitive deficits of drug users. The plethora of evidence suggesting that chronic, recreational
use of both licit and illicit substances results in changes to cognitive processes do propose
research gaps that would be better addressed by detailed, focused studies.
Literature Review and Designin Research
Several methods and designs were implored in these studies. Platt et al. (2019) is an
archival research design incorporating evidence from several reputable databases including
MEDLINE, EMBASE, and PsycINFO. The six other studies used an experimental research
design with multiple subjects and control groups. For example, Lopes et al. (2017) evaluated 103
cocaine dependent inpatients divided in two groups: early-onset users (EOG; n = 52), late-onset
users (LOG; n = 51), and 63 healthy controls. Several tests were used including a Trail Making
Test, Stroop Color Word Test, and Wisconsin Card Sorting Test. Similarly, Tang et al. (2019)
used a longitudinal study analyzing 114 ketamine users at both a baseline evaluation and a 12-
week follow-up. Several assessments were used in this study including the Wechsler Adult
Intelligence Scale and the Rey-Osterrieth Figure Test.

Ethics
Ethical considerations are always a concern for biopsychological researchers. As
advancements to technology emerge, increased concern for ethics and its application to research
develop. These studies used informed consent to ensure respect for and protection of
participants. The harm in these studies was minimal and the benefits outweighed potential risk.
Tang et al. (2019) also obtained approval by the Clinical Research Ethics Committee of the
Chinese University of Hong Kong. Similarly, due to the controversial nature of studying illicit
substance use, Parrott et al. (2019) stated “before being accepted into the study therefore, each
subject was required to sign a written informed consent form. This stated that MDMA was an
illegal drug, with a range of adverse side-effects, and that neither the experimenters nor the
University condoned its use. However, while the initial ethical considerations were addressed in
these studies, as technology advances and brain privacy become more concerning, the protection
of protected health information and personal information remain a priority for researchers.
Research Design
Gap Statement
While research in the field addresses the impact of substances on cognitive development,
there is a gap in research addressing the severity or progression of cognitive deficits in a familial
history of chronic substance abuse.
ResearchQuestion
In individuals with chronic familial substance abuse, is there an increase of cognitive
deficits and do these deficits vary in severity when compared to the control group?

ResearchDesign
My proposed study will include 30 families with a history of substance abuse. Families
with young children will be able to participate and no family will be excluded or targeted based
on race, gender, socioeconomic status, or other demographic information. Participant median
household income will be less than $64,000 for a household of four and adjusted accordingly
based on number on members in the household. Median household income must be less than the
average noted in the 2010 census. While participant size cannot be estimated at this moment,
projected family size will be four to six members. 15 of the families in this study will have an
extensive history of substance abuse addictions. Severity of familial substance abuse will be
noted during the initial interview with a psychiatrist to establish a baseline for both the
experimental group and controls. 15 of the families in this study will have no history of
substance abuse and will serve as the control group. Prior to commencement, this study will brief
every family member and obtain informed consent from both parents/guardians for children and
from participating individuals. Following the interview with a psychiatrist, a cognitive
assessment will be administered. Incorporating elements from the studies reviewed, assessment
techniques for this population will be the Stroop Color Word Test (Lopes et al., 2017), Cognitive
Drug Research System (Parrott et al., 1998), and the Wechsler Adult Intelligence Scale (Tang et
al., 2019). These tests are effective in measuring elements of cognitive ability such as attention,
working memory, episodic secondary memory, orientation, language, and visual-spatial skills, in
both adults and older adolescents. Data will be complied and interpreted accounting for the age
of the participant. Results will be displayed via a comprehensive statistical analysis.

Issues of Ethics
Ethical considerations for this study include working with children. Informed
consent will be obtained from parents and consent may be revoked at any time. Parrott et al.
(2019) expressed in their ethical considerations that “it is important that undertaking a field study
such as this, should not be seen as providing tacit approval for the use of MDMA.” Therefore,
this will be a statement included in the consent form of this research design. All participants will
be treated according to the APA’s Ethical Principles of Psychologists and Code of Conduct and
no demographic characteristic will be excluded or pursued in this study.
Ethics informed
The studies reviewed did not include child participants. Therefore, additional care was
taken to protect underage participants. The five elements considered for ethics included
beneficence, autonomy, nonmaleficence, justice and confidentiality for the protection of
adolescent and adult participants (AACAP, 2014). While only parents/guardians may give
consent for participation, the child may assent or dissent their participation. Meaning, after
approval from the parent, the researchers would still obtain a form of consent from children.
While the American Psychiatric Association has released ethical codes for working in
psychological research, the American Academy of Child and Adolescent Psychiatry has released
a code of ethics to follow when incorporating child participants into research (AACAP, 2014).

References
American Academy of Child and Adolescent Psychiatry. (2014). Code of Ethics.
https://www.aacap.org/App_Themes/AACAP/docs/about_us/transparency_portal/aacap_
code_of_ethics_2012.pdf
Beatty, W. W., & Borrell, G. K. (2000). Forms of knowledge, cognitive impairment and drug
abuse: A demonstration. Progress in Neuropsychopharmacology & Biological
Psychiatry, 24(1), 17–22. https://doi-org.ezproxy.snhu.edu/10.1016/S0278-
5846(99)00086-X
Fitzpatrick, R. E., Rubenis, A. J., Lubman, D. I., & Verdejo-Garcia, A. (2020). Cognitive deficits
in methamphetamine addiction: Independent contributions of dependence and
intelligence. Drug and Alcohol Dependence, 209. https://doi-
org.ezproxy.snhu.edu/10.1016/j.drugalcdep.2020.107891
Halpern, J. H., Sherwood, A. R., Hudson, J. I., Yurgelun-Todd, D., & Pope, H. G., Jr. (2005).
Psychological and cognitive effects of long-term peyote use among Native Americans.
Biological Psychiatry, 58(8), 624–631.
Lopes, B. M., Gonçalves, P. D., Ometto, M., dos Santos, B., Cavallet, M., Chaim-Avancini, T.
M., Serpa, M. H., Nicastri, S., Malbergier, A., Busatto, G. F., de Andrade, A. G., &
Cunha, P. J. (2017). Distinct cognitive performance and patterns of drug use among early
and late onset cocaine users. Addictive Behaviors, 73, 41–47. https://doi-
org.ezproxy.snhu.edu/10.1016/j.addbeh.2017.04.013
Parrott, A. C., Lees, A., Garnham, N. J., Jones, M., & Wesnes, K. (1998). Cognitive performance
in recreational users of MDMA of “ecstasy”: evidence for memory deficits. Journal of
Psychopharmacology, 12(1), 79–83. Oxford: England.

Platt, B., O’Driscoll, C., Curran, V. H., Rendell, P. G., & Kamboj, S. K. (2019). The effects of
licit and illicit recreational drugs on prospective memory: a meta-analytic review.
Psychopharmacology, 236(4), 1131–1143. https://doi-
org.ezproxy.snhu.edu/10.1007/s00213-019-05245-9
Tang, W. K., Lau, C. G., Ungvari, G. S., Lin, S.-K., & Lane, H.-Y. (2019). Recovery of
cognitive functioning following abstinence from ketamine. Addictive
Behaviors, 99. https://doi-org.ezproxy.snhu.edu/10.1016/j.addbeh.2019.106081

Deficits in Memory and Cognition due to Chronic Substance Abuse

Recommended

Recommended

More Related Content

What's hot

What's hot (18)

Similar to Deficits in Memory and Cognition due to Chronic Substance Abuse

Similar to Deficits in Memory and Cognition due to Chronic Substance Abuse (20)

More from AlexandraPerkins5

More from AlexandraPerkins5 (20)

Recently uploaded

Recently uploaded (20)

Deficits in Memory and Cognition due to Chronic Substance Abuse