Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2018 | Month : May | Volume : 12 | Issue : 5 | Page : VC01 - VC05

Cognition and Opioid Substitution Therapy Adherence in Patients with Opioid Dependence

Shabina A Sheth, Nilanjan C Chandra, Ritambhara Y Mehta

1. Resident, Department of Psychiatry, Government Medical College, Surat, Gujarat, India. 2. Senior Resident, Department of Psychiatry, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India. 3. Professor and Head, Department of Psychiatry, Government Medical College, Surat, Gujarat, India.

Correspondence Address :
Dr. Shabina A Sheth,
Ameen-E-Shariat Street, Opposite Sarvodaya Society, Pologround, Sabarkantha, Himatnagar-383001, Gujarat, India.


Introduction: Opioid Substitution Therapy (OST) is an effective long term treatment option for opioid dependence as well as Human Immunodeficiency Virus (HIV) prevention and intervention for opioid dependent Intravenous Drug User (IDUs). Department of Psychiatry is running DOST centre for opioid dependent patients for last four years. The dropout rates are also high.

Aim: To assess the cognition, medical complications, social, financial impact of opioid addiction and to study correlation of cognition with OST adherence in patients with opioid dependence.

Materials and Methods: The cross-sectional study was conducted in the DOST Centre, OPD-13, New Civil Hospital, Surat, Gujarat, India, in August 2015. All 22 patients taking OST as a part of DOTS in DOST centre (name of the OST centre) were enrolled in this study. After giving ‘Participant Information Sheet’ informed valid consent were taken from all participants. Semistructured questionnaire which investigated qualitative and quantitative information about opioid and other substance use with related complications, scales Addenbrooke’s Cognitive Examination-III (ACE-III) Hindi and Mini Mental State Examination (MMSE) for cognitive assessment were used and analysed.

Results: Out of 22 patients coming to DOST centre for OST 22.72%, 31.81% and 45.45% patients were Irregular (IR), Regular (R), Very Regular (VR) respectively (as per, criteria given by NACP-IV). Mean MMSE score in IR, R and VR patients were 21.8, 23.29, 22.8 respectively and ACE-III score in IR, R and VR patients are 63.2, 79.57, and 67.9 respectively. Patients who were non adherent and irregular had statistically significant lower ACE-III score (p=0.032). Cognition (ACE-III) and adherence showed a statistically significant linear positive relationship (p<0.001) with moderate strength on Pearson’s correlation test.

Conclusion: As there is no significant result outcome regarding comparison of adherence with other variables like education, marital status, socioeconomic status, social support, it can be concluded that the only robust factor which affects OST adherence is cognitive decline of the patient which is responsible for no behavioural changes, harmful use, relapse and not maintaining abstinence in opioid dependent patients.


Buprenorphine, Cognitive functioning, Questionnaire

How to cite this article :

Shabina A Sheth, Nilanjan C Chandra, Ritambhara Y Mehta. COGNITION AND OPIOID SUBSTITUTION THERAPY ADHERENCE IN PATIENTS WITH OPIOID DEPENDENCE. Journal of Clinical and Diagnostic Research [serial online] 2018 May [cited: 2018 Aug 15 ]; 12:VC01-VC05. Available from

DOI and Others

DOI: 10.7860/JCDR/2018/34600.11455

Date of Submission: Oct 29, 2017
Date of Peer Review: Jan 24, 2018
Date of Acceptance: Feb 06, 2018
Date of Publishing: May 01, 2018


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