Rachel Stuehm, a third-year student in NIU’s Doctor of Audiology program, will present a poster at the upcoming annual conference of the American Academy of Audiology.
She will present: “Under the influence: narcotics abuse and hearing loss,” a case study examining the possible effects of methamphetamine use on the auditory system. Issues addressed include the impact of imbalances of neurotransmitters on hearing, possible synergistic effects of meth and noise on neural connections before damage is seen to outer hair cells, and the importance of non-biased care towards drug abusing patients.
Further details of her presentation:
“Use of methamphetamine continues to skyrocket in the United States, with CDC-published use rates climbing to nearly 7 percent of young adults, and with death rates higher than that for opioid narcotics (CDC, 2016). Audiologists working in clinics with broad demographics are likely to provide care to patients with addictions or in recovery. It is important for audiologists to consider the use of drugs in the diagnostic workup and in overall treatment planning.
The current case study is of a 49 year-old male who was referred for a hearing aid consultation following a evaluation at an external private ENT office. The patient arrived with complaints of “nerve pain”, speech sounding muffled, bothersome tinnitus, and a visibly noticeable tremor. The patient is managed by several physicians with a large number of prescription medications to address his neuralgia, tremors, anxiety and depression. He reported a history of noise exposure, is a heavy smoker, and has nerve damage down his spine and back. He was additionally diagnosed with early onset Parkinson’s disease, and spoke candidly about his struggle with methamphetamine use. Audiometry revealed a mild sloping to moderate sensorineural hearing loss in the left ear, and mild sloping to moderately severe loss in the right ear. Tympanometry was within normal limits; acoustic reflexes were not obtained due to concerns related to the tinnitus.
Casual observation of the audiogram and history might suggest noise induced hearing loss, though no marked notch/recovery was noted, and no asymmetrical pattern of exposure was reported. One might also consider presbycusis, but the patient is only 49 years old. There was no known family history of hearing loss in middle age. None of the current medications are known to cause hearing loss or tinnitus.
Methamphetamine is a highly addictive stimulant drug that has short term and long term effects. Some of the long term effects are: usage can increase the amount of chemical dopamine in the brain, it increases a person’s risk of developing Parkinson’s disease (which may carry a hearing loss profile similar to that of presbycusis), it causes permanent damage to blood vessels, and increases changes of developing mental health issues. Neurotransmitter levels in the brain change due to depression, anti-depression medications, certain CNS disorders, and addictive drugs.
Case studies have shown that individuals who use addictive drugs have developed sudden high frequency sensorineural hearing loss after episodes of overdose. Audiologists, like other healthcare providers, are likely to care for patients who have substance abuse problems. In 2015, Bina’s study of medical students’ perceptions showed that by a student’s fourth year of medical school, 54 percent of residents feel that “drug abusing patients provide nothing in return to receiving healthcare,” a significant increase from earlier years of schooling.
We suggest that audiologists must seek to be informed about the potential impact of drug use on the hearing mechanism, but also that we must maintain a response of unconditional positive regard to patients seeking our care. We must provide a non-biased and knowledgeable approach to this vulnerable population.”