By: Hiya Shah
Epilepsy puts adults at a much higher risk of developing substance use disorder. (Jones, 2023). A study in Norway (2014) found that 4.32% of the population with epilepsy suffered from drug use disorder, compared to 1.22% of people without it. Epilepsy is severe, and dealing with it can be difficult, which is why it is important to be aware of such cases.
To start, an understanding of Substance Use is necessary…
What is Substance Use Disorder?
Substance Use Disorder (SUD) as described by the American Psychiatric Association, is “a complex condition in which there is uncontrolled use of a substance despite harmful consequences.” While the individual is aware of its impact, the compulsive reliance on the use of drugs, alcohol, and other psychoactive substances to the extent that it disrupts the user’s daily life is categorized as SUD.
Causes of Substance Use Disorder
Drugs can provide short-term relief with long-term harm. As a result, people may use drugs to feel good (pleasure) or better (forget or relieve stress). Sometimes, people start taking drugs to try something new or as a result of peer pressure. They may also stick as it may improve performance or thinking. (American Psychiatric Association, 2024)
Symptoms of Substance Use Disorder
The American Psychiatric Association describes four main groups of symptoms associated with SUD:
– Impaired control: the strong urge to use substances, despite attempts to stop – Social problems: inability to complete tasks and fulfill responsibilities, or relax – Dangerous use: the use of the substance despite awareness of dangerous consequences
– Drug effects: tolerance (to the same dosage; the need for a higher one) and withdrawal (symptoms specific to the drug experienced with less usage)
Treatments for Substance Use Disorder
Depending on the severity of the condition (SUD), various treatment methods can be employed. Hospitalization, therapeutic communities, mutual aid groups, self-help groups, and sober houses can support the avoidance of substance use and recovery. Residential treatment and intensive outpatient programs may also be used for severe cases (American Psychiatric Association, 2024).
Epilepsy and Substance Use Disorder
As previously mentioned, the use of substances is correlated with epilepsy. People with epilepsy are more likely to develop SUD. Thus, it is important to know the effects of the substances on the condition more thoroughly:
Cocaine
Cocaine is one of the most widely used substances, and it has also been found to stimulate seizures in patients with both a history of seizures and no history of seizures. Additionally, chapter 23 of the book, Epilepsy and the Interictal State (2015, p.254) mentions that cocaine “can lower the seizure threshold in patients with an existing seizure disorder”. It has also been found to cause all types, and forms of seizures (Epilepsy Foundation, n.d.). Seizures caused by cocaine are not effectively blocked by treatments such as sodium and calcium channel blockers. However, GABA-A and NMDA have been found to inhibit these seizures (Kutuluay, 2015).
Heroin
Heroin use has been found, in many studies, to induce seizures. However, because these studies tested patients with multiple substance addictions, a true correlation is difficult to find (Kutuluay, 2015). Thus, it is not directly related to seizures. Nevertheless, it has been found that timely seizure medications have not been taken as a result of heroin usage (Epilepsy Foundation, n.d.).
Marijuana
One paper on marijuana stated that its effects on a person with epilepsy are not well known due to a lack of data on the topic. A statistically significant effect in men was observed in prevention against unprovoked seizures (Kutuluay, 2015). Similarly, the Epilepsy Foundation states that marijuana can both provoke or prevent seizures, depending on the case.
Methamphetamine (Meth), and MDMA (ecstasy)
Both stimulants, meth and ecstasy, have been found to trigger seizures among other adverse health consequences (Kutuluay, 2015).
Amphetamines
Amphetamines have been found to increase seizure risk (Epilepsy Foundation, n.d.). A study in Australia also found that amphetamine was responsible for 4% of patients experiencing their first seizure (Kutuluay, 2015).
Benzodiazepines and Barbiturates
Medical treatment of epilepsy and acute seizures often involves prescription of benzodiazepines and barbiturates. However, since both substances can be used as recreational drugs, it is important to be cautious (Kutuluay, 2015).
Nicotine and Caffeine
The dosage of nicotine and caffeine matters when discussing epilepsy. While neither has been directly related to causing seizures, they have been found to affect other factors that do trigger seizures (Epilepsy Foundation, n.d.).
Conclusion
Substance Use Disorder can have a variety of effects on the body, including adverse side effects, especially for individuals with pre-existing epilepsy. The use of substances such as cocaine, heroin, methamphetamines, MDMAs, and amphetamines have all been found to trigger seizures. While marijuana, benzodiazepines, barbiturates, nicotine, and caffeine are not directly related to epileptic seizures, it is always important to take them in moderation if at all. Substance Use Disorder is a serious topic that should not, at any cost, be handled lightly. With the help of treatments and groups, recovery from Substance Use Disorder is possible.
References
American Psychiatric Association. (2024). What is a substance use disorder? Psychiatry.org. Retrieved March 7, 2025, from https://www.psychiatry.org/patients-families/addiction-substance-use-disorders/what-is-a substance-use-disorder
Bakken, I. J., Revdal, E., Nesvåg, R., Brenner, E., Knudsen, G. P., Surén, P., Ghaderi, S., Gunnes, N., Magnus, P., Reichborn-Kjennerud, T., Camilla Stoltenberg, Trogstad, L. I., Håberg, S. E., & Brodtkorb, E. (2014). Substance use disorders and psychotic disorders in epilepsy: A population-based registry study. Epilepsy Research, 108(8), 1435–1443. https://doi.org/10.1016/j.eplepsyres.2014.06.021
Epilepsy Foundation. (n.d.). Drug abuse as a seizure trigger. Epilepsy.com. Retrieved March 7, 2025, from https://www.epilepsy.com/what-is-epilepsy/seizure-triggers/drug-abuse Jones, S. K., Korte, J. E., & Wilson, D. (2023). Hazard of substance abuse onset among adults diagnosed with epilepsy or migraine. Epilepsy & Behavior, 144, 109258. https://doi.org/10.1016/j.yebeh.2023.109258
Kutluay, E., & Edwards, J. C. (2015). Epilepsy and alcohol and substance abuse. In E. K. St. Louis, D. M. Ficker, & T. J. O’Brien (Eds.), Epilepsy and the interictal state (1st ed., pp. 252–257). Wiley. https://doi.org/10.1002/9781118951026.ch23
