| Journal | Continuum (Minneapolis, Minn.) |
| Study Type | Clinical Study |
| Population | Human participants |
This comprehensive review addresses a critical gap in neurologic training regarding substance-related complications. With rising cannabis legalization and novel psychoactive substances, neurologists need updated frameworks for recognizing and managing these increasingly common presentations.
This clinical review examines neurologic syndromes associated with various substances, including newly identified opioid-related toxic encephalopathies and complications from unregulated novel psychoactive substances available online. The authors highlight emerging concerns about cannabis and ischemic stroke associations, while noting that substance use complications increased during COVID-19. The review provides neurologists with diagnostic approaches and emphasizes opportunities for intervention in substance use disorders.
“This review reflects what I see clinically – cannabis patients often have complex substance use histories, and we must maintain awareness of potential neurologic risks. The stroke data remains preliminary but warrants careful monitoring in higher-risk patients.”
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Table of Contents
- FAQ
- What is the relationship between cannabis use and stroke risk?
- How has substance use-related neurologic complications changed during COVID-19?
- What are novel psychoactive substances and their neurologic risks?
- What opioid-related neurologic complications should clinicians recognize?
- What role do neurologists play in managing substance use disorders?
FAQ
What is the relationship between cannabis use and stroke risk?
Some studies suggest an independent association between cannabis use and ischemic stroke, though this is still an emerging area of research. Neurologists should be aware of this potential complication as cannabis legalization expands and usage increases.
Substance use and overdose mortality rose sharply during the COVID-19 pandemic, largely driven by fentanyl-related deaths. While recent data show modest decreases, current overdose rates remain higher than pre-pandemic levels, requiring continued vigilance from healthcare providers.
What are novel psychoactive substances and their neurologic risks?
Novel psychoactive substances are largely unregulated compounds that can be easily obtained online or in stores. Several of these substances have been associated with seizures and other serious neurologic complications, making identification and management challenging for clinicians.
A wide variety of opioid-related toxic encephalopathies have been identified recently, representing serious neurologic complications of opioid use. These conditions require prompt recognition and appropriate management by neurologists and other healthcare providers.
What role do neurologists play in managing substance use disorders?
Neurologists frequently encounter severe neurologic complications from substance use and have a unique opportunity to intervene. They can guide patients with substance use disorders toward appropriate treatment and play a crucial role in both acute management and long-term care coordination.