At least 80% of opioid overdose are not fatal, but how do they affect the brain?

To better understand this topic, researchers at West Virginia University School of Medicine and Rockefeller Neuroscience Institute (Erin Winstanley) and James Mayo James Mahoney reviewed 79 studies of neurocognitive disorders and brain abnormalities related to non-fatal opioid overdose
.

These studies have limitations, which indicates that more precise research is needed in this area

"I think there may be a lot of diseases related to non-fatal opioid overdose, which is largely ignored from a public health perspective," said Winstanley, who specializes in behavioral medicine and psychiatry as well as Associate Professor in the Department of Neuroscience
.

"We should first focus on saving lives

Their findings were published in the journal Drug and Alcohol Dependence
.

Winstanley, Mahoney and their colleagues-Felipe Castillo and Sandra Comer of Columbia University-conducted a systematic review of journal articles published from 1973 to 2020
.

In general, these studies lack details and consistency, and are unable to make many direct comparisons and inferences
.

For example, less than half of the studies reported toxicological results confirming an overdose of opioids
.

Only 27.

The team found that all research is at risk of some form of bias
.

For example, some studies did not measure the mental function of participants, did not consider whether they received timely overdose treatment, and did not report whether they used anything other than opioids

Mahoney is an associate professor and clinical neuropsychologist in the WVU Department of Behavioral Medicine and Psychiatry and the Department of Neuroscience.
He said: "Except for overdose, addiction research is generally complicated because of all these confounding variables
.

" "Usually.

The overdose itself complicates the problem
.

How long is this person’s brain deprived of oxygen? Did they get adequate treatment in time? How long after taking the medication for neuroimaging or cognitive testing? All these variables — and many others — can affect the results of the study

Mahoney said: "In addition, there are many different measurement methods used to test cognitive function, which makes it more difficult to compare findings in the literature
.

"

Despite these inconsistencies, the evidence provided by research suggests that an overdose of opioids may change a person's brain performance or behavior
.

In turn, these changes may affect a person's attention span, memory, executive function, or other advanced thinking skills

"This news is quite positive.
If we can start early identification and screening of neurocognitive deficits - whether they are related to overdose or not, we may have appropriate rehabilitation treatment, including some promising new treatments for cognitive impairment.
"Winstanley said
.

This is important because neurocognitive deficits make people who want to stop using opioids or other substances more likely to get poor treatment results
.

"If we can target those who are at higher risk of cognitive impairment—perhaps those who have overdose five to six times—and personalize their treatment plan to address these deficiencies as early as possible in the treatment process, we It may improve their results, Mahoney said
.

To gain a deeper understanding of these deficiencies and how to solve them, Winstanley, Mahoney and their colleagues at West Virginia University and Columbia University started a new project
.

They compared the cognitive abilities of two groups of patients with opioid use disorder: one group had a history of overdose, and the other group had no history of overdose
.

The researchers asked all participants to complete the same comprehensive neurocognitive test
.
When collecting and analyzing data, researchers will consider the participants’ age, education level, and intellectual function; the amount of time they use drugs; and what substances they use
.

In addition, the research team also used functional MRI to image the brains of some participants to understand how their brains work when they complete working memory tasks
.

"Although neurocognitive tests let us know that these people are actually performing various thinking tasks, the functional magnetic resonance imaging data will also give us a reasonable neuroanatomy of how the brain works, and how different brain networks are engaged with the brain.
How different areas interact," Mahoney said
.
"We will have the opportunity to better understand that factors other than opioid use and overdose (such as simultaneous use of other substances) may affect these brain networks
.
"

Understanding how opioid use, overdose and other variables affect the brain may lead to new neuromodulation therapies, including those currently being explored by Mahoney
.

Neuromodulation involves the use of electrical impulses, magnetic fields, or other forms of stimulation to change the activity of specific brain regions and networks
.

In 2019, Mahoney was a member of the team of scientists from RNI and WVU Medicine.
They initiated the world's first clinical trial of deep brain stimulation approved by the Food and Drug Administration for the treatment of opioid use disorder
.

He is also studying how to use transcranial magnetic stimulation (another form of neuromodulation) to combat addiction, and low-intensity focused ultrasound
.
People have studied this technology for a variety of diseases, but its exploration as a potential treatment for drug use disorders is still in its infancy
.

He said: "By helping to reconnect areas of the brain related to desire and cognition, such as inhibition, decision-making, attention and higher executive functions, we are expected to improve cognitive function and thereby improve treatment outcomes
.
" "Thinking that neuromodulation will Simply'fixing' addiction is unrealistic, but when combined with standard care—comprehensive behavioral therapy for opioid use disorders—we will hopefully provide another strategy to help people achieve withdrawal
.
"

Journal Reference :

1. Erin L.
   Winstanley, James J.
   Mahoney, Felipe Castillo, Sandra D.
   Comer.
   Neurocognitive impairments and brain abnormalities resulting from opioid-related overdoses: A systematic review .
   Drug and Alcohol Dependence , 2021; 226: 108838 DOI: 10.
   1016/j.
   drugalcdep.
   2021.
   108838