American researchers have diagnosed the first case of toxic leukoencephalopathy triggered by the inhalation of Fentanyl, a very powerful analgesic used as an opioid. The condition causes devastating damage to the brain and is often fatal. The case of a 47 year old man found unconscious in a hotel.
For the first time a peculiar form of has been diagnosed brain damage caused by Fentanyl (or Fentanyl), a very powerful analgesic opioid – up to 50 times more than heroin and 100 times more than morphine – which is causing a real massacre in the United States. It is in fact used as drug for the numbing and painkilling effects, but the risks of overdose and death by suffocation (respiratory system depression) are very high. We are talking about tens and tens of thousands of deaths per year, with an estimate of over 100,000 according to the Washington Post in 2021 alone. In light of these frightening data on deaths, the finding of specific damage to the brain may not seem significant, yet it is because of the method in which Fentanyl is used. The doctors, in fact, discovered that it is his inhalation to trigger a pathology called toxic leukoencephalopathywhich specifically affects the white matter of brain tissue.
The first case of this disease triggered by “Fentail smoke” was diagnosed and described by an American research team led by specialists from the Department of Internal Medicine of the Oregon Health & Science University, who collaborated closely with colleagues from the Department of Diagnostic Radiology. To be involved a 47 year old man found senseless on a hotel bed, with crushed pills and a white substance scattered on a nearby nightstand. Transported to hospital, the man appeared completely stunned and did not respond to voice commands, but recoiled from painful stimuli. Initial urinalysis revealed nothing, but a subsequent test revealed Fentalin at a concentration of nearly 140 nanograms per milliliter.
Due to neurological symptoms the forty-seven year old was subjected to brain MRIwhich he brought out extensive brain damage. In particular, a significant alteration was detected in the bilateral supratentorial white matter, both in the cerebellum and that in pale globe. As explained on The Conversation by Professor Colin Davidson, professor of Neuropharmacology at the University of Central Lancashire (UK), these parts of the brain play a crucial function in movement and in the coordination. Doctors led by Professor Christopher O’Eden diagnosed toxic leukoencephalopathy, a potentially fatal condition that can be triggered by several drugs. Among them i chemotherapy to fight tumors, those to prevent rejection after a organ transplant and others against autoimmune diseases like Lupus. Several studies have highlighted a significant percentage of deaths in people affected by this adverse reaction which destroys the white matter. Between symptoms include confusion, dizziness, loss of coordination and vision, difficulty moving, muscle weakness and others. They can result in coma and death.
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A possible infection was initially also assessed for the 47-year-old, but in the end the doctors came to the conclusion that the leukoencephalopathy had been induced by the inhalation of Fentanyl. There were already known cases triggered byheroin, but this was the first in scientific literature associated with the powerful analgesic. In most cases, those who use the drug as a drug inject it, but many smoke/inhale it; Knowing that it can trigger this serious brain damage is valuable information for doctors and clearly also for consumers themselves.
After a few days of hospitalization, the patient was able to answer questions verbally and follow commands. After about a month in hospital he was transferred to a specialized rehabilitation clinic and finally discharged. He recovered after a year, but was considered very lucky, considering the lethality of the condition he suffered. The case report “Clinical and neuroradiographic features of fentanyl inhalation-induced leukoencephalopathy” was published in the scientific journal The British Medical Journal.
