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Sex-related differences in self-reported neurocognitive impairment among high-risk cocaine users in methadone maintenance treatment program


Wednesday, November 4, 2015

Roman Shrestha, MPH, Department of Community Medicine & Health Care, University of Connecticut Health Center, Farmington, CT
Tania B. Huedo-Medina, PhD, Statistics & Allied Health Sciences, University of Connecticut, Storrs, CT
Michael Copenhaver, PhD, Department of Allied Health Sciences, University of Connecticut, Storrs, CT
Background: Previous research suggests possible sex-related differences in executive functioning among cocaine-users; however, no studies specifically explain sex-related differences in neurocognitive impairment (NCI) among cocaine-users receiving clinical-care. Knowledge about this association can aid in the development of targeted prevention strategies to reduce adverse health outcomes. This study was designed to examine the sex-related differences in NCI among high-risk cocaine-users receiving substance-abuse treatment.

Methods: The Neuropsychological Impairment Scale (NIS) was administered to 199 cocaine-users (98 males; 101 females), receiving methadone-maintained treatment, to assess self-reported neurocognitive impairment by identifying patients’ awareness of neuropsychological symptoms. T-test comparison was done to find differences in neurocognitive impairment between males and females and multiple regression analysis was used to explore the relative contribution of sex to neurocogntive impairment.

Results: Consistent with prior work, high neurocognitive impairment was evident within this sample, as indicated by high scores on most of the NIS subscales. Females reported greater impairment than did males as evidenced by significantly higher scores on several NIS subscales, after controlling for confounding variables, such as age, years of cocaine use, methadone dose, years in MMT program, use of opiate in the past 6 months, and duration of opiate use. Interestingly, cocaine craving significantly predicted neurocognitive impairment among males but not among females, as suggested by significant association between cocaine craving and all except one of the NIS subscales.

Conclusions: These findings suggest that cocaine-users enter into treatment with a range of neurocognitive impairment – with women having significantly more neurocognitive deficits than men - that may contribute to differential treatment outcomes. This highlights the need to include additional services, such as neuropsychological screening and sex-specific treatment programs, to optimally reduce adverse health outcomes in these high-risk cognitively impaired patients.

Learning Areas:

Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify sex-related differences in neurocognitive impairment among high-risk cocaine-users receiving substance-abuse treatment.

Keyword(s): Drug Abuse Treatment, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in substance abuse prevention research on multiple projects both nationally and internationally. My current work includes behavioral HIV prevention intervention among HIV infected high-risk drug users in methadone maintenance program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.