Neurocognitive, psychiatric, and substance use characteristics in opioid dependent adults

Abstract

Among this sample of opioid-dependent adults, there were high rates of global and domain-specific neurocognitive impairment, with severe impairment in learning and memory. Lifetime alcohol and cocaine dependence were associated with greater neurocognitive impairment, particularly in executive functioning. Because executive functioning is critical for decision-making and learning/memory dysfunction may interfere with information encoding, these findings suggest that opioid-dependent adults may require enhanced support for medical decision-making.

Factors associated with cognitive impairment in a cohort of older homeless adults: Results from the HOPE HOME study

“…Homeless adults who lack social support, economic resources, and have a high prevalence of chronic disease might not be able to adapt to cognitive deficits (Fazel et al, 2014; Solarz and Bogat, 1990). Executive function, which includes planning, organizing, social behavior, and impulse control, might be important for navigating social services, medical treatment, and behavioral therapies employed in the treatment of substance use disorders (Arias et al, 2016; Hagen et al, 2016). Persons with executive dysfunction might have difficulty completing multi-step commands, organizing their daily schedule, or participating in interactive treatment models such as cognitive behavioral therapy and self-help programs.…”

The Opioid-Addicted Tetrapartite Synapse

“…Linking brain cellular pathophysiology with symptoms of human opioid use disorder (OUD) requires preclinical animal models that mimic behavioral phenotypes observed in humans with OUD. For example, rats receiving long-term noncontingent administration of opioids exhibit deficits in learning and memory tasks (13)(14)(15)(16), and opioid use and abstinence in rodents involves development of social withdrawal (17), anxietylike and depression-like behaviors (18,19), vulnerability to stressors (20), and decreased motivation for natural rewards (21), similar to symptoms observed in OUD (3,4,(22)(23)(24)(25)(26). In selfadministration models of OUD, rodents perform operant tasks to receive intravenous opioid infusions, often paired with a conditioning stimulus (cue).…”

“…Remarkably, 80% of heroin users report early use of opioid analgesics (2), supporting the notion that opioid exposure produces long-lasting brain adaptations that can lead to compulsive drug use and seeking. Such brain adaptations manifest in clinical symptoms including impaired cognition (3); deficits in learning, memory, and attention (4); and increased impulsivity (5,6). These impairments are thought to arise from pathological disruptions in prefrontal and subcortical circuits that contribute to an uncontrollable desire to use opioids (craving) and can escalate drug use and increase the likelihood of relapse (6)(7)(8).…”

Association between executive function and outcome measure of treatment in therapeutic community among cocaine dependent individuals

“…In addition, substance use is related to other problems such as increased traffic accidents or psychiatric comorbidity (Alvarez, Gómez-Talegón & Marcos, 2010;Arias et al, 2016;Paim Kessler et al, 2012;Vergara-Moragues et al, 2011;Vergara-Moragues et al, 2012).…”