Neurologic Complications of Drug and Alcohol Use

Area of Science:

• Neurology
• Toxicology
• Public Health

Background:

• Substance use disorders (SUDs) and associated overdose mortality, particularly from fentanyl, surged during the COVID-19 pandemic.
• Current overdose rates remain elevated compared to pre-pandemic levels, highlighting an ongoing public health crisis.
• Neurologists frequently encounter severe neurological complications stemming from substance use.

Purpose of the Study:

• To review the spectrum of neurologic syndromes linked to substance use.
• To propose a systematic approach for the identification and management of substance use disorders.
• To emphasize the role of neurologists in guiding patients toward treatment.

Main Methods:

• Literature review of neurologic complications associated with various substances.
• Analysis of trends in substance use, overdose mortality, and novel psychoactive substances.
• Discussion of diagnostic and management strategies for substance use disorders in a neurologic context.

Main Results:

• Opioid-related toxic encephalopathies are increasingly identified.
• Novel psychoactive substances are associated with neurologic complications, including seizures.
• Rising use of cannabis and hallucinogens may be linked to neurologic events like ischemic stroke.

Conclusions:

• Substance use presents a diverse range of neurologic challenges requiring clinical attention.
• Early identification and intervention by neurologists are crucial for managing substance use disorders.
• A proactive approach by neurologists can improve patient outcomes and guide them toward necessary treatment.