Cognitive Impairments in Substance Use Patients Treated with Methadone.

Abstract

Introduction: Substance abuse remains a critical global challenge with social, economic, and health impacts. Cognitive impairments are recognized as significant risk factors for relapse and poor treatment outcomes in individuals undergoing substance abuse treatment. This study investigated the prevalence of cognitive impairments and associated factors among patients receiving methadone maintenance therapy (MMT).

Methods: A cross-sectional analytical study was conducted among 370 patients receiving MMT at substance abuse treatment centers in Rasht in 2022. Participants were selected through a two-stage cluster sampling method after obtaining informed consent. Data were collected using demographic questionnaires, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Montreal Cognitive Assessment (MoCA). Statistical analyses, including standard deviation, Spearman's correlation, and the Kruskal-Wallis test, were conducted using SPSS version 21 (P=0.0001).

Results: Cognitive impairments were observed in 11.1% of participants, with an average age of 49.58±14.40 years. Male participants scored significantly higher on the verbal fluency (P=0.004) and delayed recall (P=0.030) subscales. Employed or retired patients demonstrated better cognitive performance compared to their unemployed counterparts (P=0.0001). Cognitive scores were inversely correlated with age (P=0.0001) and positively correlated with education level (P=0.0001). Longer primary substance use duration, higher methadone doses, and longer treatment durations were inversely associated with cognitive performance (P=0.0001). Stress, depression, and anxiety scores were inversely correlated with MoCA scores (P=0.0001).

Conclusion: Cognitive impairments were identified in 11.1% of participants. Longer durations of primary substance use, higher methadone maintenance doses, and extended treatment durations were significantly associated with poorer cognitive performance.