Can You Repeat What You Just Said? A Case of Unusual Hearing Loss

Abstract

INTRODUCTION Synthetic opioids are a class of psychoactive drugs that are designed to relieve pain. Synthetic opioids are constructed so that they have a base structure that is akin to naturally derived opiates and have similar effects.1 These include drugs such as fentanyl, methadone, and tramadol among others. Synthetic opioids have significant advantages over naturally derived opiates including decreased cost, higher potency, and faster production speed, however they are not without drawbacks. As of 2017, an estimated two out of three opioid-involved overdose deaths involved synthetic opioids.2 While overdose deaths already were increasing in the months preceding the 2019 novel coronavirus disease (COVID-19) pandemic, the latest numbers suggested an acceleration of synthetic opioid overdose deaths during the pandemic.3 The classic signs of opioid intoxication include altered mental status, decreased respiratory rate, decreased tidal volume, decreased bowel sounds, and miosis. This report presents a rare case of a young patient who developed toxic leukoencephalopathy and transient hearing loss after a presumed synthetic opioid overdose. The purpose of this case report was to draw attention to these less common complications and provide a review of the literature.