Widespread opioid use began in the United States in 1775 when it became legal in the colonies. By the Civil War, they were widely given soldiers for pain, and many became addicts. In 1914 the Harrison Act made commercial use of opioids illegal and became prescription medications only.
Unfortunately, this has not stopped their use or abuse, and countless individuals have lost their health (and lives) due to opioid addiction. This isn’t to say that opioid medications don’t have their place in medicine. After an injury, surgery, or treatment for cancer, they are often necessary for recovery. Perhaps you have needed them yourself on occasion.
If you have hearing loss, maybe you’ve wondered if opioids have caused your issues or made it worse. Let Hearing Associates of Las Vegas explain how opioids work and the link between opioids and hearing loss.
What are Opioids?
Opioid pain relievers help with moderate to severe pain. These medications can be naturally occurring or synthetic chemicals that bind opioid receptors. Opioid refers to a mixture of alkaloids (such as codeine or morphine).
Drugs included within this class are:
- Hydrocodone
- Oxycodone
- Morphine
- Codeine (and related medications)
The use of opioids goes back thousands of years, and ancient Egyptian records report using opium for pain relief.
The use and abuse of opioids have confounded doctors, police, and politicians.
The World Health Organization estimates there are 185 million users of illicit drugs, 1.3 billion tobacco smokers, and 2 billion alcohol users globally.
The National Institute on Drug Abuse states that prescription drugs used to treat pain, anxiety, and ADHD are abused only second to marijuana.
Can Opioids Cause Hearing Loss?
For all the good opioids can do with pain relief, in high doses, they can be detrimental and lead to deafness, according to researchers from Rutgers. Their Journal of Medical Toxicology study examined the New Jersey Poison Control Center records between 1999 and 2018 and found the link between opioids and various degrees of hearing loss.
The researchers found that tinnitus, partial and complete hearing loss to 41 opioids using subjects was likely due to toxicity to the ear. Better than half had used heroin, while the others reported using oxycodone, tramadol, and methadone. 88 percent were only aware of being exposed to one of
Deafness struck 12 people, 15 reported a partial loss or dampening of their hearing, ten developed tinnitus, and four subjects reported a mix of symptoms. Interestingly, of these subjects, the majority said their condition affected both ears. Just over half of these subjects had no improvement in their hearing when being released from the hospital. The other 20 people either regained some if not all their hearing.
Co-author of the study, and chair of the Department of Emergency Medicine, Lewis Nelson, said, “The delicate structures of the inner ear are very susceptible to injury if oxygen supply is insufficient, as well as to the direct effect of toxins like opioids.”
Diane Calello, executive and medical director of the New Jersey Poison Control Center, added,
“Although the study found a link with heroin, toxicity to the ear can occur with every opioid. This study supports what has been found in animal studies, which is that any opioid can cause hearing loss. This might be because we already have built-in opioid receptors, or binding sites, in the inner ear. Activating them may trigger this injury in some patients.”
These findings have urged those who prescribe opioids to patients with reduced hearing to be aware of the link with hearing loss when increasing dosages.
How Do Opioids Cause Hearing Loss?
The pathology of hearing loss after using and abusing opioids is obscure. But several theories have been put forward, including ototoxicity, nerve damage, and cochlear anoxia. It could also reduce blood flow, causing hearing loss. Cocaine is known to cause vasoconstriction, leading to hearing loss in those who use it in high doses.
High frequencies seemed to be affected more seriously than the lower frequencies amongst the subjects taken into account for this article. This may suggest that the primary site of damage is the cochlea’s lower region.
While this study found subjects had hearing loss because they abused opioid peptides and a variety of other drugs, it suggests that these substances affect the opioid system of the inner ear. The specific component of action with these drugs, though, remains cloudy. These are the variables that determine whether opioid effects are reversible or not:
- Type of drug used
- Duration
- Time of exposure
- Health status of the user
High doses of hydrocodone and acetaminophen seem to contribute to permanent hearing loss. In comparison, the use of heroin, amphetamines, or methadone tends to induce more reversible hearing loss.
Research suggests that pharmaceutical treatment of hearing loss caused by drug abuse is case-by-case. That being the case, your hearing professional needs to be aware of any hearing loss caused by drug abuse. They must ask their patients regularly about their recent drug use, be it prescription or recreational.
Your doctor can look into your specific opioid-induced hearing loss and help you determine the extent of your loss and whether it’s reversible. Contact our hearing professionals at Hearing Associates of Las Vegas for specialized hearing care. We will help you regain your hearing and your life!
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