The aim of this study was to evaluate the changes in impulsivity scores among those who are still using buprenorphine as maintenance substitution treatment and those relapsed to heroin use in heroin dependent inpatients at the end of 12 month follow-up. We also controlled depression and trait state anxieties on the relationship between impulsivity and relapse.

Among 78 consecutively admitted male heroin dependents, 52 (66.7%) were examined by face to face interview 12 months after discharge from hospital. Patients were investigated with the Barratt Impulsiveness Scale, version 11 (BIS-11), Beck Depression Inventory and State-Trait Anxiety Inventory at the end of 12 months.

Among 52 heroin dependent patients that were avalible to examine by face to face interview 23 (44.2%) were considered as relapsed to heroin use during the last year, whereas 29 (55.8%) were still in the maintenance treatment. Relapsed group has less attended to polyclinic control, outpatient treatment, they did not change their social environment, continue to see their dependent friends and used other drugs during 12 monts. Mean impulsivity, depression and anxiety scores were higher in the relapsed group. State anxiety and impulsivity, particularly motor impulsivity determined the relapse in regression analyses.

Together with state anxiety, which may be mediated by craving, motor impulsivity predicted relapse. In response to stress or environmental cues, an individual with substance abuse could use the substance in a rapid unplanned action without regard to the consequences.