Illicit drug use: neurologic complications

John C M Brust MD (Dr. Brust of Columbia University College of Physicians and Surgeons has no relevant financial relationships to disclose.)
Matthew Lorincz MD PhD, editor. (Dr. Lorincz of the University of Michigan receives salary support from Wilson Therapeutics AB for performing UWDRS examinations in a clinical trial.)
Originally released October 8, 2008; last updated January 23, 2017; expires January 23, 2020

This article includes discussion of illicit drug use: neurologic complications, trauma, infection, seizures, stroke, and cognitive dysfunction. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations

Overview

The author describes the clinical features of intoxication and withdrawal of the major illicit drugs, as well as the neurologic complications often encountered in users, including seizures, stroke, and cognitive dysfunction. During 2016, the United States experienced a continuing epidemic of prescription opioid and heroin abuse as well as increasing recreational use of synthetic cannabinoid agents marketed as “Spice” and “K2.”

Key points

 

• In addition to overdose, major complications of illicit drug use include trauma, infection, seizures, stroke, persistent cognitive impairment, and teratogenic effects.

 

• A seizure in an illicit drug user can have an indirect cause, such as cerebral contusion or CNS infection, or can be a manifestation of direct toxicity or withdrawal (eg, barbiturate).

 

• Evidence has increasingly demonstrated that a number of drugs can cause lasting neuropsychiatric impairment.

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