Substance Use Disorders and the Vestibular System: A Rising Issue

Presenter:
Amanda Chiao, AuD, PhD

CEUs: 0.1 AAA CEUs

Duration: 60 minutes

Instructional Level: Beginner

Program Focus: Knowledge

Description:

The oto-vestibulotoxic effects of certain prescribed medications have been well known for decades. These include aminoglycoside antibiotics, loop diuretics, platinum-based chemotherapeutics, and some non-steroidal anti-inflammatories.  However, case-reports and a few cohort studies suggest that substance misuse from illicit drugs, opioids, and alcohol also negatively affect vestibular and auditory function, and may have mechanisms similar to oto-vestibulotoxicity.

The literature, consisting mainly of single-study case reports, suggests that illicit and prescribed opioid drug misuse can cause temporary or permanent hearing loss, and, more consistently, alcohol misuse impairs balance function (Moreira et al. 2012; Schmidt et al. 2010) but could affect the peripheral vestibular organs (Belle et al., 2007; Sasa et al., 1982), thus there is likely differential effects based on substance type and use patterns.

This presentation will provide snapshot of the existing literature, with an emphasis on the vestibular system, and discuss the practical approaches to vestibular assessment in patients with suspected substance misuse-related vestibular dysfunction.

Learning Outcomes:

1. Describe basic vestibular toxicity mechanisms and predisposing factors in adults.
2. Describe the existing literature on substance use disorders and the vestibular effects.
3. Identify vestibular testing modifications for patients with substance misuse histories.

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