Explain some of the common neurocognitive deficits in those with substance use disorder (SUD) and how they impede traditional SUD treatment.

Numerous deficits exist-some substance-specific and some across all/many substances-that impede treatment early on in the process. These include deficits in attention, executive functioning, emotion regulation, memory impairments, abstract reasoning and cognitive flexibility, and the deterioration of brain white matter, which may impact stress response and decision-making. Now, think about the way SUD treatment is implemented for an individual new to recovery. Long treatment groups, emphases on self-reflection, attention to history-related data, personal growth homework, and the need to understand the social cues so to be an effective group member all are skills that require a neurocognitive level of functioning that is perhaps beyond what the new to treatment SUD client can reasonably demonstrate. Consequently, what may be declared "denial" or "resistance" may simply be a person who lacks certain neurocognitive skills and either cannot function or just shuts down/drops-out due to the frustration with the unspoken/unknown mismatch between treatment demands and neurocognitive capabilities.