Substance Use Disorders and the Vestibular System: A Rising Issue
Amanda Chiao, AuD, PhD
CEUs: 0.1 AAA CEUs
Duration: 60 minutes
Instructional Level: Beginner
Program Focus: Knowledge
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.
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.
Amanda Chiao, AuD, PhD - Texas Tech University Health Sciences Center, El Paso
Dr. Chiao is an Assistant Professor in the Department of Surgery and Director of the Concussion and Vestibular Evaluation Laboratory at Texas Tech University Health Sciences Center El Paso. She received her AuD-PhD from Texas Tech University and completed a postdoctoral fellowship at Boys Town National Research Hospital. Dr. Chiao’s research has been to investigate the physiological and functional vestibular effects that occur in children with concussion and people with substance use disorders. Dr. Chiao’s research also seeks to identify minority health disparities among people with hearing and vestibular loss, and the methods to reduce barriers for diagnosis and intervention. Dr. Chiao is also a practicing audiologist at El Paso Children’s Hospital.
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