# Neurologic Complications of Drug and Alcohol Use > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/neurologic-complications-drug-alcohol/ > **Published:** 2026-03-24T16:39:09-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T10:40:37-04:00 > **Clinical Summary:** Explore neurologic complications drug alcohol use including opioid encephalopathies and cannabis stroke risks in this clinical review for neurologists. --- CED Clinical Relevance  #56Monitored Relevance  Early-stage or contextual signal requiring further evidence before action. 🔬 Evidence Watch  |  CED Clinic NeurologyCannabisStrokeSubstance UseClinical Review Journal Continuum (Minneapolis, Minn.) Study Type Clinical Study Population Human participants Why This Matters This comprehensive review addresses a critical gap in neurologic training regarding substance-related complications. With rising [cannabis legalization](https://cedclinic.com/the-forgotten-history-of-hemp-in-america/) and novel psychoactive substances, neurologists need updated frameworks for recognizing and managing these increasingly common presentations. Clinical Summary 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](https://cedclinic.com/cannabinoid-clinical-trials-mental-disorders-evidence-2/). Dr. Caplan’s Take “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.” Clinical Perspective 🧠 Clinicians should maintain high suspicion for substance-related neurologic complications, particularly in younger stroke patients or those with unexplained encephalopathy. Cannabis prescribers should screen for other substance use and counsel patients about potential vascular risks, especially those with cardiovascular risk factors. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/) Have thoughts on this? Share it: [𝕏 Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Neurologic%20Complications%20of%20Drug%20and%20Alcohol%20Use.%20%40drcaplan&url=https%3A//pubmed.ncbi.nlm.nih.gov/41631916/)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A//pubmed.ncbi.nlm.nih.gov/41631916/)[🦥 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Neurologic%20Complications%20of%20Drug%20and%20Alcohol%20Use.%20--%20via%20%40drcaplan.bsky.social%20https%3A//pubmed.ncbi.nlm.nih.gov/41631916/)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan/)[📝 Read more on Substack](https://substack.com/@doctorapproved)[🔔 Subscribe via RSS](https://cedclinic.com/category/cannabis-news/feed/) 📰 Source: [https://pubmed.ncbi.nlm.nih.gov/41631916/](https://pubmed.ncbi.nlm.nih.gov/41631916/) Table of Contents - [FAQ](#FAQ)[What is the relationship between cannabis use and stroke risk?](#What_is_the_relationship_between_cannabis_use_and_stroke_risk) - [How has substance use-related neurologic complications changed during COVID-19?](#How_has_substance_use-related_neurologic_complications_changed_during_COVID-19) - [What are novel psychoactive substances and their neurologic risks?](#What_are_novel_psychoactive_substances_and_their_neurologic_risks) - [What opioid-related neurologic complications should clinicians recognize?](#What_opioid-related_neurologic_complications_should_clinicians_recognize) - [What role do neurologists play in managing substance use disorders?](#What_role_do_neurologists_play_in_managing_substance_use_disorders) - [Related](#Related) ## FAQ #### What is the relationship between cannabis use and stroke risk? Some studies suggest an independent association between [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) and ischemic stroke, though this is still an emerging area of research. Neurologists should be aware of this potential complication as [cannabis legalization](https://cedclinic.com/the-forgotten-history-of-hemp-in-america/) expands and usage increases. #### How has substance use-related neurologic complications changed during COVID-19? Substance use and overdose mortality rose sharply during the [COVID-19 pandemic](https://cedclinic.com/will-the-coronavirus-force-states-to-legalize-marijuana/), 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. #### What opioid-related neurologic complications should clinicians recognize? 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](https://cedclinic.com/cannabinoid-clinical-trials-mental-disorders-evidence-2/) toward appropriate treatment and play a crucial role in both acute management and long-term care coordination. {“@context”: “https://schema.org”, “@type”: “ScholarlyArticle”, “headline”: “Neurologic Complications of Drug and Alcohol Use.”, “url”: “https://pubmed.ncbi.nlm.nih.gov/41631916/”, “about”: “continuum minneapolis minn clinical study neurologic”, “isPartOf”: “Continuum (Minneapolis, Minn.)”} [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. Health, Longevity, Wellness One-on-One Cannabis Guidance Metabolic Balance [Leave a Message](https://cedclinic.com/contact/) [Metabolic Care](https://cedclinic.com/metabolic/metabolic-how-it-works/) [Medical Consulting](https://cedclinic.com/book/) [Cannabis Care](https://cedclinic.com/book/) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) RELATED READING AT CED CLINIC Continue exploring the evidence [Neurologic Complications of Drug and Alcohol Use.](https://cedclinic.com/cannabis-neurologic-complications-clinical-review-evidence/) A detailed clinical review focusing on cannabis-related neurologic complications and evidence-based insights. [Read More](https://cedclinic.com/cannabis-neurologic-complications-clinical-review-evidence/) [Cannabis Use Disorder Treatment Europe Review](https://cedclinic.com/cannabis-use-disorder-treatment-europe-evidence-watch/) An evidence watch on [cannabis use disorder](https://cedclinic.com/sex-differences-cannabis-stress-reactivity-oxytocin/) treatments available in Europe with clinical relevance. [Explore Treatments](https://cedclinic.com/cannabis-use-disorder-treatment-europe-evidence-watch/) [Study highlights stroke risk linked to recreational drugs, including among young users](https://cedclinic.com/cannabis-stroke-risk-young-users-study-highlights/) Research findings on stroke risks associated with recreational drug use, emphasizing young populations. [Learn More](https://cedclinic.com/cannabis-stroke-risk-young-users-study-highlights/) ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).