Characterizing the Effects of Chronic Substance Misuse on Auditory and Vestibular Function

描述慢性药物滥用对听觉和前庭功能的影响

基本信息

项目摘要

Accumulating reports indicate that substance use disorders (SUDs) and overdoses result in hearing loss (HL) and vestibular loss (VL). This is problematic because hearing and balance are important for communication, employment, mental health, physical independence, and overall quality of life. HL and VL would have a greater negative impact on people with SUDs, as this population already struggles with a higher incidence of mental health issues, unemployment, and poorer quality of life. People of minority status with HL/VL are further marginalized because of socioeconomic and/or cultural barriers to audiological healthcare. Unfortunately, the literature on substance-misuse-related HL is sporadic and primarily consists of case reports describing various degrees of either temporary or permanent HL from illicit drugs or prescribed opioid misuse. Even less is known about the effects of SUDs on the vestibular system. A few studies indicate alcohol misuse impairs balance, and opioids and alcohol disrupt peripheral and central vestibular function. The existing studies suggest differential effects on the inner ear based on substance type and use patterns. There is a critical lack of rigorous research using objective measures to identify the peripheral and central effects of SUDs on hearing and vestibular function. Likewise, the influence of health comorbidity, demographics, socioeconomic position, and substance-use patterns on HL/VL in the SUD population has not been investigated. Our project goals are to improve our knowledge of the impact of SUDs on hearing and vestibular function and to identify who is most at risk for HL/VL. To accomplish these goals, we will be the first to investigate peripheral and central hearing (Aim 1) and vestibular (Aim 2) function in a large cohort of diverse people who have SUDs, recruited across three regionally unique study sites. Data will be compared to an age-sex-race or ethnicity-matched control group without SUDs. Last, we will determine the predictive health, demographic, socioeconomic, and substance-use factors that increase the risk of developing HL/VL secondary to substance misuse (Aim 3). We hypothesize that chronic substance misuse will affect the auditory and/or vestibular systems like mechanisms underlying oto- vestibulotoxic medications. Based on the literature, we hypothesize that more health comorbidities, older age, being of non-Hispanic White background, lower socioeconomic position, and riskier substance-use patterns will predict the severity of HL or VL. Biological sex differences are unclear in the existing HL/VL literature; however, our results will help elucidate sex differences in HL/VL and SUDs. SUDs and overdoses have significantly increased since the coronavirus pandemic and disproportionately so among minority populations. Thus, this work is timely and important because early HL/VL intervention is key to minimizing health and social burdens, but care is impeded in SUD and minority populations. Our findings will enhance awareness among professionals who serve people with SUDs so they can make appropriate diagnoses and recommendations. The results will inform our future work to develop accessible, equitable interventions for people with SUDs and health disparities.
越来越多的报告表明,物质使用障碍(SUD)和过量导致听力损失(HL)和前庭损失(VL)。这是有问题的,因为听力和平衡对沟通,就业,心理健康,身体独立和整体生活质量都很重要。HL和VL将对SUD患者产生更大的负面影响,因为这一人群已经在与更高的心理健康问题、失业和更差的生活质量作斗争。由于听力保健方面的社会经济和/或文化障碍,HL/VL少数群体进一步被边缘化。不幸的是,关于药物滥用相关HL的文献是零星的,主要由描述非法药物或处方阿片类药物滥用导致的不同程度的暂时性或永久性HL的病例报告组成。关于SUD对前庭系统的影响,我们知道的更少。一些研究表明,酒精滥用会损害平衡,阿片类药物和酒精会破坏外周和中枢前庭功能。现有的研究表明,不同的物质类型和使用模式对内耳的影响不同。严重缺乏使用客观措施来确定SUD对听力和前庭功能的外周和中枢影响的严格研究。同样,尚未研究SUD人群中健康合并症、人口统计学、社会经济地位和药物使用模式对HL/VL的影响。我们的项目目标是提高我们对SUD对听力和前庭功能影响的认识,并确定谁是HL/VL的最大风险。为了实现这些目标,我们将是第一个研究外周和中枢听力(目标1)和前庭(目标2)的功能在一个大的队列的不同的人谁有SUD,招募了三个地区独特的研究网站。将数据与无SUD的年龄-性别-人种或种族匹配对照组进行比较。最后,我们将确定增加继发于药物滥用的HL/VL风险的预测性健康、人口统计学、社会经济学和药物使用因素(目标3)。我们假设慢性药物滥用会影响听觉和/或前庭系统,就像耳前庭毒性药物的潜在机制一样。基于文献,我们假设更多的健康合并症、年龄较大、非西班牙裔白色背景、较低的社会经济地位和风险较高的药物使用模式将预测HL或VL的严重程度。在现有的HL/VL文献中,生物学性别差异尚不清楚;然而,我们的结果将有助于阐明HL/VL和SUD的性别差异。自冠状病毒大流行以来,SUD和过量用药显著增加,在少数群体中不成比例。因此,这项工作是及时和重要的,因为早期HL/VL干预是最大限度地减少健康和社会负担的关键,但在SUD和少数民族人群中,护理受到阻碍。我们的研究结果将提高为SUD患者服务的专业人员的认识,以便他们能够做出适当的诊断和建议。研究结果将为我们未来的工作提供信息,为SUD和健康差异的人制定可获得的,公平的干预措施。

项目成果

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