"When people overdose on opioids, whether they wake up on their own or are revived by Narcan, many doctors assume they are fully recovered. This is a mistake because hypoxia (insufficient oxygen to the brain and body) occurs during overdose, yet often is undiagnosed. Many with opioid use disorder (OUD) experience multiple overdoses. Each overdose adds additional brain cell loss. Research suggests that significantly more evaluation, follow-up, and treatment than currently provided is needed by nearly all overdose patients."
"A prepublication of a new study by McKinstry may be definitive enough to change how people with OUDs are treated, especially after overdose. This study showed that people with OUD had significantly smaller hippocampal volumes than healthy controls. In addition, hippocampal volumes were associated with past non-fatal overdoses. Overdose history did not separate OUD subgroups and hippocampal volume by prior overdoses, suggesting overdoses are commonly not recognized. Thus, OUD patients are likely suffering anoxic damage to the hippocampus."
Opioid overdose causes cerebral hypoxia/anoxia by decreasing oxygen availability rather than directly poisoning neurons. Repeated nonfatal overdoses produce cumulative hippocampal cell loss, manifesting as reduced hippocampal volumes and lower cognitive function. Many overdoses are undiagnosed, so prior anoxic injuries are often unrecognized. Recent neuroimaging found significantly smaller hippocampal volumes in people with OUD compared with healthy controls, with volumes associated with past nonfatal overdoses. The biological cascade of oxygen-deprivation damage in opioid overdose mirrors that seen in near-drowning. Standard post-overdose care frequently fails to include sufficient neurological evaluation, follow-up, and treatment to address anoxic brain injury.
Read at Psychology Today
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