Decision making of individuals with heroin addiction receiving opioid maintenance treatment compared to early abstinent users

Drug Alcohol Depend. 2019 Dec 1;205:107593. doi: 10.1016/j.drugalcdep.2019.107593. Epub 2019 Oct 1.


Background and aims: Individuals with heroin addiction are prone to dysfunctional decision-making. They frequently choose the short-term rewarding option of drug intake despite experiencing long-term negative consequences. Opioid maintenance treatment (OMT) is the most common treatment of heroin addiction.

Methods: In this study, 38 individuals in an early stage of abstinence from heroin addiction (ESA-HA individuals) at the end of inpatient detoxification treatment and 41 individuals in long-term OMT were examined. Decision-making was assessed by (I) a modified version of the Iowa Gambling Task (IGT) with drug-related stimuli focusing on decision-making under ambiguity and (II) the Game of Dice Task (GDT) assessing decision-making under objective risk.

Results: OMT-individuals showed significantly better performance in the IGT than the ESA-HA-individuals. They also showed significantly less craving under exposure of drug-related pictures. In the GDT, OMT-individuals showed significantly less risky decision-making than ESA-HA-individuals.

Conclusion: The results suggest that patients receiving OMT show better functional decision-making and lower craving reactions. It could be assumed that the effectiveness of OMT in preventing relapse is linked to better decision-making and lower craving among these patients.

Keywords: Decision making; Game of dice task; Iowa gambling task; Methadone maintenance treatment; Opioid dependence; Opioid maintenance treatment.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Craving
  • Decision Making*
  • Female
  • Gambling / psychology
  • Heroin / therapeutic use
  • Heroin Dependence / psychology*
  • Heroin Dependence / therapy
  • Humans
  • Male
  • Middle Aged
  • Opiate Substitution Treatment / psychology*
  • Reward
  • Secondary Prevention / methods*
  • Temperance / psychology*


  • Analgesics, Opioid
  • Heroin