The connection between executive functioning and substance abuse

What in the world is executive functioning? Well, you can think of it like the air traffic controller of the brain. Thoughts, emotions, and impulses pop up and executive functioning intercepts them to send them in the right direction. Executive functioning also supervises, coordinates, and manages cognitive, behavioral, and emotional tasks. It’s a lot! 

And no one is born with executive functioning skills — we have to learn them. The prefrontal cortex, which houses executive functioning, doesn’t begin to really develop until about six months and continues developing all the way through adulthood. 

Think about it — as a kid, you didn’t understand how to set goals (like finishing homework), regulate emotions (like when to sit quietly instead of throwing a tantrum), or adapt easily to new situations (like going to a new classroom). These are all skills you learned through repetition, practice, structure, and examples that were set for you. 

External factors like domestic violence, abuse, neglect, and chronic toxic stress can hinder the ability to develop effective executive functioning. It gets even more difficult as an adolescent to adapt quickly. Being a teenager already means you’re going through rapid developmental changes in the brain — and this includes executive functioning, which is still developing! 

Understanding executive functioning challenges 

So executive functioning challenges could look like difficulty completing tasks or figuring out how much time something will take to complete. It could also look like struggling to balance schedules or being unable to handle the complexity required to organize multiple tasks, assignments, classes, extracurriculars, and so on. 

Sometimes those challenges end up being interpreted as laziness or disobedience. And more often than not, these challenges can lead to increased risky behavior (like substance abuse), particularly in teens and young adults. Moreover, trying to help teens further develop their executive functioning skills can clash with their desire for independence and asserting their individuality. Ever tried to get a teenager to clean their room while they’re about to go out?  

How substance abuse affects executive functioning 

It’s no wonder that substance abuse can really impact executive functioning in a negative to downright dangerous way. In fact, executive functioning impairment affects anywhere from 30 to 80 percent of people with substance abuse disorder! That’s why it’s so important to also determine how executive functioning skills are impacted by substance abuse and treat them accordingly in addition to treating the addiction itself. 

Knowing how substance abuse can affect a person’s executive functioning is equally important to treating the addiction. Here are just a few examples of executive functions impacted by substance abuse:

• Short-term memory
• Motor skills
• Decision-making and inhibition skills
• Ability to focus 
• Task completion
• Cognitive functioning
• Learning abilities 
• Spatial planning
• Risky behaviors instead of exerting impulse control  
• “Foggy” brain

Addiction is already known to diminish executive functions like impulse control. (Hello, three glasses of wine and online shopping spree!) But it’s less known that when someone is struggling to get sober or refrain from using, their executive function skills are kneecapped by withdrawals and cravings. This means within the addiction cycle, the withdrawal period is a particularly difficult point to try and have the addict navigate executive functioning. 

How to improve executive functioning

Improving executive functioning isn’t going to happen overnight, but there are plenty of ways to support it. During periods of use, it’s important to recognize that those executive functioning skills are being severely challenged.

And if dealing with someone in sobriety, there are other ways to bolster executive functioning beyond what they may already be doing. While in treatment or getting sober, those skills can and will come back to some degree, but need time and patience to recover. It’s also going to depend on the type of substance being abused. 

For sober teens specifically, executive functioning can be recovered with step-by-step approaches to work, school, and life. Due dates for assignments and visual aids are helpful, as are time organizers. Teach your teen to make their own schedule and have them look at it multiple times daily to learn how to balance their time against other obligations. Explain how to break bigger assignments, like an essay, into chunks that they can complete in a set period of time. 

Though substance abuse recovery requires motivation and determination, it also requires understanding just how much a person’s executive functioning has been affected. And while executive function abilities may be compromised during or after substance abuse recovery, there is still a good chance that they can be implemented and improved upon!

If you, your kid or someone you love is struggling with substance abuse, know that you are not alone. Seeking help can be a difficult step, but it is a courageous one. There are many resources available to support you or your loved one on this journey, including professional treatment, therapy, support groups and coaching. 

It's important to remember that recovery is possible, and that it is never too late to get help. If you're ready to take that step, we encourage you to reach out to a trusted healthcare provider, addiction specialist, or support group to start your journey to recovery today. Bend Health is also here to provide your family support when you need it.

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