Improvement in Cognitive Performance after One Year of Methadone Maintenance Treatment

Psychiatry Res. 2020 Dec;294:113526. doi: 10.1016/j.psychres.2020.113526. Epub 2020 Oct 22.


Individuals with substance use disorders are known to suffer from stress, poor sleep, and cognitive impairment. We investigated whether individuals with opioid use disorder would improve cognitive performance following a year of methadone maintenance treatment (MMT). Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), and a standardized computerized cognitive battery were administered at admission (T0) to 29 patients, and repeatedly following one year of MMT (T1) by 19 patients. Admission measures did not differ between those who studied once or twice. Patients who perceived very high stress levels (PSS ≥24) at T0 (11, 37.9%) had lower computerized global cognitive scores (67.6±16.2 vs. 90.9±12.5 p≤0.0005). At T1, PSS and PSQI scores improved significantly among 11 patients with no substance abuse, but worsened among 8 with substance abuse (PSS p(interaction)=0.009, p(groups)=0.005, PSQI p(interaction)=0.01, p(groups)=0.04). Global cognitive score improved at T1 for the entire sample (81.8±20.1 to 89.2±13.8, p=0.05). Differentiation by high stress at T0 or by substance abuse at T1 subgroups showed that improvement was observed by those with very low cognitive scores at T0. Patients with poor cognition may improve following one year of MMT, due to stress and substance abuse reduction. Interventions for stress reduction are recommended.

Keywords: Cognitive performance; Longitudinal study; Methadone maintenance treatment (MMT); Perceived stress; Sleep quality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / pharmacology
  • Analgesics, Opioid / therapeutic use
  • Cognition / drug effects*
  • Cognition / physiology
  • Female
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Male
  • Methadone / pharmacology
  • Methadone / therapeutic use*
  • Middle Aged
  • Opiate Substitution Treatment / psychology*
  • Opiate Substitution Treatment / trends*
  • Opioid-Related Disorders / diagnosis
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / psychology*
  • Psychomotor Performance / drug effects
  • Psychomotor Performance / physiology
  • Sleep / drug effects
  • Sleep / physiology
  • Stress, Psychological / diagnosis
  • Stress, Psychological / drug therapy
  • Stress, Psychological / psychology


  • Analgesics, Opioid
  • Methadone