Doctors report world’s first case of brain disease from inhaling fentanyl

Oregon patient lost consciousness after white matter became inflamed and risked irreversible loss of brain function and possibly death

Doctors have reported the world’s first case of a man suffering brain disease from fentanyl inhalation, further revealing how dangerous the opioid can be.

Fentanyl is 50 times more potent than heroin.

The 47-year-old patient was taken to the emergency department of Oregon Health & Science University in February last year after he was found unconscious and “near death” in his hotel room.

Clinicians diagnosed that inhaling fentanyl had caused major sections of white matter in the patient’s brain to become inflamed, to the point he lost consciousness and risked irreversible loss of brain function and possibly death.

While similar cases have previously been reported in people after heroin inhalation, researchers said the Oregon patient is the first such documented case involving fentanyl.

“This is a case of a middle-class man, in his late 40s, with kids, who used fentanyl for the first time. It demonstrates that fentanyl can affect everyone in our society,” lead researcher Chris Eden said.

There could have been such cases before, researchers said, but they weren’t recognised as relatively little is known about the syndrome’s physiology.

“We know very well the classic opiate side effects – respiratory depression, loss of consciousness, disorientation. But we don’t classically think of it causing possibly irreversible brain damage and affecting the brain, as it did in this case,” Dr Eden said.

The patient gradually recovered after nearly a month in hospital followed by a stay at a nursing facility that helped him regain his speech and function.

The finding, according to researchers, should be taken as a warning about the danger of fentanyl, which is cheap and readily available.

“I have regrets often about what I did to myself, my wife and my family. I’m grateful to all the doctors, nurses and EMTs who saved my life, and the therapists who got me back to a functioning member of society,” the patient told the journal BMJ Case Reports.