Systematic Review and Meta-analysis of the Impact of Cocaine Use on Cognitive Inhibition

Evidence exists that cocaine impacts cognition and behaviour. Yet, uncertainty remains as to what extent cognitive inhibition efficiency decreases in cocaine users. We carried out a systematic review and meta-analysis following the PRISMA 2020 checklist. Our search yielded 1725 articles from Scopus, PubMed and WOS, from which twenty-four studies were finally identified as meeting the inclusion criteria for the systematic review and twenty (providing twenty-three effect sizes) for the meta-analysis. A multi-level random-effects meta-analysis was conducted, and moderation analysis was implemented to examine the potential moderating effects of sex, age, years of regular cocaine use, days of cocaine abstinence, and sample type (clinical vs. community) in the estimated effects. Results showed worse inhibition in cocaine users compared to controls (g = 0.65; 95% CI [0.28, 1.03], p < .001), but none of the moderators significantly impacted this effect. Findings highlight the link between impaired cognitive inhibition and cocaine use disorder and suggest that inhibitory control training approaches would be promising. Future clinical studies are needed to elucidate on the efficacy of neuropsychological approaches for improving inhibitory control and augment the effectiveness of first-line interventions for cocaine use disorder.