Psychiatr. praxi. 2025;26(3):184-188 | DOI: 10.36290/psy.2025.030

The impact of opioids and substitution treatment on cognitive functions

Mgr. Aneta Votavová, Mgr. Lenka Šťastná, Ph.D.

Klinika adiktologie, Všeobecná fakultní nemocnice, 1. lékařská fakulta Univerzity Karlovy, Praha

This theoretical article focuses on the relationship between opiates and cognitive functions, which can lead to significant changes ranging from acute effects to long-term deficits. Published studies indicate impaired cognitive functions, with some difficulties persisting even during abstinence. Prenatal opioid exposure is associated with high risks for child development, underscoring the importance of prevention and support for pregnant users. Although substitution treatment reduces the incidence of relapse, it may continue to negatively affect cognitive status. Contradictory research findings stem from various factors, such as differing methodologies, comorbidities, and socio-economic influences. Nevertheless, a partial restoration of cognitive abilities is seen in some clients following prolonged abstinence or during stabilized substitution therapy. The optimal approach likely involves combining substitution treatment with cognitive rehabilitation and tailoring therapeutic strategies to the individual.

Keywords: opioids, substitution treatment, cognitive functions, executive functions, addictology, cognitive impairment.

Accepted: October 15, 2025; Published: November 6, 2025  Show citation