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

Drug Alcohol Depend. 2006 Jun 28;83(2):163-8. doi: 10.1016/j.drugalcdep.2005.11.008. Epub 2005 Dec 15.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Buprenorphine / therapeutic use*
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology*
  • Decision Making*
  • Female
  • Gambling / psychology
  • Humans
  • Male
  • Methadone / therapeutic use*
  • Middle Aged
  • Narcotic Antagonists / therapeutic use*
  • Neuropsychological Tests
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / rehabilitation*
  • Severity of Illness Index

Substances

  • Narcotic Antagonists
  • Buprenorphine
  • Methadone