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Cognitive Function Impaired During Early Opioid Withdrawal And Abstinence

I’ve been aware for quite some time through my own personal experience with addiction, subsequent withdrawal and recovery that my cognitive function was certainly not 100% whilst using or should I say – abusing opiate-based medications. And now, the research I have reviewed certainly adds further impetus to this view and argument that certain cognitive deficits and/or impairments are evident in those who use or abuse opiates.

In research conducted by a range of authors and published through BMC Psychiatry in 2006, researchers found that when opioids are used chronically as pain relievers they may cause mild cognitive deficits in a range of cognitive functions such as attention, complex working memory, and episodic memory. In a sign of potential “hope” for many (although not proven), there is no evidence yet to suggest that these impairments would or do continue after cessation of oral opioid medication. It is important to note, that further research and study is needed to understand the long-term cognitive function of recovering addicts and chronic opiate users to determine whether there are any lasting effects on the brain and its cognitive abilities. In another twist however, when opioids are abused, they are often used intravenously with frequent high doses and in conjunction with other drugs – and there is some evidence (not consistently or broadly) that there is a general intellectual decline in some people.

When looking at cognitive function during early withdrawal and abstinence, there was evidence of marked declines or impairment in the following test categories: working memory, verbal memory, executive function, and fluid intelligence. The following extract from the research provides an excellent analysis of the background, the methods, results and conclusions of the research conducted –

Individuals with opioid dependence have cognitive deficits during abuse period in attention, working memory, episodic memory, and executive function. After protracted abstinence consistent cognitive deficit has been found only in executive function. However, few studies have explored cognitive function during first weeks of abstinence. The purpose of this study was to study cognitive function of individuals with opioid dependence during early abstinence. It was hypothesized that cognitive deficits are pronounced immediately after peak withdrawal symptoms have passed and then partially recover.

Fifteen patients with opioid dependence and fifteen controls matched for, age, gender, and verbal intelligence were tested with a cognitive test battery. When patients performed worse than controls –correlations between cognitive performance and days of withdrawal, duration of opioid abuse, duration of any substance abuse, or opioid withdrawal symptom inventory score (Short Opiate Withdrawal Scale) were analyzed.

Early abstinent opioid dependent patients performed statistically significantly worse than controls in tests measuring complex working memory, executive function, and fluid intelligence. Their complex working memory and fluid intelligence performances correlated statistically significantly with days of withdrawal.

The results indicate a rather general neurocognitive deficit in higher order cognition. It is suggested that cognitive deficit during early abstinence from opioid dependence is related to withdrawal induced neural dysregulation in the prefrontal cortex and is partly transient.

These results and conclusions further endorse the dangers surrounding the abuse of opiates and their effects on the body and brain. Furthermore, the lack of current research and evidence on the long-term cognitive function of those who abuse opiates provides additional incentive for addicts to quit and for recovering addicts to remain clean.


  1. http://www.biomedcentral.com/1471-244X/6/9/

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