Cognitive Impairment among People Who Use Heroin and Fentanyl: Findings from the Miami Adult Studies on HIV (MASH) Cohort.

Journal Article (Journal Article)

Background: Cognitive impairment is common in people living with HIV (PLWH). Opioid drugs exert direct and indirect effects on cognitive processes, which may contribute to cognitive dysfunction among PLWH. This study was designed to determine if opioid use is associated with cognitive impairment and whether the effect differs between PLWH and HIV-uninfected adults. Other neuropsychiatric symptoms, such as depression and apathy, were also examined. We conducted a cross-sectional analysis of 265 PLWH and 284 HIV-uninfected participants from the Miami Adult Studies on HIV (MASH) cohort. The Mini-Mental State Examination (MMSE) was used to assess cognitive impairment. Substance use was self-reported. Overall, 26.8% of PLWH and 15.1% of HIV-uninfected used opioids. Cognitive impairment was more frequent among people who used heroin and/or fentanyl than those who misused prescription opioids (31.6% vs. 10.5%, p = .005). The use of heroin/fentanyl was associated with increased odds for cognitive impairment (adjusted OR: 2.21, 95% CI 1.05-4.64, p = .036). Among PLWH only, the misuse of opioids was associated with a higher frequency of neuropsychiatric symptoms such as depression and apathy. A higher risk for cognitive impairment was seen among people who used heroin and fentanyl. PLWH who misuse opioids may be at an increased risk for neuropathology, but elucidation of mechanisms for opioid-induced cognitive deficits is needed.

Full Text

Duke Authors

Cited Authors

  • Tamargo, JA; Campa, A; Martinez, SS; Li, T; Sherman, KE; Zarini, G; Meade, CS; Mandler, RN; Baum, MK

Published Date

  • 2021

Published In

Volume / Issue

  • 53 / 3

Start / End Page

  • 215 - 223

PubMed ID

  • 33225878

Pubmed Central ID

  • PMC8140063

Electronic International Standard Serial Number (EISSN)

  • 2159-9777

Digital Object Identifier (DOI)

  • 10.1080/02791072.2020.1850946


  • eng

Conference Location

  • United States