Buket KOPARAL, Ceyda Oktay YANİK, Ismail Volkan SAHİNER, Hatice Ayca KALOGLU, Muhammed Hakan AKSU, Cisem UTKU, Zehra ARİKAN

Cognitive functions in opioid-dependent males according to duration of abstinence

Objective: Opioid dependence is a neurobehavioral disorder characterized by repeated compulsive craving or using an opioid. In this study, we aimed to evaluate cognitive functions according to the duration of abstinence and other factors affecting cognitive functions.Method: The study was carried out between February and April 2017 at the Psychiatry Department of Gazi University Medical Faculty. A total of 96 adult males participated; all of them had received detoxification treatment and were undergoing maintenance treatment. Patients were divided into three groups according to the duration of abstinence. First, a sociodemographic data form and Beck Anxiety Inventory were administered. Afterwards, the Wisconsin Card Sorting Test, Rey Auditory-Verbal Learning Test, and Stroop Test were applied.Results: The sample group showed no significant impairment in their cognitive functions when compared to the norm values. The group of patients with 0-3 months of abstinence had higher memory scores than those who had been abstinent for more than 1 year. We also found that duration of multiple substance use, age of first substance use, and the number of treatments undergone affected some of the cognitive functions negatively.Conclusion: This study is the first in which cognitive functions have been evaluated in opioid-dependent males in Turkey. It is not possible to control all of the factors affecting cognitive functions. Therefore, prospective studies and animal studies in which the effect of opioids can be examined exclusively are needed

PDF

___

1. Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s Synopsis of Psychiatry: Behavioral Science/Clinical Psychiatry. Bozkurt A (Translation Editor) Eleventh ed., Ankara: Gunes Kitabevi, 2016, 659-666. (Turkish)

2. Turkey Drug Report – Data for 2016. Ankara: Turkish Drug and Drug Addiction Monitoring Center, 2017. (Turkish)

3. United Nations Office on Drugs and Crime. World Drug Report 2016. New York: United Nations, 2016.

4. Bukten A, Skurtveit S, Gossop M, Waal H, Stangeland P, Havnes I, et al. Engagement with opioid maintenance treatment and reductions in crime: a longitudinal national cohort study. Addiction 2012; 107:393-399.

5. Mattick RP, Breen C, Kimber J, Davoli M. Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Syst Rev 2009:CD002209.

6. Lezak MD. Neuropsychological Assessment. Oxford: Oxford University Press, 1995.

7. Pennington BF, Ozonoff S. Executive functions and developmental psychopathology. J Child Psychol Psychiatry 1996; 37:51-87.

8. Ersche KD, Sahakian BJ. The neuropsychology of amphetamine and opiate dependence: implications for treatment. Neuropsychol Rev 2007; 17:317-336.

9. Baldacchino A, Balfour DJ, Passetti F, Humphris G, Matthews K. Neuropsychological consequences of chronic opioid use: a quantitative review and meta-analysis. Neurosci Biobehav Rev 2012; 36:2056-2068.

10. Soyka M. Cognitive Functioning in Methadone Use; In Preedy V (editor). Neuropathology of Drug Addictions and Substance Misuse. Amsterdam: Elsevier (Academic Press), 2016, Vol. 3, 603-607.

11. Fields FR, Fullerton JR. Influence of heroin addiction on neuropsychological functioning. J Consult Clin Psychol 1975; 43:114.

12. Li X, Zhang F, Zhou Y, Zhang M, Wang X, Shen M. Decision-making deficits are still present in heroin abusers after short- to long-term abstinence. Drug Alcohol Depend 2013; 130:61-67.

13. Fishbein DH, Krupitsky E, Flannery BA, Langevin DJ, Bobashev G, Verbitskaya E, et al. Neurocognitive characterizations of Russian heroin addicts without a significant history of other drug use. Drug Alcohol Depend 2007; 90:25-38.

14. Ornstein TJ, Iddon JL, Baldacchino AM, Sahakian BJ, London M, Everitt BJ, et al. Profiles of cognitive dysfunction in chronic amphetamine and heroin abusers. Neuropsychopharmacology 2000; 23:113-126.

15. Fernandez-Serrano MJ, Perez-Garcia M, Verdejo-Garcia A. What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance? Neurosci Biobehav Rev 2011; 35:377-406.

16. Pau CW, Lee TM, Chan SF. The impact of heroin on frontal executive functions. Arch Clin Neuropsychol 2002; 17:663-670.

17. Mintzer MZ, Copersino ML, Stitzer ML. Opioid abuse and cognitive performance. Drug Alcohol Depend 2005; 78:225-230.

18. Verdejo-Garcia AJ, Perales JC, Perez-Garcia M. Cognitive impulsivity in cocaine and heroin polysubstance abusers. Addict Behav 2007; 32:950-966.

19. Fernandez-Serrano MJ, Perez-Garcia M, Schmidt Rio-Valle J, Verdejo-Garcia A. Neuropsychological consequences of alcohol and drug abuse on different components of executive functions. J Psychopharmacol 2010; 24:1317-1332.

20. Karakas S, Erdogan E, Dincer Dogutepe E. BIL-NOT YETISKIN: Studies for the Development of Neuropsychological Tests for Adults. Ankara: Egitim Yayinevi, 2013. (Turkish)

21. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56:893-897.

22. Ulusoy M, Sahin N, Erkmen H. Turkish version of Beck Anxiety Inventory: psychometric properties. J Cognit Psychother 1998; 12:163-172.

23. Karakas S, Basar E. Standardization of neuropsychological tests in a Turkish sample according to different ages and levels of education. Kriz Dergisi 1993; 159-166. (Turkish)

24. Karakas S, Erdogan E, Sak L, Soysal AS, Ulusoy T, Ulusoy IY, et al. Stroop Test TBAG Form: Standardisation for Turkish Culture, Reliability and Validity. Klinik Psikiyatri Dergisi 1999; 2:75-88. (Turkish)

25. Karakas S, Dogutepe Dincer E. Handbook for the BILNOT Battery: Studies for Research and Development of Neuropsychological Tests for Children (BILNOT COCUK). Ankara: Nobel Tıp Kitabevleri, 2011. (Turkish)

26. Zhang XL, Shi J, Zhao LY, Sun LL, Wang J, Wang GB, et al. Effects of stress on decision-making deficits in formerly heroin-dependent patients after different durations of abstinence. Am J Psychiatry 2011; 168:610-616.

27. McDonald S, Darke S, Kaye S, Torok M. Deficits in social perception in opioid maintenance patients, abstinent opioid users and non-opioid users. Addiction 2013; 108:566-574.

28. Darke S, McDonald S, Kaye S, Torok M. Comparative patterns of cognitive performance amongst opioid maintenance patients, abstinent opioid users and non-opioid users. Drug Alcohol Depend 2012; 126:309-315.

29. Darke S, Sims J, McDonald S, Wickes W. Cognitive impairment among methadone maintenance patients. Addiction 2000; 95:687-695.

30. Ersche KD, Clark L, London M, Robbins TW, Sahakian BJ. Profile of executive and memory function associated with amphetamine and opiate dependence. Neuropsychopharmacology 2006; 31:1036-1047.

31. Pirastu R, Fais R, Messina M, Bini V, Spiga S, Falconieri D, et al. Impaired decision-making in opiate-dependent subjects: effect of pharmacological therapies. Drug Alcohol Depend 2006; 83:163-168.

32. Brands B, Blake J, Marsh DC, Sproule B, Jeyapalan R, Li S. The impact of benzodiazepine use on methadone maintenance treatment outcomes. J Addict Dis 2008; 27:37-48.

33. Zeng H, Lee TM, Waters JH, So KF, Sham PC, Schottenfeld RS, et al. Impulsivity, cognitive function, and their relationship in heroin-dependent individuals. J Clin Exp Neuropsychol 2013; 35:897-905.

34. Zacny JP, Conley K, Galinkin J. Comparing the subjective, psychomotor and physiological effects of intravenous buprenorphine and morphine in healthy volunteers. J Pharmacol Exp Ther 1997; 282:1187-1197.

35. Rapeli P, Fabritius C, Alho H, Salaspuro M, Wahlbeck K, Kalska H. Methadone vs. buprenorphine/naloxone during early opioid substitution treatment: a naturalistic comparison of cognitive performance relative to healthy controls. BMC Clin Pharmacol 2007; 7:5.

36. Arias F, Arnsten JH, Cunningham CO, Coulehan K, Batchelder A, Brisbane M, et al. Neurocognitive, psychiatric, and substance use characteristics in opioid dependent adults. Addict Behav 2016; 60:137-143.

37. Soyka M, Hock B, Kagerer S, Lehnert R, Limmer C, Kuefner H. Less impairment on one portion of a driving-relevant psychomotor battery in buprenorphine-maintained than in methadone-maintained patients: results of a randomized clinical trial. J Clin Psychopharmacol 2005; 25:490-493.

38. Preedy V (editor). Neuropathology of Drug Addictions and Substance Misuse Volume 1: Foundations of Understanding, Tobacco, Alcohol, Cannabinoids and Opioids. Boston: Elsevier, 2016.