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Rapidly progressive deafness in healthy young persons is very unusual. We recently encountered two young patients who experienced profound bilateral hearing loss developing over a few weeks. Known primary causes of hearing loss were excluded. There was no response in either patient to high-dose oral prednisone. Both patients were addicted to high doses of hydrocodone in combination with acetaminophen. Hydrocodone is a semisynthetic narcotic analgesic that is chemically similar to codeine but more potent on a milligram basis and with greater addiction potential.1 Deafness has been reported in association with high doses of propoxyphene, a similar compound.2-4 We subsequently became aware of an abstract describing acute hearing loss in six other southern California patients abusing hydrocodone, suggesting that this is more than a random association.5 Hydrocodone/acetaminophen (Vicodin [Knoll Pharmaceutical Company, Mount Olive, NJ] and others) is a commonly used recreational drug in the Los Angeles area, but an association with hearing loss is not well known.
Case reports.
Patient 1. A 34-year-old woman was addicted to Vicodin, which was originally started for migraine headaches. She adopted a regimen of 15 tablets (5 mg hydrocodone/500 ng acetaminophen) four times per day. …
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