The role of neuropsychology in substance misuse treatment

Abstract

Many substance misusers presenting for treatment may be suffering from diffuse cortical damage, particularly in the frontal and temporal areas. Walsh (Understanding Brain Damage: A Primer of Neuropsychological Evaluation. Churchill Livingstone, London, 1985) suggests that these individuals can maintain the ‘appearance of intactness’ in many situations of everyday living. The lowering of adaptive abilities often remains concealed until a novel situation is encountered (e.g. treatment or recovery from drug/alcohol misuse). Subtle deficits in learning and cognitive flexibility may then be misinterpreted as ambivalence or absence of motivation to change. This overview presents a neuropsychological perspective reviewing brain structure, functional assessment, behaviour and treatment.