The Effect of Drug Abstinence Program on Memory Functioning of Heroin Addicts

Document Type : Original Article


1 School of Psychology and Human Development, National University of Malaysia, Selangor, Malaysia

2 Medicine and Health Promotion Institute, Tehran, Iran

3 Universal Network for Health Information Dissemination and Exchange (UNHIDE), Tehran, Iran

4 Department of Psychiatry, University of Michigan, Ann Arbor, USA

5 Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, USA


Introduction: Most of our knowledge regarding the link between opioid dependence and poor cognitive functioning is derived from cross sectional studies.This longitudinal study measured the change in memory functioning following complete abstinence among individuals with heroin dependence.
Methods: Using a before-after design,this study followed 30 adults with heroin dependence from entry to completion of an abstinence program (cold Turkey method). We collected data on demographic factors and drug use variables. Memory was measured using the Wechsler Memory Scale. Using the paired t test, we compared different domains of memory functioning (i.e. personal information, orientation, mental control, logical memory, number repetition, visual memory, associative learning and memory quotient) before and after abstinence.
Results: There wasa significant improvement in memory functioning on orientation, mental control, logical memory, number repetition, visual memory, association learning and memory quotient following completion of the abstinence program. The improvement, however, was not statistically significant for memory on personal information.
Conclusion: This study documented improvement of memory functioning among heroin dependent adults following complete abstinence (cold turkey method). Further research is needed on the effect of heroin abstinence on memory functioning.


  1. Covin R, Donovan LA, MacIntyre PD. The relationship between self-estem and performance when information regarding others' performance is available. J Soc Psychol. 2003;143(4):541-4.
  2. Tiggemann M. The impact of adolescent girls' life concerns and leisure activities on body dissatisfaction, disordered eating, and self-esteem. J Genet Psychol. 2001;162(2):133-42.
  3. Avants SK, Margolin A, Mckee S. A path analysis of cognitive, affective, and behavioral predictors of treatment response in a methadone maintenance program. J Subst Abuse. 2000;11(3):215-30.
  4. Verdejo A, Toribio I, Orozco C, Puente KL, Pérez-García M. Neuropsychological functioning in methadone maintenance patients versus abstinent heroin abusers. Drug Alcohol Depend. 2005;78(3):283-8.
  5. Faggiano F, Vigna-Taglianti FD, Versino E, Zambon A, Borraccino A, Lemma P. School-based prevention for illicit drugs use: a systematic review. Prev Med. 2008;46(5):385-96.
  6. Buckman JF, Bates ME, Morgenstern J. Social support and cognitive impairment in clients receiving treatment for alcohol- and drug-use disorders: a replication study. J Stud Alcohol Drugs. 2008;69(5):738-46.
  7. Streel E, Antoniali V, Campanella S, Castronovo J, Hanak C, Pelc I, Verbanck P. Evaluation of cognitive functioning in 101 patients before opiate detoxification: implications in setting up therapeutic strategies. J Opioid Manag. 2005;1(1):49-53.
  8. Curran HV, Kleckham J, Bearn J, Strang J, Wanigaratne S. Effects of methadone on cognition, mood and craving in detoxifying opiate addicts: a dose-response study. Psychopharmacology (Berl). 2001;154(2):153-60.
  9. Darke S, Sims J, McDonald S, Wickes W. Cognitive impairment among methadone maintenance patients. Addiction. 2000;95(5):687-95.
  10. Davis PE, Liddiard H, McMillan TM. Neuropsychological deficits and opiate abuse. Drug Alcohol Depend. 2002;67(1):105-8.
  11. Lyvers M, Yakimoff M. Neuropsychological correlates of opioid dependence and withdrawal. Addict Behav. 2003;28(3):605-11.
  12. Rapeli P, Fabritius C, Alho H, Salaspuro M, Wahlbeck K, Kalska H. Methadone vs. buprenorphine/naloxone during early opioid substitution treatment: a naturalistic comparison of cognitive performance relative to healthy controls. BMC Clin Pharmacol. 2007;7:5.
  13. Specka M, Finkbeiner T, Lodemann E, Leifert K, Kluwig J, Gastpar M. Cognitive-motor performance of methadone-maintained patients. Eur Addict Res. 2000;6(1):8-19.
  14. Prosser J, Cohen LJ, Steinfeld M, Eisenberg D, London ED, Galynker II. Neuropsychological functioning in opiate-dependent subjects receiving and following methadone maintenance treatment. Drug Alcohol Depend. 2006;84(3):240-7.
  15. Gossop M, Battersby M, Strang J. Self-detoxification by opiate addicts. A preliminary investigation. Br J Psychiatry. 1991;159:208-12.
  16. MaƄkowski W, Sikorski M. "Cold turkey" detoxification of drug, narcotic and chemical addicts conducted at the Occupational Diseases and Toxicology Ward of the Polish Center of Occupational Medicine in Poznan in 1986-1996. Przegl Lek. 1997;54(6):474-6. Polish.
  17. Aldhous P. Drug rehabilitation: cold turkey, Vietnamese style. Nature. 2005;433(7026):568-9. 
  18. Munro R. Cod and cold turkey. Nurs Times. 1999;95(24):14-5.
  19. Schuckit MA, Daeppen JB, Danko GP, Tripp ML, Smith TL, Li TK, et al. Clinical implications for four drugs of the DSM-IV distinction between substance dependence with and without a physiological component. Am J Psychiatry. 1999;156(1):41-9.
  20. Baer JS, Ginzler JA, Peterson PL. DSM-IV alcohol and substance abuse and dependence in homeless youth. J Stud Alcohol. 2003;64(1):5-14.
  21. Compton WM, Cottler LB, Dorsey KB, Spitznagel EL, Mager DE. Comparing assessments of DSM-IV substance dependence disorders using CIDI-SAM and SCAN. Drug Alcohol Depend. 1996;41(3):179-87.
  22. Deas D, Roberts J, Grindlinger D. The utility of DSM-IV criteria in     diagnosing substance abuse/dependence in adolescents. J Subst Use. 2005;10(1):10-21.
  23. Fulkerson JA, Harrison PA, Beebe TJ. DSM-IV substance abuse and dependence: are there really two dimensions of substance use disorders in adolescents?. Addiction. 1999;94(4):495-506.
  24. McKeganey N, Bloor M, Robertson M, Neale J, MacDougall J. Abstinence and drug abuse treatment: Results from the Drug Outcome Research in Scotland study. Drugs Educ pre policy. 2006;13(6):537-50.
  25. D'Elia L, Satz P, Schretlen D. Wechsler Memory Scale: a critical appraisal of the normative studies. J Clin Exp Neuropsychol. 1989;11(4):551-68   .
  26. Wechsler D. A Standardized Memory scale for clinical use. Journal of psychology. 1945;1:87-95.
  27. Howard AR. Further validation studies of the Wechsler Memory Scale. J Clin Psychol. 1954;10(2):164-7.
  28. Makatura TJ, Lam CS, Leahy BJ, Castillo MT, Kalpakjian CZ. Standardized memory tests and the appraisal of everyday memory. Brain Inj. 1999;13(5):355-67.
  29. Mintzer MZ, Stitzer ML. Cognitive impairment in methadone maintenance patients. Drug Alcohol Depend. 2002;67(1):41-51.
  30. Cunha PJ, Nicastri S, Gomes LP, Moino RM, Peluso MA. Neuropsychological impairments in crack cocaine-dependent inpatients: preliminary findings. Rev Bras Psiquiatr. 2004;26(2):103-6.
  31. Browndyke JN, Tucker KA, Woods SP, Beauvals J, Cohen RA, Gottschalk PC, et al. Examining the effect of cerebral perfusion abnormality magnitude on cognitive performance in recently abstinent chronic cocaine abusers. J Neuroimaging. 2004;14(2):162-9.
  32. Lindholst C, Andreasen MF, Kaa E. Narcotics and illicit drug market. Status and 10-year development. Ugeskr Laeger. 2008;170(1):54-7.
  33. Assari S, Lankarani MM, Dejman M, Farnia M, Alasvand M, Sehat M, Roshanpazooh M, Tavakoli M, Jafari F, Ahmadi K. Drug Use among Iranian Drivers Involved in Fatal Car Accidents. Front Psychiatry. 2014;5:69.
  34. Assari S, Yarmohamadivasel M, Lankarani MM, Sehat M, Narenjiha M, Rafiey H, Noori R, Shirinbayan P, Ahmadi K. Having Multiple Sexual Partners among Iranian Intra-Venous Drug Users. Front Psychiatry. 2014;5:125.
  35. Assari S, Yarmohmmadi Vasel M, Tavakoli M, Sehat M, Jafari F, Narenjiha H, Rafiey H, Ahmadi K. Inconsistent Condom Use among Iranian Male Drug Injectors. Front Psychiatry. 2013;4:181. 
  36. Assari S, Ahmadi K, Rezazade M. Socio-Economic Status Determines Risk of Receptive Syringe Sharing Behaviors among Iranian Drug Injectors; A National Study Front Psychiatry. 2014;5:194.
  37. Karimi M, Ghaheri H, Assari S, Ahmadi K, Lankarani MM, Lankarani RM, Narenjiha H, Rafiey H, Tavakoli M, Jafari M. Drug Injection to Sites other than Arm: A Study of Iranian Heroin Injectors. Front Psychiatry. 2014;5:23.
  38. Rafiey H, Narenjiha H, Shirinbayan P, Noori R, Javadipour M, Roshanpajouh M, Samiei M, Assari S.  Needle and syringe sharing among Iranian drug injectors.  Harm Reduct J. 2009;6:21.
  39. Ahmadi K, Rezazade M, Nafarie M, Moazen B, Yarmohmmadi Vasel M, Assari S. Unprotected Sex with Injecting Drug Users among Iranian Female Sex Workers: Unhide HIV Risk Study.    AIDS Res Treat. 2012;2012:651070.
  40. Daneshmandan N, Narenjiha H, Tehrani K, Assari S, Khoddami-Vishteh HR.  Initiation to the first drug use among substance-dependent persons in Iran.  Subst Use Misuse. 2011;46(9):1124-41.
  41. Khooshabi K, Ameneh-Forouzan S, Ghassabian A, Assari S.  Is there a gender difference in associates of adolescents' lifetime illicit drug use in Tehran, Iran?  Arch Med Sci. 2010. 30;6(3):399-406.