Alcohol and Substance Use in an Outpatient Multiple Sclerosis Population

Abstract

Objective: Little research has examined the prevalence of alcohol and substance use in individuals with multiple sclerosis. Even less research has been done to examine the effects of alcohol and drug use on cognition in this disease. The main focus of this study was to examine the prevalence of substance use in an East Coast United States outpatient MS sample and the associated demographic and psychosocial correlates. A second aim was to determine if substance use negatively impacted cognition.;Method: The sample was composed of participants from the Multiple Sclerosis Center at Holy Name Medical Center. Graduate students from Ferkauf Graduate School of Psychology as well as staff from the MS Center completed recruitment. Upon consent each participant was given a packet of questionnaires, which they completed prior to, during, or after their office visit. They were also asked to complete the Symbol Digit Modalities Test (SDMT), a short 90-second neuropsychological measure. A total of 171 individuals were recruited, 26.3% of the population was male and 72.7% female. The mean age of the sample was 48.6 years old (SD = 9.5), the mean education of the sample was 14.6 years (SD = 2.4) and the mean physical disability rating (ISS) was 8.7 (SD = 5.6).;Results: A large portion of the sample met criteria for clinically significant drinking according to the AUDIT-C (41.3%). Clinically significant drinkers had higher levels of education and were younger than non-drinkers. Utilizing the CAGE-A, 6.4% of the sample met criteria for a lifetime history of problem drinking and men endorsed higher rates of lifetime alcohol use than women. A small portion of our sample met criteria for clinically significant drug use according to the CAGE-D (3.9%). Drug use was associated with higher reports of depression, pain and greater disability. Processing speed was not significantly correlated to alcohol or drug use.;Conclusion: Further research is needed to conclusively state that substance use is not associated with a decline in cognitive processing in individuals with MS. Alcohol use was associated with younger, healthier MS patients, while drug use was associated with individuals in psychological and physical distress.