Can a Learning Disorder Impair Addiction Recovery?
Recovery from addiction is a multi-faceted process that involves understanding the nature of the condition and learning new skills to combat it. Sometimes this is complicated by the brain changes and cognitive impairments that can be caused by substance abuse to drugs like clonazepam. Patients who have pre-existing learning disorders may have an additional level of challenge, but quality treatment centers will adapt programming to meet the needs of all their patients.
The Relationship between Learning Disorders and Addiction
Research indicates that learning disabilities may pre-dispose individuals to engage in substance abuse and may also make recovery more challenging. Studies of the issue include the following:
- A 2002 article published in the Journal of the American Academy of Child and Adolescent Psychiatry reported on a study which followed adolescents over an eight year period. A neuropsychological assessment given at the beginning of the study identified youths with impaired attentional and executive functioning abilities. Those scores significantly predicted the future development of substance use and dependence.
- A 2004 article in the journal Neuropsychology reported on a study examining substance dependence and its relationship to decision making and working memory. Study participants completed a gambling task in which 61% of individuals with substance dependence to drugs like clonazepam made the choice to take immediate gains despite higher future losses. Only 11% of non-substance-dependent participants made the same decision. The researchers then examined the working memory of all those, both dependent and non-dependent, who made the choice. All performed more poorly than others on the memory tasks, and those with substance dependence performed more poorly than those without. Results indicate that those with substance dependence may have impairments in the prefrontal cortex which affects the executive process of working memory.
- A 2005 article in the journal Trends in Cognitive Sciences concluded that drug abuse may be related to the ability to detect error signals and alter behavior accordingly. Studies indicate that drug abusers monitor and respond to negative feedback in a manner that differs from the way that non-abusers do.
Unfortunately substance abuse worsens cognitive functioning. Many parts of the brain, including the amygdala, hippocampus and cerebral cortex, can be affected by drugs and alcohol. Often it becomes more difficult for different parts of the brain to communicate with each other, which impairs learning and memory. The brains of substance abusers may also be less able to metabolize glucose or to absorb glutamate, a neurotransmitter involved in the learning process. Memory may also be impaired by nutritional deficiencies which substances of abuse can cause.
Addiction Treatment for Individuals with Learning Disorders
A publication by the Substance Abuse and Mental Health Services Administration (SAMHSA) notes that addiction treatment programs should be proactive in determining cognitive functioning levels because impairments are not always obvious and may not have been previously diagnosed. The authors note that it is possible for learning disorders to have been misinterpreted previously as poor motivation. The authors also note that individuals may hide problems with memory, decision-making or learning with noncompliant or negative behavior.
It is always wise when presenting information to present it in varying forms in order to reinforce the concepts and meet the needs of people with different learning styles. Being creative with the presentation of information can also help people with learning disorders. It is wise, for example, to present information in written, oral and pictorial form. Patients can role play or otherwise dramatize concepts or use art or music to reinforce their understanding. Clinicians can use comic books, flash cards and poems to present information and clients can produce their own. Oral presentations can be recorded so that patients can listen to or view them multiple times if they wish.
It is also helpful for clinicians to present information in concrete rather than abstract terms. The SAMHSA publication suggests, for example, that service providers avoid asking about abstinence and instead ask more concrete questions such as “Did you get high today?” Instead of asking general questions about alcohol, the authors suggest asking specific questions about various types of alcoholic beverages. They also suggest the use of props, such as glasses or bottles of different sizes, so that patients can answer questions about amounts consumed without having to determine the number of ounces.
Specific goals of addiction treatment for those with learning disorders include identifying and building on strengths while simultaneously acknowledging the reality of practical limitations. It is especially important for limitations to be acknowledged within the framework of relapse risk and for patients to develop compensatory skills. Developing those skills is an important part of the recovery process to overcome addiction to drugs like clonazepam.
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