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A ‘Vicious Cycle’ of Nonfatal Overdoses Causes ‘Alzheimer’s-like’ symptoms, Drexel Team Suggests

Oxycodone is the generic name for a range of opoid pain killing tablets. Prescription bottle for Oxycodone tablets and pills on glass table with reflections

opioid tablets

Deaths skyrocketing from the nation’s opioid crisis overshadows another growing nightmare for communities and families across the United States: the long-term health effects of nonfatal opioid overdoses.

In a new review paper in International Journal of Drug Policy, Janna Ataiants, DrPH, a senior research scientist, Stephen Lankenau, PhD, professor and associate dean for research, both in the Dornsife School of Public Health, and their colleagues, go beyond opioid-associated deaths and look at previous studies on how an opioid overdose affects brain function and risk behaviors. The team found a body of knowledge showing that a history of overdoses can lead to neurodegeneration, then feed into risky behaviors and may ultimately result in a new overdose.

“Many people still think of opioid overdose as a strictly life-or-death issue, but fatal overdoses constitute only 3-4% of all overdoses and repeated nonfatal overdoses may have far-reaching consequences for survivors,” said Ataiants. “We need to acknowledge how nonfatal overdoses attack brain cells, perhaps to the point of bringing on symptoms similar to those of Alzheimer’s disease.”

It’s easy to see why nonfatal overdoes are often left out of the conversation when talking about opioids. Overdose deaths have quadrupled since 1999 and there were more than 100,000 drug overdose deaths in a year for the first time ever, from April 2019 to April 2020, the Centers for Disease Control and Prevention recently reported. Despite this, the authors argue a need for accurate numbers on the broad scope of the nation’s opioid crisis.

“Typically, only overdoses that result in trips to an emergency room are tracked, and it leaves out a lot of cases,” said Ataiants. “This lack of tracking of repeated nonfatal overdoses makes it impossible to get an accurate picture of the magnitude of these cases.”

The team looked at the previous research, documenting a possible interconnection between the biochemical, brain and behavior side effects from overdoses that work in conjunction to cause the brain decline that leads to additional, unsafe drug use.

“We found strong evidence in the literature that opioid overdoses lead to these Alzheimer’s-like pathologies in the brain,” said Lankenau, who is senior author on the paper. “We also know that these processes in the body may progress for decades before these symptoms are evident, because of lower rates of health care access for many of those who use opioids.”

The authors note that many questions remain about how much this brain deterioration influences the odds of another overdose and whether these nonfatal overdoses can cause Alzheimer’s disease — and if so, whether one overdose is sufficient to cause the early stages of Alzheimer-like side effects, and how the severity of an overdose and total number of overdoses can induce these side effects.

This research comes at a time when American Medical Association experts are linking the ongoing COVID-19 pandemic to a rise in overdose deaths. And the nation’s first overdose prevention center recently opened in New York City, aimed at reducing opioid deaths and offering those struggling with substance use disorders a link to addiction treatment services.

During an overdose, there are implications for much of the body, including impaired blood circulation, brain, heart and lung function. Signs include loss of consciousness, change in skin color, irregular or no heartbeat and inability to talk, among other symptoms. If you see someone experiencing an overdose, among other steps, call 911 immediately.

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