New cause of death in young adults: Association between illicit drug abuse and amyotrophic lateral sclerosis

Abstract

Background: Neurodegenerative effects of illicit drugs have been proposed in many investigations. Amyotrophic lateral sclerosis is a fatal motor neuron disease characterized by degeneration of motor neurons, but the risk of amyotrophic lateral sclerosis among drug abusers is unknown. Methods: A nested case-control study was conducted in a teaching hospital to examine the association between drug abuse and amyotrophic lateral sclerosis. The study population included persons 18 to 40 years of age who were admitted in an electrodiagnostic medicine clinic for more than two year during the study period (January 2013 through April 2015) For each subject with ALS, 2 smoking-matched controls without ALS were randomly selected from the same population. Self-reported history of drug abuse was acceptable in both groups. Results: A total of 17 persons with ALS and 34 controls were identified, of whom 10 (58.8 percent) and 8 (23.5), respectively, had history of drug abuse. Persons with history of drug abuse had an increased risk of ALS (adjusted odds ratio, 2.6; 95 percent confidence interval, 1.2 to 5.7) as compared with controls. Conclusion: Drug abuse is an important risk factor for ALS, at least among young adults. The risk among drug abusers was at least or about double that among control group. The burden of mortality due to background ALS in drug abusers needs to be determined in future investigations.