Evidence map›Paper›PMID 42266507›Full record

ArticleActa scientific neurology2026

Opioid-Induced Nodding-Not a Nice Nap.

Kenneth Blum, Alireza Sharafshah, Kyriaki Thanos, Frank Fornari, Igor Elman, Edward J Modestino, Morgan P Lorio, Debasis Bagchi, Rajendra D Badgaiyan, Paul R Carney and 12 more

Abstract read
PubMed Full text at PMC
In one paragraph

Article in Acta scientific neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Kenneth BlumDepartment of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel.
Alireza SharafshahDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Kyriaki ThanosDepartment of Psychology, University of Buffalo, Buffalo, NY., USA.
Frank FornariDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Igor ElmanDepartment of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel.
Edward J ModestinoDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Morgan P LorioDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Debasis BagchiDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Rajendra D BadgaiyanDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Paul R CarneyDepartments of Pediatrics and Neurology, University of Missouri School of Medicine, Columbia, Missouri, USA.
Albert PinhasovDepartment of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel.
Abdalla BowirratDepartment of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, Israel.
Rossano Kepler Alvim FiorelliHospital Universitário Gaffree Guinle Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Sergio SchmidtHospital Universitário Gaffree Guinle Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Mark S GoldDepartment of Psychiatry, Washington University School of Medicine, USA.
Keerthy SunderDivision of Addiction Research and Education, Center for Sports, Exercise, and Mental Health, Western University of Health Sciences, Pomona, USA.
Alexander Pl LewandrowskiDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Mark OdronDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Álvaro DowlingDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Rafaela DowlingDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Joao Paulo BergamaschiDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.
Kai Uwe-LewandrowskiDivision of Clinical Neurology, The Origen Institute of Neurobiology and Genetics, Austin, TX., USA.

Funding

Prenatal Tobacco and Cannabis Exposure: A Translational StudyR33DA045640 · NIDA · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EIDEN, RINA D, THANOS, PANAYOTIS K · 2021 to 2023
$999k
Prenatal Tobacco and Cannabis Exposure: A Translational StudyR21DA045640 · NIDA · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI EIDEN, RINA D, THANOS, PANAYOTIS K · 2018 to 2019
$434k
A Systematic Medical Approach to Reward Transformation (SMART) for Brain Health in Opioid Use DisorderR41MD012318 · NIMHD · VERSA INTEGRATED SOLUTIONS, INC. · PI BLUM, KENNETH, GONDRE-LEWIS, MARJORIE C · 2017 to 2017
$221k
CSRD VA I01 CX000479NIDA NIH HHS R21 DA045640NIDA NIH HHS R33 DA045640NIMHD NIH HHS R41 MD012318
6 · The paper itself

Abstract

Opioid-induced "nodding" is commonly misinterpreted as benign sleep but represents a high-risk state of fluctuating consciousness caused by drug-induced respiratory depression. This condition may lead to progressive hypoxia and hypercapnia without normal protective arousal. In the fentanyl era, nodding may reflect a subclinical overdose, with a dangerously narrow transition between sedation and fatal respiratory failure, particularly when opioids are combined with alcohol, benzodiazepines, or other sedative agents. We utilized PUBMED to adopt various works linked to this important topic. Accumulating clinical and neuroimaging evidence suggests that repeated non-fatal overdose events and nodding episodes may contribute to cumulative hypoxic-ischemic brain injury, hippocampal volume loss, and persistent cognitive impairment. Current surveillance systems largely emphasize mortality, thereby underestimating the neurological burden among survivors. Public health and clinical frameworks should redefine nodding as a sentinel respiratory-compromise state and prioritize early intervention, expanded reporting, and improved harm-reduction strategies.

Indexed as

NoddingOpioid Use Disorder (OUD)Sleep

Identifiers

PMID42266507
PMCPMC13245562

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.