As expected, substance abuse was associated with cognitive inefficiency. More importantly, these findings suggest that the cognitive effects of chronic stimulant abuse are not additive with those of alcohol abuse. That is, singly addicted stimulant abusers demonstrated similar or greater neurocognitive impairments than individuals who abuse alcohol and stimulants concurrently. The reason for this pattern is speculative but may be attributed to alcohol's opposing actions on cerebrovascular effects brought on by stimulant abuse.

Background:  Historically, the concomitant use of nicotine among alcoholics has not been methodologically accounted for. Given the observed cognitive enhancing effects of acute nicotine on attentional processes, it is important that the potentially positive effects of nicotine be disentangled from the negative effects of chronic alcohol dependence. The current study was conducted to address this question and to test the hypothesis that alcoholics who are regular smokers are more sensitive to the effects of nicotine on cognition as compared to regular smoking community controls. Methods:  A 2 [drug group; alcoholics (n = 28), community controls (n = 27)] X 2 nicotine dose level [low (7 mg dose) vs. high (14 or 21 mg dose)] double‐blind design was used to assess the differential effects of nicotine dose on a battery of neurocognitive tests focusing on attentional efficiency. Results:  As expected, the alcoholic group performed more poorly than did the control group. However, of greater interest to the current study was the finding that alcoholic participants differentially benefited from nicotine administration, as demonstrated in the differential dose effect. Conclusion:  The concomitant use of nicotine may serve to “mask” or “overcome” some of the negative effects of chronic alcohol dependence in newly recovering alcoholics. This potential effect has significant implications for treatment development and further understanding of the process of recovery of function in chronic alcoholics.

Cigarette smoking is prevalent among alcoholics and illicit substance abusers. However, the potentially confounding effect of nicotine on studies of cognition in detoxified substance users has rarely been addressed. In the current study of 87 participants, behavioral and electrophysiological indices of cognitive efficiency were measured in tobacco smokers from four groups: alcoholics, illicit stimulant abusers, concurrent abusers, and control subjects. Data were collected from 2001 to 2003. We hypothesized that acute nicotine administration would modify cognitive deficits in alcoholics and illicit stimulant abusing groups. An adaptation of the Rapid Visual Information Processing task was administered after stabilization of nicotine levels via a high- or low-dose transdermal nicotine patch. Across groups, increased nicotine dose was associated with decreased reaction time (p = .03). A group x nicotine dose interaction trend was noted in which increased nicotine was associated with increased correct responding within the alcoholic group (p = .02). No significant differences in electrophysiology were observed. These results suggest that nicotine may modify cognitive efficiency in alcoholics and illicit stimulant abusers, a concept with relevance to both the design of experimental work and the treatment of alcohol and illicit stimulant dependence. Further work is needed to determine whether this effect predominantly reflects facilitation of cognition function or alleviation of nicotine withdrawal.

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