Headaches related to psychoactive substance use

• Published in: Clinical neurology and neurosurgery Vol. 114; no. 7; pp. 990 - 999
• Main Authors: Beckmann, Yeşim Yetimalar, Seçkin, Mustafa, Manavgat, Ali İlhan, Zorlu, Nabi
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.09.2012; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Age Factors; Age of Onset; Aged; Biological and medical sciences; Central Nervous System Depressants - adverse effects; Cluster Headache - chemically induced; Cluster Headache - epidemiology; Diagnostic and Statistical Manual of Mental Disorders; Disorderly conduct; Drug abuse; Ethanol - adverse effects; Family; Female; Headache; Headache - chemically induced; Headache - diagnosis; Headache - epidemiology; Headache Disorders, Secondary; Humans; Male; Medical sciences; Middle Aged; Migraine; Migraine Disorders - chemically induced; Migraine Disorders - epidemiology; Neurology; Neurosurgery; Pain Measurement; Physicians; Psychotropic Drugs - adverse effects; Sex Factors; Studies; Substance use; Substance Withdrawal Syndrome - complications; Substance-Related Disorders - complications; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tension-Type Headache - chemically induced; Tension-Type Headache - epidemiology; Young Adult; Substance use; Headache; Migraine; Nervous system diseases; Cardiovascular disease; Substance abuse; Cerebral disorder; Vascular disease; Pain; Surgery; Central nervous system disease; Neurological disorder; Cerebrovascular disease
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2012.02.041

Abstract Aim To investigate a possible association between headache and psychoactive substance use. Methods 1055 psychoactive substance abusers were consecutively admitted. All patients filled out a detailed headache questionnaire and 1015 patients were included. Results Twenty seven percent of patients reported having headache. Eighteen percent of patients reported having headache attributed to a substance or its withdrawal and 1.4% had unclassified headache. The most commonly used substances were cannabis (80.5%), alcohol (74.6%), methylamphetamine (18.7%), benzodiazepine (10.4%), volatile solvent (5.8%), cocaine (4.4%), heroin (2.1%), opioids (0.5%), and other substances (1.7%). Fifteen patients reported that onset of headache occurred prior to onset of substance use, while 94.5% had headaches occurred after substance abuse. A higher incidence of headache was found in the benzodiazepine, methylamphetamine, cocaine, heroin, volatile solvent abusers. Seventy-eight percent of headache patients have never sought help from a physician despite the severity and frequency of headache. Conclusions In our study, the prevalence of headache among all psychoactive substance abusers was 26.9%. Although this is one-group study without any comparison with non-addict population and associational data must be interpreted with caution, the results of this study indicate a possible relationship may exist between headache and substance use since 94.5% of substance users described headaches after the onset of substance use. The younger start and the longer duration of cannabis use caused the higher incidence of headache, but this correlation was not observed in other substance use. Migraine was far more prevalent in the abusers than in previously reported community populations.