Background and Objective:Cognitive impairment is one of the consequencesof substance abuse. Tramadol abuse is a public health problemin Egypt. The objective of this study was to study the effect of tramadol addiction on cognitive functions, determine if cognitive impairment caused by tramadol is reversible or not and to study the impact of other related factors as duration of intake and dose of tramadol on cognition.Methods: This study included 30 patients with active tramadol abuse, 30 patients abstinent from tramadol for 3 to 6 months and 30 control subjects (matched for age, sex, and education) who were recruited from Kasr Al-Aini psychiatric and addiction hospital (from outpatient clinic and inpatient admitted patients), Egypt.The participants were interviewed using Montreal Cognitive Assessmenttest (MoCA), Trail making test A and B and had urine screening for drugs. Results: 53.33%(n=16) of active group had impaired total MoCA scores compared to 10 % (n=3) in control group.This was statistically significant with P value <0.0001.46.67% (n=14) of abstinent group had impaired total MoCA scores compared to 10 % (n=3) in control group. This was statistically significant with P value 0.002. As regard MoCAsubscores; we found statistically significant impairment in delayed recall and verbal fluency subscores in both the active and abstinent group. There was no statistically significant impairment in Trail making tests A and B.Therewas no association between cognitive impairment and sociodemographicor clinical factors. Conclusions: Cognitive impairment occurs commonly among tramadolabusepatients. Memory impairment and verbal fluencyare the most common cognitive domainsto be affected. Cognitive impairment is not reversible after 3 to 6 months.There is no effect of tramadol dose or duration of abuse on cognitive impairment.PDF created with pdfFactory Pro trial version www.pdffactory.com SOHAG MEDICAL JOURNAL

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Aim:The primary aim of this study was to study, for the first time to our knowledge in Egypt, the relationship of initial use of cannabis as a gateway drug to later dependency on opioid among Egyptian adults. Methods:Forty-eight patients were recruited from outpatient psychiatric attendees at a psychiatric hospital, Cairo, Egypt. A semistructured interview was conducted to assess the relationship of initiating cannabis abuse to later opioid dependence, and its relationship to demographic and clinical variables.