Problems Related to Substance Abuse

Additionally, chronic drug use has been linked to neuropsychological problems that in turn make it harder to stop the cycle of abuse. Psychoactive drugs by definition affect the brain, and long-term or acute exposure to psychoactive substances can be toxic. Furthermore, we know that drug abuse can increase the risks of stroke, brain injury related to accidents, malnutrition, or liver damage, all of which can adversely affect brain function as well. 

What has been difficult to determine is whether the neuropsychological problems are consequences of the abuse, or whether some of these cognitive problems may have preceded drug use. For example, many people who have drug problems also exhibit signs of hyperactivity or attention problems, but it is unclear whether these problems preceded the drug use or whether the drug use caused 

Additionally, impulse-control and attention problems, hyperactivity, and even antisocial behavior could be caused by a prenatal exposure to psychoactive drugs that escaped detection. Research has linked these conditions with known prenatal toxicity, and the consequences of low levels of prenatal exposure to psychoactive substances can sometimes be missed. In these instances, the symptoms are more likely to be observed as behavioral and attributed to other causes (such as Attention-Deficit Disorder). Recent research also suggests that children of mothers who may have used substances during pregnancy also may be at risk for drug problems later in life (Baer, Sampson, Barr, Connor, Streissguth, 2003). 

There is some good news, in that brain function begins to improve in most cases when drug abuse is stopped, and the improvement may continue for many months. Improvement often begins after the detoxification period, when mental confusion and some acute cognitive problems often improve rather dramatically. Other cognitive problems, some of which can be subtler and more difficult to detect, may persist for several months or years, as mentioned but eventually many are reversible. 

The expression of emotions in inappropriate ways can cause a vicious cycle for a person. For example, expressing emotions inappropriately can cause problems with interpersonal relationships. If a person is perceived as emotionally awkward or volatile, others may go out of their way to limit contact with that person. The result maybe increased social isolation, which in turn may reinforce the belief by many clients with drug problems that they are social misfits (recall the earlier discussion about environmental risk factors). In addition, the disinhibiting effects of drugs may exacerbate emotional dysregulation, potentially making the dys-regulation that much worse. 

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