The Value of Neuropsychological Testing in Addiction Treatment

As our understanding of substance abuse grows, the medical community is increasingly recognizing the need for neuropsychological testing as part of the recovery process. So what is neuropsychological testing and what role does it play in addiction treatment? By exploring the value of neuropsychological testing, particularly when administered in a residential setting, you can come to understand why this may be an essential component of your healing journey.

Prolonged drug abuse changes you. In some ways, these changes are obvious—you become increasingly preoccupied with substances of abuse, your personality may become altered, your ability to maintain healthy relationships, keep a job, or practice self-care can be compromised. Even if these changes may not be visible or alarming to you while in a state of active addiction, they are often observable to those around you, providing important clues about your emotional and behavioral state.

However, drug abuse also changes you in ways that are not always as apparent. We now know that addiction is a chronic, relapsing brain disorder; drugs change the way your brain functions, priming it for ongoing drug use. But addiction doesn’t only perpetuate itself; rather, its impact on the brain can create significant cognitive changes that alter the way you think, feel, and behave. These changes can have a drastic effect on your ability to function in ways great and small, including your ability to engage in treatment when you decide to get help for your addiction. At the same time, your cognitive state may be affected by cognitive challenges and comorbid conditions, including mental health disorders and neurodegenerative diseases that can, in turn, inform your addiction and your overall functionality.

Considering the complex relationship between cognitive function and drug addiction, evaluating and describing your cognitive abilities should be a fundamental part of the addiction treatment process. High-quality addiction treatment programs recognize the value of neuropsychological testing at various stages of recovery and use the findings of these assessments to create more personalized, transformative treatment experiences.

What is Neuropsychological Testing?


Neuropsychological testing is designed to evaluate your cognitive abilities through a series of standardized tests. These tests investigate your functioning in a number of areas, including:

  • Intelligence
  • Memory
  • Attention
  • Executive function
  • Language
  • Motivation
  • Perception
  • Sensorimotor functions
  • Mood state and emotion
  • Quality of life
  • Personality style

The full battery of tests typically take 2-5 hours to complete and should be administered by a neuropsychologist with specialized training in interpreting such test results. Once the tests are completed, your individual scores are compared to the scores of healthy people from a similar demographic background in order to assess where you fall on the spectrum of expected functioning.

Often, these tests are thought of primarily in terms of their role in diagnosing neurodegenerative diseases, such as Alzheimer’s and Parkinson’s, or assessment of the impact of brain injuries. However, neuropsychological testing can provide important information about cognitive function in anyone for whom such function is a potential area of concern or whose treatment may benefit from cognitive insight. Through in-depth analysis, the neuropsychologist can develop a complete picture of your areas of cognitive struggle and better understand how these struggles impact your daily functioning. However, it’s important to remember that the value of neuropsychological testing lies not only in the detection of weaknesses, but in the recognition of strengths, which can be used to fuel recovery.

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The Role of Neuropsychological Testing in Addiction Treatment


Research consistently confirms that drug use can have both short and long-term effects on cognitive functioning. Alcohol-dependent people, for example, often experience impairment of executive function and working memory, as well as deleterious alterations in learning, speed of information processing, and problem-solving abilities. These phenomena may be related to changes in the prefrontal lobe areas brought on by chronic alcohol exposure. As noted by Drs. Paulo Cunha and Maria Alice Novaes in their study on alcohol-related cognitive dysfunction, “The alterations found in alcohol-dependent subjects seem to represent diffuse brain damage and although they improve substantially during withdrawal, some deficits remain even years after the last alcohol ingestion.” In advanced cases, cognitive deficits may progress to more serious conditions such as alcohol-induced persistent dementia or alcohol-induced persistent amnesic disorder. Alcohol, however, is not the only drug that can impair cognition; many drugs of abuse, including opiates, cocaine, and benzodiazepines, have the potential to produce cognitive dysfunction with chronic exposure.

When neuropsychological testing is used in the addiction treatment process, it can assess how and to what extent drug use has impacted your cognitive function. This allows clinicians to better understand your areas of weakness and your areas of strengths in order to devise an individualized treatment plan. As Laurence Miller of Fair Oaks Hospital writes, “Neuropsychological evaluation of substance abusers frequently proves useful for the evaluation of those aspects of cognitive functioning that may be relevant for optimal therapeutic management and treatment planning.” By gaining insight into your cognitive needs, clinicians can get a better understanding of your prognosis, ensure that you engage in modalities with proven success for your specific areas of struggle, and modulate therapies to harness your strengths. This allows for a high level of personalization and exposure to appropriate cognitive rehabilitation techniques, which “can accelerate and even revert cognitively altered conditions, contributing to the acquisition of new capabilities and treatment success.”

However, the cognitive dysfunction associated with addiction is not a one-way street. Rather, other types of cognitive challenges are often present in people struggling with addiction and contribute to addictive behaviors. Of particular concern are mental health disorders, which often co-occur with substance use disorders and are associated with a broad range of cognitive disturbances that can affect general functionality and deeply inform your experience of addiction itself. Neuropsychological testing by an expert neuropsychologist can tease out the sources of cognitive dysfunction in order to get a more nuanced understanding of your neurological, emotional, and behavioral state.

Although neuropsychological testing is not designed to diagnose mental health disorders in isolation, it can provide valuable information that facilitates the diagnostic process and more fully articulates the impact of mental health disorders on your life. Achieving diagnostic clarity, describing cognitive deficits caused by mental illness, and identifying appropriate interventions are essential to addressing the full scope of your needs and fortifying recovery. For example, engaging in therapies designed to improve cognitive dysfunction associated with mood disorders may help enhance impulse control, self-regulation, and strengthen your ability to learn, all of which are critical for the addiction recovery process.

The Value of Neuropsychological Testing in a Residential Setting


While neuropsychological testing is undeniably valuable in addiction treatment, the process of recovery presents unique challenges to testing. This is due to the impact of active drug use and withdrawal on your cognitive function and the potential for unreliable results if testing is not judiciously administered. The need for well-timed testing at appropriate points of the recovery process means that neuropsychological testing is best if administered in a residential treatment setting where withdrawal and recovery will be continuously monitored. In this environment, the timing of your testing can be well-chosen to ensure that the results will be meaningful considering your stage of treatment, eliminating the risk of skewed results from active drug use or the withdrawal process. This not only helps clinicians to gain clarity into your cognitive state, it also helps you to better understand your own abilities and challenges, giving you greater self-awareness and helping you set useful and realistic treatment goals.

The true value of neuropsychological testing, of course, isn’t simply in the results themselves. Rather, it is in the guidance those results give you in terms of moving forward. Because high-quality residential addiction treatment programs work from an interdisciplinary team approach, the evaluating neuropsychologist can directly liaise with your treatment team to flesh out diagnosis and design a treatment plan for immediate implementation. This means that you will have the opportunity to participate in appropriate treatment modalities from the very beginning, including those that incorporate relevant cognitive rehabilitation techniques designed to harness the potential of neuroplasticity and restore cognitive function. Additionally, your treatment team can ensure that you receive support for any areas of functional challenges your cognitive dysfunction presents. Throughout this process, the focus is not solely on your areas of weakness. Rather, you can come to recognize your own areas of cognitive strength and hone those strengths in order to propel yourself toward recovery.

When you are ready to begin your healing journey, make sure that neuropsychological testing is part of the picture and that it is incorporated in your recovery in a way that will be meaningful to you. The information this testing provides can give you an extraordinary new understanding of yourself and a path toward a brighter, healthier future.

Alta Mira offers comprehensive treatment for people struggling with drug and alcohol addiction as well as co-occurring mental health disorders and process addictions. Contact us to learn more about our renowned Bay Area programs and how we can help you or your loved one find lasting recovery.