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Open Access Highly Accessed Research

Do drug treatment variables predict cognitive performance in multidrug-treated opioid-dependent patients? A regression analysis study

Pekka Rapeli123*, Carola Fabritius2, Hely Kalska3 and Hannu Alho24

Author Affiliations

1 Unit for Drug Dependence. Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland

2 Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare (THL), Helsinki, Finland

3 Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland

4 Research Unit of Substance Abuse Medicine, University of Helsinki, Helsinki, Finland

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Substance Abuse Treatment, Prevention, and Policy 2012, 7:45  doi:10.1186/1747-597X-7-45

Published: 2 November 2012

Abstract

Background

Cognitive deficits and multiple psychoactive drug regimens are both common in patients treated for opioid-dependence. Therefore, we examined whether the cognitive performance of patients in opioid-substitution treatment (OST) is associated with their drug treatment variables.

Methods

Opioid-dependent patients (N = 104) who were treated either with buprenorphine or methadone (n = 52 in both groups) were given attention, working memory, verbal, and visual memory tests after they had been a minimum of six months in treatment. Group-wise results were analysed by analysis of variance. Predictors of cognitive performance were examined by hierarchical regression analysis.

Results

Buprenorphine-treated patients performed statistically significantly better in a simple reaction time test than methadone-treated ones. No other significant differences between groups in cognitive performance were found. In each OST drug group, approximately 10% of the attention performance could be predicted by drug treatment variables. Use of benzodiazepine medication predicted about 10% of performance variance in working memory. Treatment with more than one other psychoactive drug (than opioid or BZD) and frequent substance abuse during the past month predicted about 20% of verbal memory performance.

Conclusions

Although this study does not prove a causal relationship between multiple prescription drug use and poor cognitive functioning, the results are relevant for psychosocial recovery, vocational rehabilitation, and psychological treatment of OST patients. Especially for patients with BZD treatment, other treatment options should be actively sought.

Keywords:
Opioid-dependence; Opioid agonist therapy; Pharmacotherapy; Psychotropic drugs; Neurocognitive performance; Neuropsychological testing