Mindfulness, Metacognition and Neuropsychological Functioning in Indian Men with Opioid Dependence: Implications for Addiction Recovery and Rehabilitation.

Background: Neuropsychological functioning, metacognitive awareness and mindfulness are central to self-regulatory processes operating across cognitive and affective domains. Although global research on these constructs has increased, integrated evidence from non-Western contexts, particularly India, remains limited.

Purpose: The purpose of this study was to assess and compare neuropsychological functioning, metacognitive awareness and mindfulness in adult Indian men diagnosed with opioid dependence (OD) and healthy male controls. The study also examined the relationships among these constructs within the OD group.

Methods: A total of 200 adult men aged 25-45 years (mean age = 35 years, SD = 5) participated in the study. The sample included 100 participants diagnosed with OD according to International Classification of Diseases-11 (ICD-11) criteria and 100 healthy controls without a history of substance use disorders. Standardised instruments were used to assess neuropsychological functioning, metacognition and mindfulness. Group differences were analysed using multivariate analysis of variance (MANOVA) with Bonferroni-corrected univariate analyses. Correlation and multiple regression analyses were conducted within the OD group while controlling for demographic variables.

Results: Men with OD demonstrated significantly poorer neuropsychological functioning, lower metacognitive awareness and reduced mindfulness compared to controls (all p < .05). Within the OD group, both mindfulness and metacognitive awareness showed positive correlations with neuropsychological functioning. After adjusting for demographic factors, metacognitive awareness exhibited a stronger association with neuropsychological functioning than mindfulness.

Conclusion: The findings indicate pronounced self-regulatory deficits in individuals with OD. The results support the inclusion of metacognitive and mindfulness-based components in assessment and rehabilitation programmes, particularly within South Asian cultural contexts.