Oxycodone and hearing loss

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No studies yet.

It's impairing ears for sure, though I don't know how.

I know Dr. Gail Ishimaya is one of the main researcher on opioids and hearing loss.

I am searching some of his research on Google but I can't find.

Oh and yes, the case of Rush Limbaugh is famous.

Hydrocodone should be a way to investigate, but even then I can't find any explanations on how it is impairing ears.
Mystery.

And here's the debate again: are opioids finally neurotoxic or not?
meh...
 
I lose my hearing every time a patient asks for oxycontin. :laugh:
 
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Ok, I've done my part of the investigation on that.

For the moment, all I can say is that this problem is not specific for oxycodone and vicodin only, but all codeinics and related codeinics metabolites.
I am investigating also if it's the case in all other opiates.

I think this would cause an hearing loss in those taking codeinics for a long term use or in those already having hearing problems.
Be aware and do not hesitate to recommend morphinics or any other opioids for this population.

Anyway, we already knew this, opioids are not good/ideal for prolonged treatments
 
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Actually I think one would be hard pressed to find any credible evidence for any opioid causing auditory dysfunction. Given the literally millions of users of these drugs every day, we should see a statistically valid number of reports of hearing loss, but we do not. Only when combined with APAP is there any evidence, and that is based only on a couple of case reports, if you discount the methadone ODs (2) that experienced hearing loss (of course these people may be using a bucket of other drugs). Rush Limbaugh developed ototoxicity, but was using APAP in large quantities (Percocet) in addition to the oxycodone. The very misleading title of the Pain Physician article linking hydrocodone to hearing loss conveniently left out the part that they were taking APAP also, up to 9,000 mg a day. Codeine does not equal oxycodone does not equal hydrocodone. They are not in the same chemical families and have different metabolites. So in my honest opinion, any linkage of opioids to hearing loss is speculative at best, and certainly no conclusions or causation can be ascribed to opioids.
 
Yes, there's clear evidences showing opioids decreasing hearing. What we do not know are the circumstances, mechanics and impacts, people more sensitive than others etc.

You should Google this:
hearing loss and opiates

There's a ton of evidences and people telling their story experimenting opioids developing tinnitus and other hearing disorders. I read also some APAP/codeine stories and hearing loss. And from what I know, oxycodone alone is causing hearing disorders, not only the APAP formula.

Even studies in APAP/hydrocodone lack of explanations.

Opiate medications are known to suppress pituitary hormone levels, including ACTH, which triggers adrenal production of cortisol. Perhaps opiate suppression of aldosterone hormone production is causing hearing loss in opiate users.
More importantly, aldosterone hormone replacement has decreased hearing loss in some elderly patients.

Also, about the only useful info I could find indicated that neurotranmission in the cochlea is mediated by kappa receptors. But I don't really know if this is relevant, because I don't understand how the ears work.

And I'm trying hardly to find these Dr.Gail Ishimiya researchs.
 
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If you want to ever be taken seriously as a medical student and a scientist you will learn that 1. anecdotal internet based claims of injury due to ??? are crap
2. That you should never make sweeping proclamations unless you have some pretty damned convincing evidence 3. That you need to be able to produce that evidence. The fact that combinations of opioids/APAP may produce hearing loss in isolated cases does not in any way suggest the opioids themselves are the culprit. Get a clue...start to think like a scientist instead of Dr Laura.
If you have scientific evidence (read: not a self published book without peer review or internet forum claims), then present it here instead of wildly speculating on a learned medical forum.
 
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Here are the facts: NLM Pubmed search "hearing loss opioids" generates 26 entries.
9 of the articles involve hearing loss after spinal/epidural analgesia or are general papers not relevant.
2 articles involve methadone overdose induced hearing loss
7 involve illicit drug use, 6 of which involved heroin
4 involve hydrocodone/APAP
1 involved oxycodone/APAP
1 involved codeine/APAP
2 involved propyxyphene/APAP.
Almost all were case studies with the exception of a case series of 12 patients with hearing loss due to hydrocodone/APAP and a methadone clinic study (concurrently using heroin and a variety of drugs) that found 5% had hearing loss.

The definitive research study on this was recently published: a mouse study demonstrated conclusively that hydromorphone alone or hydrocodone alone does not result in ototoxicity whereas APAP alone does. Yorgason JG, Kalinec GM, Luxford WM, Warren FM, Kalinec F. Acetaminophen
ototoxicity after acetaminophen/hydrocodone abuse: evidence from two parallel in
vitro mouse models. Otolaryngol Head Neck Surg. 2010 Jun;142(6):814-9, 819.e1-2.
Epub 2010 Apr 9
 
The definitive research study on this was recently published: a mouse study demonstrated conclusively that hydromorphone alone or hydrocodone alone does not result in ototoxicity whereas APAP alone does. Yorgason JG, Kalinec GM, Luxford WM, Warren FM, Kalinec F. Acetaminophen
ototoxicity after acetaminophen/hydrocodone abuse: evidence from two parallel in vitro mouse models. Otolaryngol Head Neck Surg. 2010 Jun;142(6):814-9, 819.e1-2.
Epub 2010 Apr 9
Thanks for the tip, I will try to see this.
But that doesn't explain well why this is happening in some cases, that's what I am trying to know.
 
Thanks for the tip, I will try to see this.
But that doesn't explain well why this is happening in some cases, that's what I am trying to know.

Same reason people get any rare disease. Shti happens.

Fairy tale science takes 2 unrelated events, assumes hey are true, then does research to prove it. How much spontaneous hearing loss occurs?
Does tramadol cause seizures, or if you select the right studies, can you prove it protects against seizures. Association is not causation, and I don't even think we have association here.
 
Agree with Steve.

The mechanism of APAP otoxicity in the mouse models, both of otic hair cells and stem cell lines of auditory nerves was direct cytotoxicity.

There is also a study listed below that demonstrates ibuprofen and ASA also cause ototoxicity. Hydrocodone is combined with APAP in 95% plus of the time in the US. Oxycodone is used with APAP at least some of the time, and if the pain relief isn't enough with pure oxycodone, doctors frequently tell patients to add Tylenol.

Am J Med. 2010 Mar;123(3):231-7.
Analgesic use and the risk of hearing loss in men.
Curhan SG, Eavey R, Shargorodsky J, Curhan GC.
Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. [email protected]

Abstract
BACKGROUND: Hearing loss is a common sensory disorder, yet prospective data on potentially modifiable risk factors are limited. Regularly used analgesics, the most commonly used drugs in the US, may be ototoxic and contribute to hearing loss.

METHODS: We examined the independent association between self-reported professionally diagnosed hearing loss and regular use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen in 26,917 men aged 40-74 years at baseline in 1986. Study participants completed detailed questionnaires at baseline and every 2 years thereafter. Incident cases of new-onset hearing loss were defined as those diagnosed after 1986. Cox proportional hazards multivariate regression was used to adjust for potential confounding factors.

RESULTS: During 369,079 person-years of follow-up, 3488 incident cases of hearing loss were reported. Regular use of each analgesic was independently associated with an increased risk of hearing loss. Multivariate-adjusted hazard ratios of hearing loss in regular users (2+ times/week) compared with men who used the specified analgesic <2 times/week were 1.12 (95% confidence interval [CI], 1.04-1.20) for aspirin, 1.21 (95% CI, 1.11-1.33) for NSAIDs, and 1.22 (95% CI, 1.07-1.39) for acetaminophen. For NSAIDs and acetaminophen, the risk increased with longer duration of regular use. The magnitude of the association was substantially higher in younger men. For men younger than age 50 years, the hazard ratio for hearing loss was 1.33 for regular aspirin use, 1.61 for NSAIDs, and 1.99 for acetaminophen.

CONCLUSIONS: Regular use of aspirin, NSAIDs, or acetaminophen increases the risk of hearing loss in men, and the impact is larger on younger individuals.
 
If you want to ever be taken seriously as a medical student and a scientist you will learn that 1. anecdotal internet based claims of injury due to ??? are crap
2. That you should never make sweeping proclamations unless you have some pretty damned convincing evidence 3. That you need to be able to produce that evidence. The fact that combinations of opioids/APAP may produce hearing loss in isolated cases does not in any way suggest the opioids themselves are the culprit. Get a clue...start to think like a scientist instead of Dr Laura.
If you have scientific evidence (read: not a self published book without peer review or internet forum claims), then present it here instead of wildly speculating on a learned medical forum.

Well Said!
 
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