Oregon hospital sees first documented case of brain disease from fentanyl

Doctor analyzing a patient’s brain scan on screen (Getty Images)

PORTLAND, OregonKOIN) – A patient who arrived at an Oregon emergency room “unconscious and near death” in 2023 is the world’s first documented case of brain illness due to fentanyl inhalation, according to Oregon Health & Science University.

The patient, a previously healthy 47-year-old man, was taken to OHSU by ambulance in February 2023 after being found collapsed in his hotel room where he was staying for a business trip, the hospital said. OHSU.

Based on the case study — published in the journal BMJ Case Reports – as doctors searched for a cause, an initial drug test came back negative for opioids.

Doctors performed a specialized test that revealed the presence of fentanyl in the patient’s body, leading to a “surprising and unprecedented diagnosis” of fentanyl inhalation toxic leukoencephalopathy, OHSU said.

According to the hospital, inhaling fentanyl caused inflammation of large portions of the white matter in the patient’s brain to the point that he lost consciousness and was at risk of irreversible loss of brain function or even the death.

Medical officials have previously documented cases of similar diagnoses in patients who inhale heroin; however, this is believed to be the first case involving the inhalation of illicit fentanyl, OHSU said.

“Opioid use, particularly fentanyl, has become very stigmatized,” said the case study’s lead author, Dr. Chris Eden, a second-year resident in internal medicine at the University School of Medicine. OHSU who was part of the patient’s treatment team. “This is the case of a middle-class man, in his forties, with children, who used fentanyl for the first time. This demonstrates that fentanyl can affect everyone in our society.

Although this is the first documented case, Eden notes that other cases have likely gone unrecognized because little is known about the syndrome and hospitals have traditionally not included fentanyl in their drug testing. standard drug screening.

“We are very familiar with the classic side effects of opiates: respiratory depression, loss of consciousness, disorientation,” Eden said. “But we don’t conventionally think of it causing potentially irreversible brain damage and affecting the brain, as it did in this case.”

“Miraculous” recovery

OHSU said the patient recovered after 26 days of hospitalization and a stay at a skilled nursing facility to regain speech and function.

Researchers said the case study should serve as a warning about the dangers of fentanyl – which is cheap, easily available and 50 times more potent than heroin – and said fentanyl should be included in screenings drugs in hospitals.

Now the patient is home with family in the Seattle area and returning to work.

“From what I remember early on, my recovery was miraculous. At first it seemed like I would need 24-hour care after my discharge, but I focused and worked hard during my therapy session and was determined not to leave the hospital just to be registered in a group setting for continuing care. It’s now been 6 months and I’m back home, working and feeling strong and healthy. I often have regrets about what I have done to myself, my wife and my family. I am grateful to all the doctors, nurses and paramedics who saved my life and to the therapists who allowed me to become a functioning member of society again,” the patient recalled in the study.

The case study is presented as Oregon saw the largest annual increase in fentanyl overdose deaths in 2023 in the country.followed closely by Washington State.

According to Centers for Disaster Control and PreventionOregon saw a 41% increase in fentanyl overdose deaths between September 2022 and September 2023, as first reported The Oregonian.

In 2019, Oregon recorded 78 fentanyl overdose deaths, followed by 705 in 2022 and 1,268 in 2023, the CDC reported.