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Heroin Addiction and Related Clinical Problems: 2025, 27, 26

The Impact of Agonist Opioid Treatment on Cognitive Efficiency in Young Males with Opioid Use Disorder: An Event-Related Potentials (ERP) P300 Analysis

Olga Ivetic, Aleksandra Dickov, Vladimir Knezevic, Dragana Ratkovic, and Masa Comic

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2025-26

Summary: Background: This study assessed cognitive function in individuals with opioid use disorder (OUD) and healthy controls, focusing on changes following opioid agonist treatment (AOT) with methadone (AOTM) or buprenorphine (AOTB). Methods: Event-related potentials (ERP), specifically the P300 component, were recorded in 150 young male participants across four groups: healthy controls, untreated OUD individuals, and OUD individuals stabilised for six months on AOTM or AOTB. P300 latency and amplitude—indices of cognitive processing speed and attentional engagement—were analysed. Data were processed using TIBCO Statistica 14.0.0. The Kolmogorov–Smirnov test assessed normality; Kruskal–Wallis with Bonferroni correction was applied for non-normal variables. Significance was set at p < 0.05 and p < 0.01. Results: Untreated OUD participants exhibited significantly longer P300 latencies and reduced amplitudes compared to controls, indicating slower cognitive processing and diminished attention. After six months of AOT, both methadone and buprenorphine groups showed improvements in P300 parameters, more markedly in the buprenorphine group. Nonetheless, latencies remained elevated relative to healthy controls. Behavioural data reflected similar trends, with higher error rates in OUD groups and limited gains in task accuracy post-treatment. Conclusions: ERP P300 is a sensitive biomarker for detecting cognitive deficits in OUD. Stabilisation with methadone or buprenorphine improves cognitive performance, though not to normative levels. These findings support the utility of P300 in monitoring treatment effects and highlight the need for further research with larger, more heterogeneous samples to clarify the cognitive impact of long-term opioid agonist therapy.

Keywords: Opioid use disorder (OUD); Event-related potential (ERP); P300; Agonist Opioid Treatment (AOT); Methadone; Buprenorphine