PEBL Technical Report #2015-02 Opioid Substitution Therapy: Measuring Impairment in a Clinically Relevant Population |
Authors J.
Cameron Davis and Howard Wetsman MD FASAM
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Abstract| The CDC has labeled opioid overdoses an epidemic while treatment is readily available to those suffering. Current research indicates that the best treatment outcomes are in opioid maintenance therapies, yet such therapies carry a significant stigma; opioid maintenance therapy is impairing to patients. Methods: Measures of cognitive ability, the Iowa Gambling task (IGT) and the continuous performance task (CPT), were used to determine cognitive impairment in opioid maintenance patients before and after prescription buprenorphine use. Data was collected from a retrospective chart review of patients enrolled in a medically managed intensive outpatient program that uses frequent neurocognitive testing. Participants were 38 sequential opioid dependent admissions from August to December 2012 who both received buprenorphine and had both before and after testing. Results: A significant difference in IGT scores between the pre and posttest conditions was found with buprenorphine medicated patients having higher average scores than in the pre medication condition, F (74) = 10.74, p=.0016. Target accuracy on the CPT did not differ significantly in any of the time blocks between pre and posttests. A significant difference in foil accuracy was found between the pre and posttests in both the two second block, F (74) = 10.81, p=.0015, and the four second block, F (74) = 5.41, p=.0228 with medicated patients showing improvement over their pre-medicated condition. Conclusion: Evidence from this study does not support the currently prevalent idea that introduction of buprenorphine opioid maintenance treatment will impair patients. This has tremendous implications for buprenorphine maintenance therapy demonstrating that reward overvaluation and impulsivity both decreased after the introduction of prescription buprenorphine in a clinically relevant population. The research also supports the subjective report of opioid dependent maintenance patients that they actually function better when prescribed buprenorphine. |
How to cite:
Davis, J. C. & Wetsman, H. (2015). Opioid Substitution Therapy: Measuring Impairment in a Clinically Relevant Population (2015). PEBL Technical Report Series [On-line] #2015-02.
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 Updating... Ċ Shane Mueller, Sep 13, 2015, 7:49 PM
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