Alcohol and Drug Use and the Developing Brain

Abstract

Adolescence is an important neurodevelopmental period marked by rapidly escalating rates of alcohol and drug use. Over the past decade, research has attempted to disentangle pre- and post-substance use effects on brain development by using sophisticated longitudinal designs. This review focuses on recent, prospective studies and addresses the following important questions: (1) what neuropsychological and neural features predate adolescent substance use, making youth more vulnerable to engage in heavy alcohol or drug use, and (2) how does heavy alcohol and drug use affect normal neural development and cognitive functioning? Findings suggest that pre-existing neural features that relate to increased substance use during adolescence include poorer neuropsychological functioning on tests of inhibition and working memory, smaller gray and white matter volume, changes in white matter integrity, and altered brain activation during inhibition, working memory, reward, and resting state. After substance use is initiated, alcohol and marijuana use are associated with poorer cognitive functioning on tests of verbal memory, visuospatial functioning, psychomotor speed, working memory, attention, cognitive control, and overall IQ. Heavy alcohol use during adolescence is related to accelerated decreases in gray matter and attenuated increases in white matter volume, as well as increased brain activation during tasks of inhibition and working memory, relative to controls. Larger longitudinal studies with more diverse samples are needed to better understand the interactive effects of alcohol, marijuana, and other substances, as well as the role of sex, co-occurring psychopathology, genetics, sleep, and age of initiation on substance use.

Alcohol use during a trial of N-acetylcysteine for adolescent marijuana cessation

“…Previously reported NAC-related reductions in marijuana use could generalize to other substances including alcohol. Effective interventions during adolescence could have substantial long-term implications by reducing acute and enduring negative social, academic, and cognitive consequences related to binge adolescent drinking (Squeglia & Gray, 2016). Evaluation of novel candidate treatments, including NAC, is warranted in adolescents, particularly in regards to interventions that effectively reduce alcohol given its high use rates during adolescence.…”

“…Several adverse outcomes are associated with adolescent alcohol and marijuana use, including poorer psychosocial (Miller, Naimi, Brewer, & Jones, 2007), cognitive (Jacobus et al, 2015; Meier et al, 2012; Nguyen-Louie et al, 2015; Squeglia & Gray, 2016; Squeglia, Spadoni, Infante, Myers, & Tapert, 2009), and educational outcomes (Latvala et al, 2014). Unfortunately, few adolescent substance use treatment options exist and current efforts have only been modestly effective (Jensen et al, 2011; Tripodi, Bender, Litschge, & Vaughn, 2010; Vandrey & Haney, 2009), with some studies suggesting up to 86% of youth return to alcohol or drug use within 12 months following treatment (Brown, Gleghorn, Schuckit, Myers, & Mott, 1996; Winters, Stinchfield, Opland, Weller, & Latimer, 2000).…”

Effects of delaying binge drinking on adolescent brain development: a longitudinal neuroimaging study

“…Imaging studies using different modalities have consistently reported that alcohol use during adolescence is associated with abnormalities in brain structure, function and connectivity [72]. However, the critical question of whether these anomalies are consequences of alcohol abuse or preexisting vulnerability factors for early use and misuse remains unanswered in the literature.…”

Effects of naltrexone are influenced by childhood adversity during negative emotional processing in addiction recovery

“…Control participants with a history of heavy alcohol or drug use were also excluded due to known associated functional and structural abnormalities. 46 Heavy alcohol use was defined as a score higher than eight on the Alcohol Use Disorders Identification Test (AUDIT). 47 Heavy drug use was defined by clinicians of the ICCAM team using the following criteria: more than 300 pills (lifetime) for MDMA; daily/almost daily THC use for more than one year and more than 2 spliffs; and more than once a week for more than six months and more than 1 g for amphetamines.…”