Relationship of neurocognition and treatment retention in subjects on opioid agonist treatment

ABSTRACT

Background

Opioid dependence affects several neurocognitive domains, which can negatively affect the treatment outcome.

Objective

Examining the relationship between neurocognitive functions and short-term treatment retention in subjects on buprenorphine-naloxone-based agonist treatment.

Methods

We recruited 56 subjects (aged between 18 and 45 years) registered between March 2017 and December 2017. We excluded subjects dependent on other substances (except cannabis and tobacco), along with medical and other psychiatric comorbidities. During the first week of the agonist treatment, we assessed executive function, decision-making, attention, psychomotor speed, and working memory with the Wisconsin card sorting test (WCST), Iowa gambling test (IGT), and Trail making and verbal and visual N-back tests. Treatment retention was assessed after 12 weeks.

Results

The mean age of the subjects was 26 (±5.9) years. Twenty-eight (50%) subjects were retained in the treatment. Neurocognitive functions at the treatment entry did not differ between subjects retained in the treatment and those who dropped out. A higher severity and lower duration of dependence and use were associated with higher treatment discontinuation. The regression model, with the cognitive functions and significant clinical variables, could explain 38% variance for treatment retention.

Conclusion

Neurocognitive functions at the treatment entry did not predict retention in opioid agonist treatment.

HIGHLIGHTS

• There is some evidence of baseline cognitive functions predicting treatment retention in substance use disorders

• We wanted to test it in a group of patients on buprenorphine (naloxone)-based agonist management

• Relevant clinical and demographic variables were controlled for

• Executive functions, decision-making, attention, psychomotor speed, and working memory at the treatment entry did not predict retention at the end of three months

• Longer duration of opioid use (and dependence) was associated with better treatment retention

KEYWORDS:

• Opioid dependence
• agonist treatment
• neurocognitive function

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.