Assessment of executive functions in adolescents with synthetic cannabinoid use disorder and comparison with adolescents with opiate use disorder

Objective: Synthetic cannabinoids and semi-synthetic opiate uses high number of noteworthy cases among drug users seeking treatment for substance abuse in adolescent age group in Turkey. Our knowledge of the effects of synthetic cannabinoids and semi-synthetic opiates on executive functions is limited. The number of studies using neuropsychological tests related to this field is not sufficient. In addition, there were no studies comparing sociodemographic characteristics and substance use characteristics of adolescents using these two substances. Taking this information into consideration, our aim is to expand our clinical knowledge about these two groups and to compare the executive functions of these two groups with neuropsychological test battery. Methods: 30 adolescent patients with synthetic cannabinoid use and 32 adolescent patients with semi-synthetic opiate use whom treated in Istanbul Bakırköy Dr. Mazhar Osman Mental Health and Nerve Diseases Training at the Research Hospital were included in the study. After the sociodemographic data form was completed, psychiatric comorbidities of the patients were evaluated by using the The Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (KSADS-PL). Then, Stroop Color Vocabulary Test and Wisconsin Card Sorting Test (WCST) were applied to evaluate the executive functions of the cases. Results: In our study, no statistically significant difference was found between the sociodemographic characteristics of the patients, the age of use of the substance, the duration of use, the frequency of use and the periods after the end of use. No statistically significant difference was found between the lifetime use of cigarette, alcohol, volatile substance, cannabis, cocaine and methamphetamine. In cases of synthetic cannabinoid group, life-long ecstasy use was higher than semi-synthetic opioid group. No statistically significant difference was found between the study groups in terms of accompanying psychopathologies. The most common comorbid diagnosis was Attention Deficit and Hyperactivity Disorder (ADHD) in both groups. Comparing the executive functions of the two groups; selective attention functions of semi-synthetic opiate users were found to be more impaired in Stroop Test. No statistically significant difference was found between the two groups in terms of other Stroop functions and WCST performances. When the relationship between total substance use and executive impairment is evaluated; no significant relationship was found between the total amount of SC and the Stroop and WCST test scores. A positive correlation was found between the total usage amount of semi-synthetic opiate and the 5th section scores of the Stroop test. There was no correlation between the total usage amounts of semi-synthetic opioids and WCST scores. A negative correlation was found between the time elapsed after semi-synthetic opiate end use and Stroop test 1. card completion time. No relationship was found between WCST scores after the last use of semi-synthetic opioids. No correlation was found between the elapsed time of synthetic cannabinoid and WKET and Stroop test scores. Conclusion: The sociodemographic characteristics, comorbid psychopathology and substance use characteristics of adolescents using synthetic cannabinoids and semi-synthetic opiates are similar in our study. It was observed that the use of ecstasy was accompanied with more synthetic cannabinoid group than the semi-synthetic opioid group. Lifetime use of other substances was found to be similar in two groups. It was found that selective attention functions of semi-synthetic opiates users were more impaired than synthetic cannabinoids group, It was found that other executive function performances were similar in both groups. According to the neuropsychological test results; it is observed that opiates disrupt executive functions as much as cannabinoids. As the amount of semi synthetic opiate use increased, further deterioration of attention and cognitive flexibility abilities. Our study is another result; more recent use of semi-synthetic opiates read speed is slower, attention functions are worse. Keywords: Synthetic cannabinoid, semi-synthetic opiate, executive functions