Research Article

Impaired Inhibitory Control in Substance Use Disorders: Neurocognitive Mechanisms, Clinical Consequences, and Therapeutic Perspectives

Authors: Edward Ruvins, Katie G Brydon, Susanna Kayserman, Mark Stein, Chloe V Ruvins.

DOI: 10.33425/2639-8451.1059

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Abstract

Impaired inhibitory control is increasingly recognized as a hallmark deficit in substance use disorders (SUDs). This executive function impairment contributes to compulsive drug-seeking, maladaptive decision-making, and heightened relapse vulnerability. Neuroimaging, behavioral, and neurochemical evidence implicate dysfunction in prefrontal–striatal circuits, particularly involving the dorsolateral prefrontal cortex (dlPFC), orbitofrontal cortex (OFC), and anterior cingulate cortex (ACC). Drug-induced dysregulation of dopamine and glutamate signaling further disrupts top-down control over subcortical reward and habit systems. This review synthesizes current knowledge on the neurocognitive underpinnings of impaired inhibitory control in SUDs, discusses its role in addiction trajectories, and evaluates therapeutic approaches targeting inhibitory dysfunction. Emerging modalities, including cognitive training,
neuromodulation, and pharmacotherapies, hold promise in complementing established behavioral interventions.

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