Seeds of drug abuse planted in youth?

Cognitive skills in childhood may hold the key

Abusers of drugs and alcohol represent some of the greatest challenges faced by employers and occupational health professionals — from the standpoint of both discipline and behavioral health. Now, a team of researchers from the University of Iowa, Iowa City, and Yale University, New Haven, CT, have discovered a potential new key to what causes drug abuse, and to which employees may present the greatest problems once they enter into a treatment program.

In a first-of-its-kind study, the researchers looked at the cognitive skills that chronic abusers possessed during childhood, as well as their current level of functioning. The data were based on fourth-grade scores on the Iowa Tests of Basic Skills. The drug abusers scored significantly lower than the control group of nonusers, and as adults, they performed even worse than would be expected, given the original gap between the two groups as children. The results were shared in a poster presentation at the recently held annual meeting of the American Society of Anesthesiologists in New Orleans.

Examining the results

The researchers tested chronic abusers of alcohol, stimulants (cocaine or amphetamines), marijuana or users with problems with two or more drugs at about two to three weeks and again at 11 to 15 weeks after their last drug use. They tested the control group at the same intervals. Drug abusers performed significantly worse than the controls on standard tests of reading comprehension, verbal express, mathematics, memory, concept formation and vocabulary. The stimulant users performed the worst of the three drug groups.

These findings may have significant implications in the workplace. "Drug abusers with lower cognitive skills may tend to wind up in treatment more," notes Mohamed M. Ghoneim, MD, one of the researchers. "Those in treatment may tend to get into more trouble with their employees, families and others."

"This is in the context of comparing drug users who are in treatment with the whole population of drug users; those who are in treatment are often those with the more severe problems," explains Robert I. Block, PhD, an associate professor in the department of anesthesia at the University of Iowa College of Medicine, and the lead author of the study. "You may see poor or erratic job performance, missing work, being late to work, and so on."

Would Iowa Test scores, or those from similar examinations, be of value to employers in pre-employment screening or evaluating potential and new employees? "I don’t see any basis for that," says Block. However, he adds, if employees end up in drug treatment there’s a possibility that some types of treatment they might receive "could have some higher expectations of intellectual capacity than might be warranted." For example, he observes, if discussions are held with these employees there may be unrealistic expectations as to whether they will remember what was being talked about. "If there is cognitive impairment, they may not learn what they’re really supposed to be learning," he asserts.

Accordingly, says Block, it might be wise when assessing employees in drug treatment to have some portion of that assessment include a testing of their cognitive ability, so that their treatment can guided by how impaired they may or may not be.

[For more information, contact: Robert I. Block, PhD, associate professor, department of anesthesia, the University of Iowa College of Medicine, Westlaw Building, Room 5140, University of Iowa, Iowa City IA, 52242. E-mail:]