Abstract
Introduction: Cognitive difficulties are evidenced in opiate-dependent populations, whether they are caused by drug use per se, or other associated life-style factors. To date no research exists which explores the subjective experience of cognitive impairment in opiate-dependent populations attending drug and alcohol services. In comparable fields such as brain injury and dementia, the subjective experience of cognitive impairment has been explored with important and beneficial results. Method: Using a qualitative design, data were collected from in-depth interviews with six working-age adults with a diagnosis of opiate-use disorder, attending a service for opiate-substitution therapy, who self-identified as experiencing memory and thinking difficulties. Transcripts were analysed in accordance with Interpretative Phenomenological Analysis. Results: Three superordinate themes emerged: “a damaged brain and mind” which included the extent of the impairment and how participants made sense of such difficulties; “perceptions of the self as spoiled” which explored the perceived changes in independence and dependence and resultant negative feelings about the self; and “coping with a lesser self” which included acceptance and adaptation, and familiar but maladaptive coping strategies. Conclusions: Participants’ understanding and experience of their cognitive difficulties contributed to their sense of well-being, and further impacted on chosen coping strategies. Consideration of cognitive impairment is important to effectively support individuals attending drug and alcohol services.