Changes in a substance user’s executive and cognitive functions over time: a case study

Introduction:
Correct and good performance in everyday life requires executive and cognitive abilities. Any impairment of these functions dramatically reduces an individual’s quality of life while the probability of their damage significantly increases with regular and prolonged psychoactive substance use.

Case description:
This case study compares the results of two rounds of testing performed on the executive functions of a selected patient in active treatment for cocaine dependence. The patient was tested twice within one year. At Testing 1, he was an active cocaine and alcohol user. At Testing 2, he had been abstaining from all addictive substances for nine months and had regularly attended individual psychotherapy appointments. This paper describes the changes in his executive and cognitive functions. The patient participated in two sessions at which a screening test battery was administered. Testing 1 took place in April 2023 and Testing 2 in April 2024.

Conclusions:
The testing showed that the patient improved in four of the domains under study – specifically in Set Shifting, Plan Generation and Execution, Psychomotor Speed and Visuoconstructive Functions. At Testing 1, the patient scored extremely below-average levels for two domains: Visuoconstructive Functions and Plan Generation and Execution. The patient managed to improve his cognitive performance significantly and reach the norm in these domains. The findings suggest that sustained abstinence and regular therapeutic care may result in marked improvement of cognitive functions. The patient’s present executive and cognitive performance shows no signs of pathology. Testing 2 clearly demonstrated the patient’s progress in the studied domains.