{"title":"Neurological aspects of drug misuse.","authors":"Robin S Howard, Paul Holmes, Paul Dargan","doi":"10.1136/pn-2023-003796","DOIUrl":null,"url":null,"abstract":"<p><p>The misuse of illicit drugs and prescription medications may cause neurological complications from overdose, withdrawal and long-term chronic misuse. Drug-use disorder has become particularly important and complex because of different patterns of presentation associated with new psychoactive substances and the growing misuse of opioids, synthetic cannabinoids and stimulants. We review worldwide demographic data of drug-use disorder and discuss the individual classes of agents, newer developments relating to understanding the mechanisms of action and the patterns of administration, usage, toxicity and withdrawal. We consider the difficulties in assessment and the specific acute syndromes of toxicity that present with neurological manifestations. We review the neurological patterns of longer-term complications and consider the effects of drug misuse-related trauma, infection, seizures, stroke, toxic leucoencephalopathy, cognitive impairment, movement disorders and neuromuscular complications. The neurological consequences of drug-use disorder disproportionately affect the young and can have devastating effects on innocent lives. It is essential that neurologists recognise acute toxicity early and understand the longer-term consequences of drug-use disorder.</p>","PeriodicalId":39343,"journal":{"name":"PRACTICAL NEUROLOGY","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PRACTICAL NEUROLOGY","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/pn-2023-003796","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
The misuse of illicit drugs and prescription medications may cause neurological complications from overdose, withdrawal and long-term chronic misuse. Drug-use disorder has become particularly important and complex because of different patterns of presentation associated with new psychoactive substances and the growing misuse of opioids, synthetic cannabinoids and stimulants. We review worldwide demographic data of drug-use disorder and discuss the individual classes of agents, newer developments relating to understanding the mechanisms of action and the patterns of administration, usage, toxicity and withdrawal. We consider the difficulties in assessment and the specific acute syndromes of toxicity that present with neurological manifestations. We review the neurological patterns of longer-term complications and consider the effects of drug misuse-related trauma, infection, seizures, stroke, toxic leucoencephalopathy, cognitive impairment, movement disorders and neuromuscular complications. The neurological consequences of drug-use disorder disproportionately affect the young and can have devastating effects on innocent lives. It is essential that neurologists recognise acute toxicity early and understand the longer-term consequences of drug-use disorder.
期刊介绍:
The essential point of Practical Neurology is that it is practical in the sense of being useful for everyone who sees neurological patients and who wants to keep up to date, and safe, in managing them. In other words this is a journal for jobbing neurologists - which most of us are for at least part of our time - who plough through the tension headaches and funny turns week in and week out. Primary research literature potentially relevant to routine clinical practice is far too much for any neurologist to read, let alone understand, critically appraise and assimilate. Therefore, if research is to influence clinical practice appropriately and quickly it has to be digested and provided to neurologists in an informative and convenient way.