Self-Reported Cognitive Impairments in Office-Based Treatment for Opioid Use Disorder with Buprenorphine or Extended-Release Naltrexone

Background: Opioid use disorder (OUD) can be associated with cognitive impairment. However, little is known about how patients with OUD self-perceive any cognitive impairments, particularly in attention, executive function, and memory. No studies have addressed this issue in patients with OUD and self-reported adherence to office-based medication-assisted treatment (MAT). Methods: This was an observational, multisite, cross-sectional survey study to evaluate self-reported cognitive function in adults with OUD, enrolled at 7 sites in the U.S., who had received ⩾3 months of office-based MAT. A cognitive self-report survey was administered to a clinical sample of adults with OUD (N = 255) adherent to buprenorphine (BUP; N = 139) or extended-release naltrexone (XR-NTX; N = 116). Impairments in attention, executive function, and memory were assessed with relevant items of the Executive Function Index (EFI) and Prospective Retrospective Memory Questionnaire (PRMQ). Factor analysis explored item factor structure; item scores were summed to generate scales, and association was estimated by linear regression. Results: Approximately one-third of participants reported head injury and nearly one-half reported psychiatric comorbidities, particularly anxiety and depression. Most participants reported difficulties in ⩾1 cognitive item: 80.8% (206/255) for EFI and 49.0% (125/255) for PMRQ. Factor analysis suggested 3 cognitive scales (attention, executive, memory). Differences between the XR-NTX and the BUP groups on memory, executive function, and attention either were not found or lost significance after adjustment for neurological history. seizure). All scales were associated with a range of demographic and clinical variables. Conclusions: Most adults receiving office-based MAT for OUD reported self-perceived cognitive impairment, but neurological comorbidities may also play a role in these perceptions.