Abstract
INTRODUCTION: Opioid use has been associated with neurocognitive impairments. These deficiencies play a key role in perpetuating addictive behaviors and hindering the effectiveness of motivational and cognitive treatments. Research on the cognitive effects of natural opium use is limited. This study aims to compare the neurocognitive functions of patients dependent on natural opium with those of healthy controls and examine the association of cognitive functions with clinical variables among cases. METHODS: This cross-sectional study involved 26 patients dependent on natural opium and 26 healthy controls matched for age and gender. A neuropsychological test battery, including the Digit Symbol Substitution Test (DSST), Stroop Color-Word Test (SCWT), F-A-S Test, Digit Span Test (DST), Trail Making Test (TMT) A & B, and Rey Auditory Verbal Learning Test (RAVLT), was used for assessment. Urinary opioid levels were measured in the patients. Partial correlation was employed to investigate the association of cognitive functions with the level of exposure to natural opium. RESULTS: The demographic profiles were comparable, with mean ages of 36 and 33 years for cases and controls, respectively. Cases performed significantly worse on the Stroop test (color word (t = -4.564, p < 0.001), interference scores (t = 2.304, p = 0.025)), the Digit Span Test (domain of sequencing (U = 479, p = 0.005)), the Trail Making Test (part B duration (t = 3.631, p = 0.001)), and the RAVLT (errors of hit (t = -3.119, p = 0.003) and omission (t = 2.990, p = 0.004)). In partial correlation analysis, the duration of opioid dependence was significantly correlated (p < 0.05) with Stroop interference (-0.481) and DST sequence (-0.464). Urine opioid levels were markedly correlated with Stroop CW (0.533). CONCLUSION: Response inhibition, cognitive flexibility, and working memory were the most affected domains of cognitive functioning, suggesting that cognitive dysfunction is limited and not global among natural opium users. The urinary opioid levels and the duration of opioid dependence showed a significant correlation with cognitive impairment. However, these effects were exploratory and cannot be generalized.