Background: The ability to accurately recognise facial expressions of emotion is crucial for social functioning and maintaining healthy relationships. Recognising the emotional state of others allows us to respond to their needs and adjust our behaviour appropriately. Impairments in facial affect recognition have been reported in chronic cocaine users but little is known whether these contribute to their difficulties in social situations.

Methods: We assessed facial emotional expression recognition in forty-five men with cocaine use disorder (CUD) and forty-four healthy control participants. Using standardised questionnaires, we also collected information on perceived social support, social provision and community integration.

Results: Our results found that male cocaine users had greater difficulty in recognising female emotional facial expressions than male controls. This effect was not explained by demographic variables but it was associated with their social network; including social support, social provisions and community integration.

Conclusion: Our findings suggest that men with CUD have greater difficulty in identifying emotional expression in female faces, which is linked with their social support networks. This may play an important role in misunderstanding non-verbal communications that contribute to destabilising friendship and family ties typically seen in drug addiction. Addressing deficits in recognising female emotional expressions may be an important piece of information for counselling and other interventions.