As the country battles the seemingly never-ending opioid epidemic, one largely overlooked, but regrettable effect of the crisis is that opioid abuse has been associated with progressive, possibly profound hearing loss, according to many medical professionals who specialize in ear care.
Audiologists say that hearing loss may be a potentially debilitating side effect of the overuse of opioids, especially medication that also includes acetaminophen or ibuprofen. While the exact reason for this phenomenon is unknown, experts believe that it may be related to poor circulation resulting from the use of pain relievers.
Proper circulation is essential for hearing because the blood pathway that carries nutrients to the ear is so tiny that it is particularly vulnerable to interruption. Many of these changes in the ability to hear happen over time – or they can result from just one binge. In any event, cases of opioid-related profound hearing loss can only be treated using cochlear implants.
Cochlear implants are most often covered by insurance – which is great if you have it. The cost of such an implant can run as much as $100,000, which includes the device, surgery, and rehab. Without coverage, the American Speech-Language-Hearing Association (ASHA) estimates the cash cost to be more than $40,000.
But the medical cost of hearing loss extends far beyond the price of implants. Research has shown that employees who experience a profound hearing loss that remains untreated earn up to $12,000 less than their normal-hearing counterparts.
Moreover, lower income and communication difficulties prevent those with hearing loss from advancing in their profession.
For those with addiction as well, keeping steady employment could be a real challenge. Indeed, many audiologists are pushing for diagnostic hearing exams to be conducted whenever opioid addiction appears to be present.
In response to a request by the House Ear Institute, The Food and Drug Administration has placed a required warning on the labels of hydrocodone-acetaminophen drugs such as Vicodin, one which cautions that large doses could result in ototoxicity of the ear, causing hearing loss.
But despite these warnings, abuse of hydrocodone and other opioids has yet to abate. Some with addictions shifted away from drugs containing acetaminophen, which can also cause liver damage, but does not negate other risks such as the potential for overdose.
A report from 2015 described a woman whose overuse of opioids led to hearing loss.
A 44-year-old, unemployed woman on disability for back pain lived with her boyfriend and disabled brother.
She experienced a troubled childhood, and began taking opioids in her late teens after falling off of a horse. Later, after being physically assaulted by her boyfriend at the time, she started abusing medications to manage her pain.
A few months before the report, she revealed in a psychiatric consultation that she had been “doctor-shopping,” or obtaining opioids and medications from multiple doctors and pain clinics. In the decade prior, she had been admitted to several inpatient detox programs, and ten years before the consultation, she developed unilateral hearing loss due to “continuous hydrocodone/acetaminophen abuse” and received a cochlear implant.
Preventing Opioid Addiction and Dangerous Side Effects
Anyone can become dependent on opioids, even those prescribed by doctors. Depending on the dosage, addiction can occur in just a few days. A high enough dose (more than 20 MMM) can cause withdrawal symptoms several days after cessation of the drug.
For many, symptoms of drug tolerance and withdrawal appear after just five days of treatment, resulting in worse pain (hyperalgesia) when they stop using the medication. When tolerance occurs, increasing doses are needed to achieve the same effect.
To prevent this from happening, request a non-addictive form of pain relief, such as a non-opioid analgesic, anti-inflammatory NSAIDs, local anesthetics, or anticonvulsants such as gabapentin – if you have health insurance, confirm they are covered or at least affordable. As noted, some of these pain relievers can contribute to hearing as loss, so please use them as directed.
Patients often obtain the most pain relief when drugs are combined with physical therapy, relaxation techniques, or other holistic practices such as acupuncture or yoga.
If your doctor advises the use of opioid medication, go for the lowest effective dosage and a short-term course of treatment (up to seven days.) Follow the dosing guidelines and if any medication is leftover, dispose of it so others cannot have access to it.
About The Drug Epidemic
Recent data from the Centers for Disease Control Prevention estimate that more than 64,000 people died in 2016 of overdoses related to drugs or alcohol. Of those, 42,000 died from overdoses related to prescription painkillers or illicit opioids such as heroin.