Background: Recreational drug abuse is a serious health problem that poses detrimental effects on central nervous system. Neuroimaging plays a pivotal role in the detection of these abnormal changes in the brain associated with the drug abuse. This study focuses on the grading of cerebral atrophy in the opioid-addicted patients and their association with the age and duration of opioid abuse. Objectives: Grading of cerebral atrophy in opioid-addicted patients and to assess the probable association between chronic opioid abuse and cerebral atrophy in patients admitted to the intensive care unit (ICU) of a tertiary care hospital. Materials and methods: A retrospective study was carried out on 40 patients of opioid abuse who were admitted in the ICU of the hospital over a period of 2 years. Magnetic resonance imaging (MRI) scan of these patients was done using Siemens Avanto 1.5 Tesla scanner. Results: All the patients were male with 25 patients having varying degrees of cerebral atrophy as assessed from Pasquier scale. Majority of the patients (n = 14) on chronic opioid abuse had global cortical atrophy (GCA) score of 1 indicative of mild cerebral atrophy. The associated factors like the duration of abuse and age of presentation had significant association with the cerebral atrophic changes in the brain (p < 0.05). Conclusion: Opioid-dependent patients with long-term substance abuse had probable association with the atrophic changes in brain as assessed from neuroimaging. The progressing age and longer duration of drug abuse may foster significant alterations to the brain structure leading to varied degree of cerebral atrophy.
Information sheet on opioid overdose [Internet]. World Health Organization. 2019 [cited 15 November 2019]. Available from: https://www.who.int/substance_abuse/information-sheet/en/.
Commonly Used Terms | Drug Overdose | CDC Injury Center [Internet]. Cdc.gov. 2019 [cited 15 November 2019]. Available from: https://www.cdc.gov/drugoverdose/opioids/terms.html.
Definition of ADDICT [Internet]. Merriam-webster.com. 2019 [cited 29 November 2019]. Available from: https://www.merriam-webster.com/dictionary/addict.
Ambekar A, Rao R, Agrawal A, Kathiresan P. Research on opioid substitution therapy in India: A brief, narrative review. Indian J Psychiatry 2018;60(3):265. DOI: 10.4103/psychiatry.IndianJPsychiatry_385_18.
Avasthi A, Basu D, Subodh B, Gupta P, Sidhu B, Gargi P, et al. Epidemiology of substance use and dependence in the state of Punjab, India: Results of a household survey on a statewide representative sample. Asian J Psychiatr 2018;33:18–29. DOI: 10.1016/j.ajp.2018.02.017.
[Internet]. Pbhealth.gov.in. 2019 [cited 15 November 2019]. Available from: http://pbhealth.gov.in/scan0003%20(2).pdf.
Borne J, Riascos R, Cuellar H, Vargas D, Rojas R. Neuroimaging in drug and substance abuse part II. Top Magn Reson Imaging 2005;16(3): 239–245. DOI: 10.1097/01.rmr.0000192154.34563.6b.
Geibprasert S, Gallucci M, Krings T. Addictive illegal drugs: structural neuroimaging. AJNR Am J Neuroradiol 2010;31(5):803–808. DOI: 10.3174/ajnr.A1811.
Mechtcheriakov S, Brenneis C, Egger K, Koppelstaetter F, Schocke M, Marksteiner J. A widespread distinct pattern of cerebral atrophy in patients with alcohol addiction revealed by voxel-based morphometry. J Neurol Neurosurg Psychiatry 2007;78(6):610–614. DOI: 10.1136/jnnp.2006.095869.
García-Valdecasas-Campelo E, González-Reimers E, Santolaria-Fernández F, De La Vega-Prieto MJ, Milena-Abril A, Sánchez-Pérez MJ, et al. Brain atrophy in alcoholics: Relationship with alcohol intake; liver disease; nutritional status, and inflammation. Alcohol Alcohol 2007;42(6):533–538. DOI: 10.1093/alcalc/agm065.
Tamrazi B, Almast J. Your brain on drugs: imaging of drug-related changes in the central nervous system. Radiographics 2012;32(3): 701–719. DOI: 10.1148/rg.323115115.
Wahlund LO, Westman E, van Westen D, Wallin A, Shams S, Cavallin L, et al. Imaging biomarkers of dementia: recommended visual rating scales with teaching cases. Insights Imaging 2016;8(1):79–90. DOI: 10.1007/s13244-016-0521-6.
Muzio B. Global cortical atrophy scale | Radiology Reference Article | Radiopaedia.org [Internet]. Radiopaedia.org. 2019 [cited 12 June 2019]. Available from: https://radiopaedia.org/articles/global-cortical-atrophy-scale.
Narayana P, Datta S, Tao G, Steinberg J, Moeller F. Effect of cocaine on structural changes in brain: MRI volumetry using tensor-based morphometry. Drug Alcohol Depend 2010;111(3):191–199. DOI: 10.1016/j.drugalcdep.2010.04.012.