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 alcoholassociated 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.