Early Initiation of Amphetamine-Type Stimulants (ATS) Use Associated with Lowered Cognitive Performance among Individuals with Co-Occurring Opioid and ATS Use Disorders in Malaysia

Abstract

Amphetamine-type stimulants (ATS) use is increasingly prevalent in Malaysia, including among individuals who also use opioids. We evaluated cognitive functioning profiles among individuals with co-occurring opioid and ATS dependence and their lifetime patterns of drug use. Participants (N=50) enrolling in a clinical trial of buprenorphine/naloxone treatment with or without atomoxetine completed the Raven’s Standard Progressive Matrices, Rey-Osterrieth Complex Figure test, Digit Span, Trail Making and Symbol Digit Substitution tasks. Multidimensional scaling and a K-means cluster analyses were conducted to classify participants into lower versus higher cognitive performance groups. Subsequently, analyses of variance procedures were conducted to evaluate between group differences on drug use history and demographics. Two clusters of individuals with distinct profiles of cognitive performance were identified. The age of ATS use initiation, controlling for the overall duration of drug use, was significantly earlier in the lower than in the higher cognitive performance cluster: 20.9 (95% CI: 18.0 – 23.8) versus 25.2 (95% CI: 22.4 – 28.0, p = 0.038). While adverse effects of ATS use on cognitive functioning can be particularly pronounced with younger age, potentially related to greater vulnerability of the developing brain to stimulant and/or neurotoxic effects of these drugs, the current study findings cannot preclude lowered cognitive performance before initiation of ATS use.

Associations of childhood experiences and methamphetamine use among Akha and Lahu hill tribe youths in northern Thailand: A cross-sectional study

“…The World Health Organization (WHO), Thailand, reported that Thai youths experienced their first use of drugs before the age of 14 years [32]. A study in Malaysia in 2018 [33] also reported that the age of beginning MA use was 13 years, which supports our finding. A report from a national survey on drug use and health in the United States in 2015 also reported that the early age of MA use was 12 years [34].…”

D4 and D5 dopamine receptor mRNA expression in human peripheral blood lymphocytes among cooccurring opioid and amphetamine-type stimulants use disorder undergoing methadone maintenance therapy

“…Lifetime ATS use was linked with HIV infection 3 . In Malaysia, popular ATS include crystalline methamphetamine and amphetamine/methamphetamine tablets while heroin and morphine remain the most commonly misused opioid 4 . Methadone maintenance treatment (MMT) is a comprehensive and effective substitution treatment for opioid use disorder and was commenced in Malaysia in 2006 by Malaysia Ministry of Health 5,6 .…”

Activation of proline biosynthesis is critical to maintain glutamate homeostasis during acute methamphetamine exposure

“…It belongs to a larger group of drugs called Amphetamine-Type Stimulants (ATS) 1-3 . Use of ATS generate a sense of euphoria, increase energy and concentration as well as decrease appetite, induce weight loss, leading to a variety of emotional, cognitive, and physical effects 4,5 . Among the ATS, METH has the greatest potential for abuse because of easy availability, low cost, and longer duration of action 1-3 .…”

“…Among the ATS, METH has the greatest potential for abuse because of easy availability, low cost, and longer duration of action 1-3 . Therefore, METH use and abuse continues to be a significant public health problem in the United States and all over the world [1][2][3] .METH is a lipophilic compound that crosses the blood-brain barrier easily to cause long lasting effects in the brain 4,5 . Since METH's chemical structure is similar to monoamines, it targets both dopaminergic (DA) and…”

“…METH is a lipophilic compound that crosses the blood-brain barrier easily to cause long lasting effects in the brain 4,5 . Since METH's chemical structure is similar to monoamines, it targets both dopaminergic (DA) and…”