Medication overuse and drug addiction: a narrative review from addiction perspective

Takahashi, T.; Ornello, Raffaele; Quatrosi, Giuseppe; Torrente, Angelo; Albanese, Maria; Vigneri, Simone; Guglielmetti, Martina; Marco, Cristiano Maria De; Dutordoir, Camille; Colangeli, Enrico; Fuccaro, Matteo; Lenola, Davide Di; Spuntarelli, Valerio; Pilati, Laura; Marco, Salvatore Di; Dycke, Annelies Van; Abdullahi, Ramla Abuukar; MaassenVanDenBrink, Antoinette; Martelletti, Paolo

doi:10.1186/s10194-021-01224-8

Cited by 47 publications

(47 citation statements)

References 119 publications

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“…Similar to the sodium withdrawal related to dietary sodium chloride intake, the withdrawal of retained sodium and edema related to NSAID use can elucidate a potential mechanism in medication overuse headache (MOH), a secondary, withdrawal or rebound headache which is a condition that commonly progresses in people with chronic migraine pain [ 29 ]. MOH is frequently seen in neurology clinics, and patients using NSAIDs for at least 15 days a month and >3 consecutive months can be susceptible to MOH as a secondary headache caused by sodium withdrawal.…”

Section: Sodium Chloride and Controversial Migraine Reliefmentioning

confidence: 99%

Sodium Chloride, Migraine and Salt Withdrawal: Controversy and Insights

Brown

2021

Medical Sciences

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This paper examines evidence implicating migraine headache as a withdrawal symptom of excessive sodium chloride intake. Emerging research in food addiction posits that food and drug addictions share common features, such as withdrawal symptoms. Salt (sodium chloride) meets the criteria for the diagnosis of substance dependence, including withdrawal in which the substance is used to relieve withdrawal symptoms. The premonitory symptoms of migraine include food cravings for salty foods, which can alleviate migraine pain. Edema, possibly related to large amounts of salt consumed in binge eating, can cause approximately four pounds of retained fluid. This amount of fluid is similar to the fluid retained before the onset of migraine headache, which may be accompanied by polyuria. This paper proposes that inhibited withdrawal from highly processed food intake, rich in salt, mediates an association between increased sodium chloride intake and relief from migraine headache pain. The relief from withdrawal symptoms could also be a mediating factor that explains the controversial findings inversely associating dietary sodium intake with migraine history. Moreover, the withdrawal of retained sodium and edema related to the use of nonsteroidal anti-inflammatory drugs may elucidate a potential mechanism in medication overuse headache. Further research is needed to investigate the pain experienced from sodium chloride withdrawal in migraine headache.

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Section: Sodium Chloride and Controversial Migraine Reliefmentioning

confidence: 99%

Sodium Chloride, Migraine and Salt Withdrawal: Controversy and Insights

Brown

2021

Medical Sciences

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“…However, the real-world regional situation varies, where self-medication managed in pharmacies can produce different levels of the risk of usual or borderline abusers. Acute medication intake (number of days used per month) should be determined to estimate the risk of medication overuse [40].…”

Section: Diagnosis Of Chronic Migrainementioning

confidence: 99%

Practical Insights on the Identification and Management of Patients with Chronic Migraine

et al. 2022

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Chronic migraine (CM) is one of the most disabling diseases, and it is commonly misdiagnosed and mistreated. Despite the importance of a timely and accurate diagnosis for the effective management of CM, recent surveys have shown that only 20-25% of individuals with CM receive a correct diagnosis. The obvious consequences of misdiagnosed CM are prolongation of symptoms and their associated effects on disability and health-related quality of life. Additionally, mistreatment of CM can lead to acute medication overuse headache with escalation of headache and end organ damage. Ideally, a diagnosis of CM should be made in the primary care setting, based on a thorough medical history including detailed descriptions of headaches occurring earlier in life as well as current headaches, and the range of headaches (not just the worst headaches). In our experience, it is often equally informative to ask the patient about the number of headache-free days (HFDs) and no accompanying symptoms (i.e., crystal-clear days) to quantify headache days and accurately estimate headache frequency/ impact. Headache frequency is important, as this count is one key means of diagnosing CM, which requires C 15 headache days/month, noting that these do not need to be migraine days. A headache day is defined as more than 4 h a day of headache. Comorbidities are common in CM and may affect the treatment choice and increase disability. Every CM patient should be offered a preventive migraine treatment. In this commentary, we provide practical insights and tips for diagnosing CM and cover issues of medication overuse, patient communication, diagnostic testing, and when to make a referral. Our key message to physicians for a patient who comes to the clinic with frequent disabling headaches having features of migraine is to assume CM until proven otherwise.

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“…Trends in usage include the decrease in the mean age of consumers [ 3 ]. The frequency of occupational lead (Pb) poisoning in adults has declined in recent years due to increased workplace safety and improving housing characteristics [ 4 ], although Pb-contaminated drugs could be an emerging source.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study on the Association of Lead, 8-Hydroxyguanine, and Malondialdehyde Levels in Opium Addicts’ Blood Serum with Illicit Drug Use and Non-Addict Persons

Hesaruiyeh

Rajabi

Motamed-Jahromi

et al. 2022

IJERPH

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While a large body of literature has shown the health problems of illicit drug use, research is needed on how substance abuse impacts DNA damage and contaminants in blood, especially given Pb-contaminated opium. This pilot study aimed to evaluate the levels of lead (Pb), 8-hydroxy di-guanine (8-oxo-Gua), and malondialdehyde (MDA) in the blood serum of opium addicts and non-addict people. The current study is a case–control study with a cross-sectional design. A sample of 50 opium-addicted and non-addict adults were chosen for this study using convenience and random sampling methods. Participants were divided into two groups: addicts and non-addicts. The atomic absorption spectroscopy method was used to measure the quantity of Pb, and the Enzyme-Linked Immunosorbent Assay (ELISA) method was used to measure the amount of 8-oxo-Gua and MDA. The data were analyzed using an independent t-test. The results show that the amount of Pb in the blood serum of addicted women and men was higher than levels in non-addict men and women, for the study participants (p-value = 0.001). Blood levels were not significantly different between addicts and non-addicts for men or women for 8-oxo-Gua (p-value = 0.647 for women and p-value = 0.785 for men) and MDA (p-value = 0.867 for women and p-value = 0.995 for men). In general, addicts’ blood Pb levels were found to be substantially higher than those of normal non-addict persons in this pilot study. As a result, testing for blood Pb levels in addicts may be informative in instances when symptoms are inconclusive.

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Medication overuse and drug addiction: a narrative review from addiction perspective

Cited by 47 publications

References 119 publications

Sodium Chloride, Migraine and Salt Withdrawal: Controversy and Insights

Sodium Chloride, Migraine and Salt Withdrawal: Controversy and Insights

Practical Insights on the Identification and Management of Patients with Chronic Migraine

A Pilot Study on the Association of Lead, 8-Hydroxyguanine, and Malondialdehyde Levels in Opium Addicts’ Blood Serum with Illicit Drug Use and Non-Addict Persons

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