Abstract
AIM: To study the effects of opioids on cognitive functions and compare cognitive impairment between natural and synthetic opioid users. METHODS: Study was conducted on patients between 18 and 60 years diagnosed with opioid dependence as per ICD-11 presenting to Deaddiction IPD/Deaddiction OPD, Department of Psychiatry, DMC and H Ludhiana, for one year. Cognitive assessment was done using PGIBBD (PGI Battery of Brain Dysfunction). RESULTS: Higher dysfunction rating score was observed in the synthetic opioid users as compared to the natural opioid users with P = 0.003 having a medium effect size with Cohen's d of 0.51. Synthetic opioid users exhibited marked impairment across various cognitive domains, particularly in executive functioning, memory retention, and perceptual-motor skills. Significant correlations were identified between age, age of onset, duration, and dose of substance used, and with recent and immediate memory, attention and concentration, PQ, TQ arithmetic, Nahor-Benson Test, and overall dysfunction rating score. These correlations varied depending on the type of substance used. CONCLUSION: Synthetic opioid users experienced significant cognitive dysfunction compared to natural opioid users. This dysfunction manifests as impaired judgment, reduced cognitive flexibility, and compromised decision-making abilities, contributing to poorer treatment outcomes.