Preliminary evidence that alcohol-related cues enhance facial emotion recognition speed and accuracy in polysubstance users

Purpose: There is evidence of impaired facial emotion recognition (FER) in individuals with 
substance use disorder (SUD). While previous studies have primarily examined group 
differences in FER performance, the influence of contextual factors remains poorly understood. 
This study investigates how alcohol-related stimuli (ARS) influence FER in polysubstance 
users, aiming to uncover potential mechanisms that could contribute to relapse in alcohol
associated environments. 
Methods: Eighty-two patients with polysubstance use with cocaine and alcohol as primary 
drugs receiving treatment at a public addiction service and 45 control participants completed 
two sequentially tasks administered in a counterbalanced order: a FER task (EMO) and a 
recognition task (ALC) incorporating ARS. Clinical data - including comorbidities, 
medications, substance use patterns and craving mesures - were collected through routine 
clinical documentation, complemented by standardized instruments: the Toronto Alexithymia 
Scale (TAS-20), Profile of Mood States (POMS), Alcohol Use Disorders Identification Test 
(AUDIT), and Inventory of Interpersonal Problems (IIP-47) 
Findings: Patients demonstrated significantly faster reaction times (RTs) for disgust, and  
enhanced anger recognition accuracy following ARS exposure compared to controls . These 
results suggest alcohol-context modulation of FER in polysubstance users. The authors 
discuss the implications and relevance of these findings for relapse prevention.