The Missing Link Between Opioid Use Disorder and Seizures During Opioid Withdrawal: A Case Series from North India

Abstract

The term “opioids” includes compounds extracted from the poppy plant/pod and semi-synthetic and synthetic compounds with similar properties that can interact with opioid receptors in the brain. These produce mental relaxation, pain relief, and euphoric feelings. Their regular use, abuse, and misuse, often without medical super- vision, can lead to opioid dependence and other health problems. Almost 2.1% of the Indian population uses opioids. The pattern of use varies across different states of India. While the use of inhalational opioid (smack/brown sugar) is much more common in Uttar Pradesh, that of injectable heroin is more common in Punjab and the northeastern states. Percentage-wise, the states of Mizoram and Nagaland are the worst affected by opioid use. The prevalence of opioid use in Uttarakhand is 0.8%. According to an article published in Times of India 2020, there was a record rise in synthetic-drug trafficking in Uttarakhand, especially in our catchment area of Dehradun and the neighboring areas of Rishikesh and Haridwar. Widespread available literature mentions opioid use disorder, intoxication, withdrawal, and other opioid-induced disorders, which include depressive disorder, anxiety disorder, sleep disorder, and sexual dysfunction. However, information is scanty on seizure episodes happening during opioid intake or withdrawal. Few studies have described complicated opioid withdrawal where a seizure occurred along with other features of opioid withdrawal.