Does Cannabis Dependence Add on to the Neurocognitive Impairment Among Patients With Opioid Dependence? A Cross‐Sectional Comparative Study

Abstract

Background and Objectives Chronic opioid exposure has been linked with neurocognitive impairments. Evidence of residual impairment with cannabis use is less consistent. We investigated whether patients with opioid and cannabis dependence perform poorly compared with those with opioid dependence alone. Methods We recruited three groups of participants aged 18 to 55 years: opioid and cannabis dependence (OCaD; n = 21), only opioid dependence (OD; n = 19), and a control group (HC; n = 20). Subjects with other substance use, human immunodeficiency virus, head injury, epilepsy, and severe mental illness were excluded. Cognitive tests, performed after at least 1 week of abstinence, consisted of the Wisconsin card sorting test (WCST), Iowa gambling task (IGT), trail making tests A and B (TMT‐A and B), verbal and visual N‐back test (NBT), and standard progressive matrices for intelligence quotient (IQ). The general linear model was used to compare the groups with age and years of education as covariates. Results IQ and severity of opioid dependence were comparable in the three groups. The mean duration of cannabis use was 76.2 (±39.4) months. Compared with the HC, both OD and OCaD had significant impairment on the IGT, WCST, TMTs, and NBT. No significant group difference was observed between the OD and OCaD groups. Discussion and Conclusions Opioid dependence is associated with impairments in decision making, executive function, working memory, and attention. Co‐morbid cannabis dependence had similar profiles of cognitive impairments. Scientific Significance Co‐morbid cannabis dependence might not add on to the existing cognitive dysfunction in opioid dependence. Further studies should be done with a larger sample. (Am J Addict 2020;29:120–128)

Course and Correlates of Stigma in Patients on Opioid Agonist Treatment: A Prospective Study from an Outpatient Treatment Program in India

“…The reason for retaining tobacco and cannabis dependence was the high comorbidity of these disorders with opioid dependence; hence, excluding these participants would have compromised the study’s generalizability. 18 , 19 Patients with HIV, hepatitis C, or other medical comorbidities were also included. However, patients with severe mental illness, intellectual disability, or organic brain disease were excluded.…”

A Review of Historical Context and Current Research on Cannabis Use in India

“…68, 70 Two studies examined cognitive functions and found significant differences in perceptual-motor functioning, but not intelligence, between users and healthy controls. 67, 74 In terms of methodological weaknesses, two studies utilized existing case notes and were prone to limitations of secondary data and recall biases. 68, 70 Use of basic cannabis-use screening measures was found in four studies.…”

“…68, 70 Use of basic cannabis-use screening measures was found in four studies. 69, 71–72,74 Apart from two studies, the remaining six had very small sample sizes as well.…”

“…68,70 Use of basic cannabis-use screening measures was found in four studies. 69,[71][72]74 Apart from two studies, the remaining six had very small sample sizes as well. 76,77 Despite the growing notion of cannabis being safer than alcohol and tobacco, a sizable proportion of cannabis users become dependent on it and exhibit negative physical and psychological effects that require treatment.…”

Legalization of cannabis in Canada—Local media analysis

“…5 Potential risks that may accompany legalization include an increase in users, 6 youth exposure, driving impairment, and cannabis use in sensitive occupations. 7 On October 17, 2018, Canada became the first country of high socioeconomic status to legalize selling and using cannabis for recreational purposes. Research suggests that media influences public perception and priorities surrounding an issue, 8,9 and the media's portrayal of this policy change provides an opportunity to discern which issues were presented most prominently to the public regarding cannabis legalization.…”