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Methods: A cross-sectional analytical study was conducted among 370 patients receiving MMT at substance abuse treatment centers in Rasht in 2022. Participants were selected through a two-stage cluster sampling method after obtaining informed consent. Data were collected using demographic questionnaires, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Montreal Cognitive Assessment (MoCA). Statistical analyses, including standard deviation, Spearman\u2019s correlation, and the Kruskal-Wallis test, were conducted using SPSS version 21 (P=0.0001). Results: Cognitive impairments were observed in 11.1% of participants, with an average age of 49.58\u00b114.40 years. Male participants scored significantly higher on the verbal fluency (P=0.004) and delayed recall (P=0.030) subscales. Employed or retired patients demonstrated better cognitive performance compared to their unemployed counterparts (P=0.0001). Cognitive scores were inversely correlated with age (P=0.0001) and positively correlated with education level (P=0.0001). Longer primary substance use duration, higher methadone doses, and longer treatment durations were inversely associated with cognitive performance (P=0.0001). Stress, depression, and anxiety scores were inversely correlated with MoCA scores (P=0.0001). Conclusion: Cognitive impairments were identified in 11.1% of participants. Longer durations of primary substance use, higher methadone maintenance doses, and extended treatment durations were significantly associated with poorer cognitive performance.<\/jats:p>","DOI":"10.34172\/ahj.1693","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:44:50Z","timestamp":1792061090000},"page":"1693","update-policy":"https:\/\/doi.org\/10.34172\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive Impairments in Substance Use Patients Treated with Methadone"],"prefix":"10.34172","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2554-5213","authenticated-orcid":true,"given":"Elahe","family":"Abdollahi","sequence":"first","affiliation":[{"name":"Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7187-0981","authenticated-orcid":true,"given":"Behnam","family":"Iravani","sequence":"additional","affiliation":[{"name":"Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-8146","authenticated-orcid":true,"given":"Mohammad Hassan","family":"Novin","sequence":"additional","affiliation":[{"name":"Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9222-1948","authenticated-orcid":true,"given":"Fatemeh","family":"Amini Khodashahri","sequence":"additional","affiliation":[{"name":"Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4662-4106","authenticated-orcid":true,"given":"Zoleikha","family":"Bayat","sequence":"additional","affiliation":[{"name":"Kavosh Cognitive Behavior Sciences and Addiction Research Center, Department of Psychiatry, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"20123","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.57.3.307"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Ungar AK, Konova AB, Patel A, Goldstein RZ, Hurd YL. 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