Table 2A.
Literature summary of hearing and vestibular outcomes from prescription opioid drug misuse by case report/series/chart review.
| Substance Class & Type | Reference | Study Type | Phase of Use | Delivery/Dose | Hearing Loss? | Hearing Results | Vestibular Loss? | Vestibular Results |
|---|---|---|---|---|---|---|---|---|
| Opioids | ||||||||
| Morphine | Kopec & Nelson (2012) | Case Report | Chronic or acute use w/overdose | IN/– | Yes*† | Sudden, Bilateral | – | – |
| Morphine | Leache et al. (2016) | Case Report | Chronic or acute use w/ overdose | PO/120 mg | Yes* | Sudden, Mod-Severe to Profound Bilateral (permanent) | – | – |
| Oxymorphone | Boyle & Rosenbaum (2013) | Case Report | Chronic or acute use w/ overdose | IN/– | Yes*† | Sudden, Bilateral | – | – |
| Oxymorphone | MacDonald et al. (2015) | Case Report | Acute ingestion w/o overdose | IN/30 mg | Yes* | Sudden, Bilateral | – | – |
| Oxycodone | Ntranos et al. (2017) | Case Report | Chronic or acute use w/ overdose | PO/34 tab | Yes*† | Sudden | – | – |
| Hydrocodone | Ho et al. (2007) | Case Series n = 5 | Chronic use w/o overdose | PO/10 – 300 mg | Yes | Progressive, Profound Bilateral (permanent) | – | – |
| Propoxyphene (Darvon®) | Harell et al. (1978) | Case Report | Chronic use w/o overdose | PO/1000 mg qd | Yes | Progressive, Profound Bilateral (permanent) | No* | – |
| Propoxyphene hydrochloride | Lupin et al. (1976) | Case Report | Acute ingestion w/o overdose | PO/1560 mg qd | Yes | Sudden, Normal to Severe Bilateral (permanent) | Yes | Peripheral Bilateral VL |
| Methadone | Ghasemi et al. (2019) | Case Report | Chronic or acute use w/ overdose | PO/40 mg | Yes | Sudden, Mod-severe Bilateral (permanent) | – | – |
| Methadone | Repple et al. (2021) | Case Report | Chronic or acute use w/ overdose | IV/2.55 mg | Yes*† | Sudden, Moderate Bilateral | Yes†* | – |
| Methadone | Saifan et al. (2013) | Case Report | Chronic or acute use w/ overdose | PO/80 mg | Yes | Sudden, Mild-moderate Bilateral (permanent) | – | – |
| Methadone | Shaw et al. (2010) | Case Report | Chronic or acute use w/overdose | PO/– | Yes*† | Sudden, Bilateral | – | – |
| Methadone | Van Gaalen et al. 2009 | Case Report | Chronic or acute use w/ overdose | PO/75 mg | Yes† | Sudden, Mod-Severe Bilateral | No* | – |
| Methadone | Vorasubin et al. (2013) | Case Report | Chronic or acute use w/ overdose | PO/90 mg | Yes | Sudden, Severe, Bilateral (permanent) | No* | – |
| MT-45 Synthetic Opioid | Helander et al. (2014) | Case Series n = 9 | Chronic or acute use w/ overdose | PO, IV, IN/6–100 mg | Yes*† (n = 3/9) | Sudden, Bilateral (permanent n = 1) | Yes* (n = 4/9) | – |
| Opioid + Acetaminophen | ||||||||
| Vicodin® (hydrocodone + acetaminophen) | Friedman et al. (2000) | Review n = 12 | Chronic use w/o overdose | PO/10 – 60 tab | Yes | Sudden/Rapid Progressive, Bilateral Profound (permanent) | Yes* (n = 2/12) | – |
| Vicodin® (hydrocodone + acetaminophen) | Novac et al. (2015) | Case Report | Chronic or acute use w/overdose | – | Yes* | Profound, Unilateral (permanent) | – | – |
| Vicodin® (hydrocodone + acetaminophen) | Oh et al. (2000) | Case Series n = 2 | Chronic use w/o overdose | PO/15 tab qid; 35 tab qd | Yes* | Rapid Progressive, Profound Bilateral (permanent) | Yes (n = 1/2) | Normal Caloric and Rotary Chair |
| Codeine + acetaminophen | Blakley & Schilling (2008) | Case Series n = 3 | Chronic use w/o overdose | PO/300 mg 2qd | Yes | Progressive, Profound Bilateral (permanent) | Yes (n = 3/3) | Absent Caloric |
| Codeine phosphate + acetaminophen | Freeman et al. (2009) | Case Series n = 10 | Chronic use w/o overdose | PO/4–20 tab, 30–500mg | Yes* | Sudden/Rapid Progressive, Profound Bilateral (permanent) | No* | Normal VNG |
| Percocet® (oxycodone + acetaminophen) | Rigby & Parnes (2008) | Case Report | Chronic use w/o overdose | PO/5 mg oxy; 325 mg acetaminophen | Yes | Progressive, Profound Bilateral (permanent) | No* | Normal VNG |
| Co-proxamol (Darvocet®) | Ramsay (1991) | Case Report | Chronic use w/o overdose | PO/ 30 qd | Yes* | Progressive, Severe Bilateral (permanent) | – | – |
| Poly- or Unspecified Opioids | ||||||||
| Methadone + marijuana | Christenson & Marjala (2010) | Case Series n = 2 | Chronic use w/o overdose | – | Yes†* | Sudden, Bilateral | – | – |
| Various opioids + heroin, oxycodone, methadone, tramadol | Mozeika et al. (2020) | Review n = 41 | – | PO, IN, IV/– | Yes* (n = 19/41) | Unilateral (n = 1), Bilateral (n = 40), (permanent n = 4) | – | – |
PO= oral
IV= intravenous
IN= intranasal
qd= once a day
qid= four times a day
tab= tablet
tx= treatment
– =
Author(s) did not address or provide evidence of test results
*
self-reported only
†
full or partial recovery
ENG/VNG= electro/videonystagmography
VL= vestibular loss