Sustained Attention in Methadone Patients

Appel, Philip W.

doi:10.3109/10826088209064064

Cited by 29 publications

(15 citation statements)

References 7 publications

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“…We believe additional investigations are warranted to better understand the development of changes in cognitive abilities over time in protracted opiate abstinence. Appel and Gordon (1982) and Sivan (1991). Table 1 Demographic data and substance use history of methadone maintained, protracted abstinence, and healthy control groups Lifetime history of any substance use in former opiate abusers and control subjects who met inclusionary and exclusionary criteria (see Section 2) as a percent of group membership Neuropsychological performance of methadone maintained, protracted abstinent, and healthy control subjects calculated with years of education as a covariate …”

Section: Resultsmentioning

confidence: 99%

Neuropsychological functioning in opiate-dependent subjects receiving and following methadone maintenance treatment

Prosser

Cohen

Steinfeld

et al. 2006

Drug and Alcohol Dependence

126

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Objective-An accumulating body of research suggests that former heroin abusers in methadone maintenance therapy (MMT) exhibit deficits in cognitive function. Whether these deficits are present in former methadone maintained patients following discontinuation of MMT is unknown. This study tests the hypothesis that former heroin users who have detoxified from methadone maintenance therapy and are drug-free have less pronounced cognitive impairment than patients continuing longterm MMT.Method-A series of neuropsychological tests were administered to three groups of subjects: 29 former heroin addicts receiving methadone maintenance treatment, 27 former heroin addicts withdrawn from all opiates, and 29 healthy controls without a history of drug dependence. Testing included Wechsler Adult Intelligence Scale-Revised Vocabulary Test, the Stroop Color-Word Test, the Controlled Oral Word Association Test, the Benton Visual Retention Test, and a Substance Use Inventory.Findings-Both methadone-maintained and abstinent subject groups performed worse than controls on tasks that measured verbal function, visual-spatial analysis and memory, and resistance to distractibility. Abstinent subjects performed worse than their methadone maintained counterparts on tests measuring visual memory and construct formation. Cognitive impairment did not correlate with any index of drug use.Conclusions-We confirmed previous findings of neuropsychological impairment in long-term MMT recipients. Both patients receiving MMT and former heroin users in prolonged abstinence exhibited a similar degree of cognitive impairment. Cognitive dysfunction in patients receiving methadone maintenance may not resolve following methadone detoxification.

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Section: Resultsmentioning

confidence: 99%

Neuropsychological functioning in opiate-dependent subjects receiving and following methadone maintenance treatment

Prosser

Cohen

Steinfeld

et al. 2006

Drug and Alcohol Dependence

126

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“…A total of 28 studies, focusing on performance among MMPs compared to various control groups, were included (Appel 1982;Appel and Gordon 1976;Baewert et al 2007;Darke et al 2000;Davis et al 2002;Dittert et al 1999;Ersche et al 2006;Gordon 1970;Grevert et al 1977;Gritz et al 1975;HauriBionda et al 1998;Hornung et al 1995;Kubitzki 1997;Lenne et al 2003;Mintzer et al 2005;Mintzer and Stitzer 2002;Moskowitz and Robinson 1985;Pirastu et al 2006;Prosser et al 2006Prosser et al , 2009Rapeli et al 2007 2015 2005), and the most relevant information is summarized in Table 3. Patient group sizes studied were between 9 and 54 subjects, with doses ranging between 2 and 150 mg.…”

Section: Methadonementioning

confidence: 99%

Can Patients Receiving Opioid Maintenance Therapy Safely Drive? A Systematic Review of Epidemiological and Experimental Studies on Driving Ability With a Focus on Concomitant Methadone or Buprenorphine Administration

Strand

Fjeld

Arnestad

et al. 2013

Traffic Injury Prevention

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Both methadone and buprenorphine were confirmed as having impairing potentials in opioid-naïve subjects. At least some opioid maintenance therapy patients are observed having only slight impairments of relevance to driving. Knowing this when approaching the question of ability to drive, an individual evaluation of the driving performance, pertaining to the opioid maintained patient, may be the most useful and conclusive procedure.

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“…Regarding attention and concentration tests, patients generally seem to perform less well, with the exception of one study result [3] where group difference was qualified as not significant (no descriptive statistics given). According to one other study without descriptive statistics, the overall test performance of methadone patients, at least regarding the group of nonemployed patients, is worse [4].…”

Section: Concentration and Attentionmentioning

confidence: 99%

Cognitive-Motor Performance of Methadone-Maintained Patients

et al. 2000

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Fifty-four methadone-maintained patients and 54 healthy controls, matched for age, gender and educational attainment, completed a battery of six cognitive-psychomotor performance tests. Results of previous studies were replicated in four areas. An attention task was performed less well by patients [mean difference more than 0.7 standard deviations (SD)] as was a tachistoscopic perception task (0.3 SD). On a simple-choice reaction test, patients showed higher speed in decision making and motor reaction as well as an increased number of decision errors (0.3 SD each). Performing a tracking test, patients showed less deviations (0.4 SD) combined with more time needed (0.8 SD). Our data go beyond previous (seemingly inconsistent) research findings by showing that patients did less well by more than 0.6 SD when on higher speed levels. Absolving a test on visual structuring, more patients than controls achieved a 100% accuracy level (52 vs. 30%), but at the same time patients were slower (0.6 SD) than controls. An inferior test performance of patients in methadone maintenance treatment has been confirmed in some areas, especially in attention. However, the fairly moderate size of these effects and the fact that in the majority of measures the observed variance was better explained by sociodemographic features than by group membership lead on the conclusion that belonging to the group of methadone patients alone is not necessarily sufficient to predict an impairment in cognitive-psychomotor skills. To conclude, assessment of fitness for certain tasks or occupations should be done individually for each patient and should take into account comorbidity, including the extent of alcohol and other drug use.

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Sustained Attention in Methadone Patients

Cited by 29 publications

References 7 publications

Neuropsychological functioning in opiate-dependent subjects receiving and following methadone maintenance treatment

Neuropsychological functioning in opiate-dependent subjects receiving and following methadone maintenance treatment

Can Patients Receiving Opioid Maintenance Therapy Safely Drive? A Systematic Review of Epidemiological and Experimental Studies on Driving Ability With a Focus on Concomitant Methadone or Buprenorphine Administration

Cognitive-Motor Performance of Methadone-Maintained Patients

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