Logan Steele
Drug abuse can have serious implications on the muscular system, causing involuntary muscle movement and even damage to the musculoskeletal system. The abuse of certain drugs can damage important areas of the brain, leading to movement problems. Powerful stimulant drugs such as cocaine, ecstasy, spice, and inhalants, as well as opiates, can all cause involuntary muscle movement. Alcohol abuse can also lead to issues with movement, including ataxia, which impairs voluntary movements and can cause accidents resulting in further damage to the musculoskeletal system.
| Characteristics | Values |
|---|---|
| Types of drugs | Street drugs, therapeutic medicines, illicit drugs |
| Drug names | Cocaine, heroin, amphetamine, methamphetamine, ecstasy, spice, inhalants, opiates, benzodiazepines, lithium, seizure medication, depression medication, stimulants, antipsychotics, antiemetics, Reglan, Phenergan, Compazine, SSRIs, opioids, migraine drugs, etc. |
| Drug categories | Dopamine receptor blocking drugs (DRBAs), dopamine receptor blocking agents, selective serotonin reuptake inhibitors, central nervous system depressants, stimulants, opiates, antipsychotics, antiemetics |
| Movement disorders | Tremors, tics, myoclonus, chorea, athetosis, dystonia, akathisia, tardive dyskinesia, stereotypies, hemiballism, asterixis, hypokinesis, oculogyric crises, truncal spasm, limb dystonia, neuroleptic malignant syndrome, serotonin syndrome, etc. |
| Movement disorder characteristics | Focal movements (affecting one anatomic region), multifocal movements (multiple regions), generalized movements (entire body), hyperkinetic disorders (unwanted or excessive movements), hypokinetic disorders (diminished movements), etc. |
| Treatment | Stopping the offending drug, supportive care, pharmacological treatment, anticholinergics, antihistamines, anticholinergic drugs, benzodiazepines, botulinum neurotoxin injections, deep brain stimulation, pro-dopamine medication, etc. |
| Timing | Acute, subacute, or chronic; symptoms can begin within minutes to days or months to years after starting the medication |
| Severity | Mild, moderate, severe, or life-threatening |
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What You'll Learn
Alcohol abuse and withdrawal
AWS is a set of symptoms that can occur when someone who struggles with alcohol abuse stops drinking suddenly. One of the most common symptoms of AWS is muscle tremors or spasms, which can start within a few hours of the last drink and last for several days. These muscle tremors are sustained misfirings of the central nervous system (CNS) affecting one or more isolated muscle groups, such as those in the hands, arms, legs, head, and trunk. They are involuntary and usually occur when the muscle is at rest, and they can be temporarily stopped by flexing the muscle.
During alcohol withdrawal, the nervous system becomes hyperexcitable, leading to jerky muscle movements, also known as "the shakes." While these tremors are not dangerous on their own, they indicate clinically significant withdrawal that may become fatal if left untreated. Seizures, on the other hand, are life-threatening bouts of abnormal electrical activity in the brain that can cause involuntary muscle movements throughout the body. They cannot be stopped by flexing muscles and typically occur within 48 hours of the last drink.
In addition to AWS, alcohol abuse and withdrawal can also lead to other movement disorders. For example, chronic alcoholics with liver disease may develop asterixis, characterised by brief, arrhythmic interruptions of sustained voluntary muscle contraction, resulting in a bilateral flapping tremor during active posture maintenance. Alcohol withdrawal can also cause tardive dyskinesia, a rare movement disorder characterised by involuntary "fluttering" movements of the fingers, as if playing an imaginary piano. These movements typically subside once the withdrawal phase is over.
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Stimulants and opiates
Involuntary muscle movements can be caused by a variety of street drugs, including stimulants and opiates.
Stimulants
Stimulants are a class of drugs that increase alertness, attention, and energy. They work by enhancing the effects of certain neurotransmitters in the brain, such as dopamine and norepinephrine. Common stimulants include caffeine, nicotine, amphetamines, and cocaine. While caffeine and nicotine are legal, they can still cause or worsen involuntary muscle movements, especially in people who are prone to these types of movements.
One of the most well-known stimulants that can cause involuntary muscle movements is cocaine. Cocaine blocks dopamine reuptake, increasing dopaminergic drive. This can lead to hyperkinetic movement disorders such as posturing, muscle spasms, tremors, and abnormal involuntary movements sometimes called "crack dancing". Amphetamines, another type of stimulant, can also cause acute involuntary muscle movements, spasms, and various unpredictable, rhythmic, and repetitive motions.
Opiates
Opiates, also known as opioids, are a class of drugs that include natural, semi-synthetic, and synthetic substances. Natural opiates are derived from the seed pods of the poppy plant and include morphine and codeine. Semi-synthetic opioids are made in a laboratory using natural opioids, such as heroin and hydrocodone. Synthetic opioids are made in a laboratory without using any natural ingredients, such as fentanyl.
While opiates are commonly prescribed to relieve pain, they can also lead to addiction and overdose. Opioids work by binding to opioid receptors in the central and peripheral nervous systems, as well as the gastrointestinal tract. Opioid receptors regulate many body functions, and their disruption can lead to involuntary muscle movements. For example, opioids are associated with myoclonus, which involves sudden, brief, and involuntary muscle twitches affecting specific muscles or muscle groups. Additionally, heroin use has been linked to a rare and severe neurological disorder called cerebral and cerebellar spongiform leukoencephalopathy, which can cause tremors, movement symptoms resembling Parkinson's disease, and abnormal, involuntary, and hyperkinetic movements.
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Illicit drugs
Some of the most common illicit drugs associated with movement disorders include stimulants such as cocaine and methamphetamine, opiates, and drugs like ecstasy (MDMA) and spice. These drugs can cause dopamine depletion, increasing the risk of stroke and leading to issues such as muscle weakness, loss of movement, or paralysis. For example, cocaine blocks dopamine reuptake, increasing dopaminergic drive, while amphetamines cause more widespread catecholaminergic stimulation. Additionally, chronic stimulant use can lead to seizures that result in violent, uncontrollable movements that damage the muscles.
Other illicit drugs that can cause movement disorders include heroin, which can cause hypokinesis, and Ephedrone, which has been linked to parkinsonism. Parkinsonism is a movement disorder characterized by bradykinesia, rigidity, and postural instability. It often presents as a symmetrical akinetic rigid syndrome that develops gradually over time.
Drug-induced movement disorders can often be relieved by stopping the offending drug. However, in some cases, additional treatment may be necessary, such as anticholinergics, antihistamines, or pro-dopamine medications. It is important to note that movement disorders can also occur during the withdrawal phase, and seeking medical advice is crucial for proper diagnosis and treatment.
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Therapeutic drugs
Involuntary movements can be categorised as either hypokinetic or hyperkinetic disorders. Hypokinetic disorders are characterised by a lack of movement, while hyperkinetic disorders are characterised by excessive movement. Many therapeutic medicines and illicit drugs can cause these movement disorders.
Dopamine blocking drugs can cause a variety of movement disorders, including Parkinsonism, tardive syndromes, chorea, dystonia, tremors, akathisia, myoclonus, tics, and a very serious condition called neuroleptic malignant syndrome. Parkinsonism, for example, is typically characterised by bradykinesia, rigidity, and postural instability.
Antipsychotic medications are the most common cause of tardive dyskinesia (TD), a movement disorder that causes involuntary, repetitive body movements. TD can also be caused by several other classes of medications, including anti-nausea medications, certain antidepressants, antiseizure medications, and antimalarials. TD typically occurs after long-term treatment with these medications, but it can also develop after short-term use or even after discontinuation of the drug.
Treatment for drug-induced movement disorders typically involves stopping the offending drug, with or without supportive care or other pharmacological treatments. In some cases, resuming anti-Parkinsonian drugs or administering pro-dopamine medications may be necessary.
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Drug-induced movement disorders
Acute drug-induced movement disorders can occur within minutes to days of drug ingestion and include symptoms such as akathisia, tremors, neuroleptic malignant syndrome, serotonin syndrome, and acute dystonic reactions. Subacute drug-induced movement disorders occur within days to weeks and are typically resolved by stopping the offending drug. Drug-induced parkinsonism, for example, is characterised by bradykinesia, rigidity, and postural instability. Tardive drug-induced movement disorders, on the other hand, occur during exposure or within weeks of stopping a drug and persist for at least one month. The most commonly implicated drugs in tardive syndromes include antipsychotics, antiemetics, and some calcium channel antagonists.
Illicit drugs can also lead to movement disorders, which are usually acute and self-limiting but can occasionally be life-threatening. For instance, cocaine blocks dopamine reuptake, increasing dopaminergic drive, while amphetamines cause widespread catecholaminergic stimulation, and chronic use results in dopamine depletion. MDMA, also known as ecstasy, can cause parkinsonism and a syndrome similar to serotonin syndrome. Additionally, chronic alcohol abuse can lead to alcoholic liver disease, resulting in asterixis, which is characterised by interruptions of sustained voluntary muscle contraction and posture lapses.
It is important to note that early recognition of drug-induced movement disorders is crucial to allow for prompt intervention, which may include stopping the offending drug, providing supportive care, and sometimes administering other pharmacological treatments.
In summary, drug-induced movement disorders encompass a wide range of symptoms and severities, varying with the type of drug and the time of onset. Illicit drugs, such as cocaine, amphetamines, and MDMA, as well as alcohol abuse, can all contribute to movement disorders with varying mechanisms and effects. Therapeutic drugs can also induce movement disorders, and early identification and intervention are vital to ensure patient well-being.
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Frequently asked questions
Many street drugs can cause involuntary muscle movements, including stimulants like cocaine and methamphetamine, ecstasy, spice, inhalants, opiates, and heroin.
These drugs can cause involuntary muscle movements by damaging important areas of the brain, particularly the central nervous system. This can lead to movement disorders such as Parkinsonism, tardive syndromes, chorea, dystonia, tremor, akathisia, myoclonus, tics, and a very serious condition called neuroleptic malignant syndrome.
Symptoms can vary depending on the drug and the individual, but generally include symmetric involuntary shaking of the hands, arms, head, or eyelids, sudden sustained contraction of the neck muscles resulting in pulling the head backward, and eyes rolling backward. In some cases, it can also cause breathing difficulties.
