Impaired decision-making in opiate-dependent subjects: Effect of pharmacological therapies

• Published in: Drug and alcohol dependence Vol. 83; no. 2; pp. 163 - 168
• Main Authors: Pirastu, R., Fais, R., Messina, M., Bini, V., Spiga, S., Falconieri, D., Diana, M.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 28.06.2006; Elsevier Science
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Buprenorphine; Buprenorphine - therapeutic use; Cognition Disorders - diagnosis; Cognition Disorders - epidemiology; Cognitive functioning; Cognitive functions; Decision Making; Drug addiction; Female; Gambling; Gambling - psychology; Gambling task; Humans; Male; Medical sciences; Methadone; Methadone - therapeutic use; Middle Aged; Narcotic Antagonists - therapeutic use; Neuropsychological Tests; Opioid-Related Disorders - epidemiology; Opioid-Related Disorders - rehabilitation; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity of Illness Index; Toxicology; Decision-making; Methadone; Buprenorphine; Cognitive functions; Humans; Gambling task; Human; Drug addiction; Replacement therapy; Poison withdrawal; Decision making; Psychology; Opiates; Cognition; Narcotic analgesic; Gambling game; Chemotherapy; Addiction; Psychopathology; Psychiatry
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2005.11.008

Cognitive dysfunction is a major feature of drug addiction. In the present paper, we compared the decision-making ability using the Iowa gambling task of methadone- and buprenorphine-maintained individuals to non opiate-dependent drug-free controls. Buprenorphine-maintained individuals performed better than methadone-maintained individuals, and not differently than non opiate-dependent controls. In addition, methadone-maintained individuals had more perseverative errors on the Wisconsin card sorting task (WCST) as compared with non opiate-dependent drug-free controls whereas buprenorphine-maintained individuals had intermediate scores. Scores on Weschler adult intelligence scale (WAIS-R) were similar for methadone- and buprenorphine-maintained individuals whereas drug-free controls had significantly higher scores. In addition, both opiate-dependent groups performed more poorly than drug-free controls on the Benton visual retention test (BVRT). The results suggest that buprenorphine in contrast to methadone improves decision-making, and thus may be more effective in rehabilitation programs of opiate-dependent subjects and this improvement may be related to its distinct pharmacological action as a k antagonist.