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A vicious cycle of neuropathological, cognitive and behavioural sequelae of repeated opioid overdose
Journal article   Peer reviewed

A vicious cycle of neuropathological, cognitive and behavioural sequelae of repeated opioid overdose

Michael Voronkov, Janna Ataiants, Benjamin Cocchiaro, Jeffry B Stock and Stephen E Lankenau
The International journal of drug policy, v 97, 103362
Nov 2021
DOI: https://doi.org/10.1016/j.drugpo.2021.103362
PMID: 34314956
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Alzheimer disease Cognitive decline Neurodegeneration Nonfatal opioid overdose Opioid use Risky behaviours
•Review hypothesizes congruency of three long-term consequences of nonfatal overdose: neuropathology, cognitive decline, and risky behaviours.•Nonfatal overdose triggers Alzheimer disease-like changes in the brain.•Repeated overdose manifests itself through cognitive decline.•Neurocognitive decline may contribute to risky drug use behaviours.•Literature is suggestive of a vicious cycle of neuropathology-cognitive decline- risky behaviours feeding to and resulting from overdose. In the midst of an escalating U.S. opioid crisis, the immediate focus of public health interventions is on fatal overdose prevention. Few studies, however, have sought to examine the long-term health consequences of exposure to repeated nonfatal opioid overdose. We reviewed recent literature to examine three corresponding downstream health outcomes of repeated overdose: a) neurodegenerative processes; b) cognition and memory; and c) overdose risk behaviours. We found a remarkable congruency among available biochemical and cognitive data on how nonfatal overdose precipitates various pathological feedforward and feedback loops that affect people who use opioids for years to come. We found however that downstream behavioural implications of neurodegenerative and cognitive sequelae are less studied despite being most proximal to an overdose. Findings point to a vicious cycle of nonfatal overdose leading to neurodegeneration – closely resembling Alzheimer Disease – that results in cognitive decline that in turn leads to potentially reduced adherence to safe drug use behaviours. The collected evidence not only brings into the focus the long-term health consequences of nonfatal overdose from the perspectives of biology, neuroscience, and public health, but also creates new cross-disciplinary context and awareness in the research and public health community that should benefit people at risk.

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11 citations in Web of Science
8 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Substance Abuse
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