Comparing attention, impulsivity, and executive functions between patients with opiate use disorder: Buprenorphine maintenance treatment versus active users, in comparison with healthy controls

Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g. , methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD. Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids. Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited. [8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations. This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al. [13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant. [1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning. Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al.[11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02. 2017/23).Background: Opioid use disorders (OUDs) affect over 16 million people worldwide, with a particularly high prevalence rate in Asia. OUDs are associated with significant health consequences, including neurocognitive impairment, which affects individuals' ability to make decisions, respond to stressful situations, and regulate behavior. Understanding the specific ways in which OUDs affect cognitive functioning is important in treatment considerations.This study compared the attention, impulsivity, and executive functions of Turkish men with active OUD (n = 40) with those of men in remission from OUD who were on buprenorphine/naloxone maintenance (BMT; n = 41) and with those of a comparison group of healthy controls (HC; n = 43). The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess neurocognitive functioning.Analyses found significant impairment in measures of continuous attention, cognitive impulsivity, motor impulsivity, and executive functions in the two patient groups compared to the control group, but the two patient groups did not differ from each other.The data from this study indicate that individuals with OUD exhibit neurocognitive damage, and those in remission from OUD who receive maintenance treatment do not show improvement in this domain. Neurocognitive damages should be considered in long-term treatment planning of patients with OUD.Deficits in neurocognitive functions among individuals with opioid use disorder (OUD) are associated with impaired daily life, social, familial, and occupational functioning, leading to low motivation and treatment resistance. Individuals with OUD experience impairment in a wide range of neurocognitive functions, with verbal working memory, cognitive impulsivity, and cognitive flexibility being the most significant.[1] Relative to healthy controls, patients with OUD demonstrate more impulsive choices[2] and a preference for risk decision-making,[3] leading to negative clinical outcomes such as human immunodeficiency virus (HIV) and Hepatitis-C infections in the long run. Furthermore, deficits in decision-making in patients with amphetamine and heroin use disorder persisted in protracted abstinence compared to healthy controls.[4]Studies on cognitive functions in individuals with OUD have mainly included patients in abstinence or undergoing detoxification. While studies on individuals with methadone maintenance treatment are relatively frequent,[5,6] research on buprenorphine maintenance is limited.[7] Furthermore, studies on patients who continue to use opioids are also limited.[8] Theoretically, while methadone is a full agonist to opioid receptors, buprenorphine is expected to have less adverse effects on cognitive functions as buprenorphine is a partial agonist.[9] In our country, the most commonly used agent for maintenance therapy is buprenorphine-naloxone.[10]Methodological differences in past studies make it hard to draw exact conclusions on the neurocognitive effects of opioid use. Additionally, participants in previous studies of the neurocognitive effects of opioid use frequently had a history of using substances other than opioids, including alcohol; a history of head trauma; and psychological co-morbidities, making it difficult to interpret the neurocognitive data. For example, in a review of the literature on recovery of neurocognitive functions following sustained abstinence from substances, Schulte et al. [11] found that impaired decision-making ability did not improve in patients with OUD but noted that these effects may be related to treatment (e.g., methadone), polysubstance use, or psychological co-morbidities. Regarding treatment, Wang et al.[12] reported in a systematic review that methadone maintenance treatment is associated with impaired cognitive functions, but the methodological limitations of studies in this area should be considered. Regarding polysubstance use, Arias et al.[13] found that lifetime alcohol and cocaine dependence in individuals with OUD had very high levels of neurocognitive impairment, particularly in executive functions. In contrast, moderately strong impairment in decision-making was evidenced in current opioid users compared to healthy controls, but this was unrelated to co-morbid head trauma or polydrug use. There were no differences between ex-users and current opioid users in terms of the magnitude of the impairment, and the impairment was not related to the duration of abstinence.[14] Patients with OUD typically have used many other substances before opioids, and differences in the treatment processes (such as duration of treatment and preferred medication) make it difficult to define the specific cognitive effects of opioids.Given the question of the persistence of neurocognitive impairment among individuals with OUD, the current study compared the executive function, impulsivity, and attention of three groups of Turkish men: (1) men with active OUD, (2) men in remission from OUD and on buprenorphine/naloxone maintenance, and (3) healthy controls. In addition to assessing attention, impulsivity, and executive functioning, all participants were screened for concurrent psychiatric disorders as well as for symptoms of attention deficit/hyperactivity disorder (ADHD) in order to exclude factors affecting neurocognitive functions. Based on prior literature,[15] we hypothesized that there would be significant neurocognitive impairment in both opioid use groups and that these groups would differ from healthy controls.Ethical approval for the study was obtained from Erenkoy Mental and Nervous Diseases Training and Research Hospital (date/number: 10.02.2017/23).