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Mental Health, Substance Use, and Lyme Disease Connection
Heliyon (Bransfield, R.C., et al.) 5.13.2024 published a case report “Late-stage borreliosis and substance abuse.” According to the article, many infectious diseases are known to contribute to substance abuse. Increased risk of substance abuse and addictive disorders can be associated with multiple symptoms of late-stage borreliosis. This case report describes, an adult male patient with a history of tick-bites and tick-borne diseases since childhood with delayed diagnosis and treatment for Lyme disease and increasing multisystem symptoms (including problems with memory and cognition, mood and psychiatric issues, pain, cardiovascular and metabolic issues, sleep issues, and fatigue) resulting in substance abuse.
The man had experimented with multiple chemical substances in an attempt to ease his symptoms, including phencyclidine (PCP), an N-methylD-aspartate (NMDA) receptor antagonist that opposes NMDA agonism caused by Borrelia infection. The man committed one homicide, two assaults, and then suicide when withdrawing from PCP. It is believed that Borrelia-induced biochemical imbalances in the brain may increase the symptoms of PCP withdrawal, increasing acute homicidal and suicidal risks. The risk of homicide or suicide in patients diagnosed with borreliosis with confirmed multiple symptoms (chronic pain, anxiety, and lack of pleasure) has been documented in patient databases.
During the autopsy of the young man, brain tissue obtained from the Lyme Disease Biobank (LDB) was stained for microglial activation and quinolinic acid (QA). Pathogens were identified in organs using immunofluorescence (IFA) and fluorescence in situ hybridization (FISH). Borrelia was isolated in the pancreas by IFA, and in heart tissue by IFA and FISH. Neuroinflammation was observed in the brain tissue by identification of activated microglia and QA which can indicate infection-induced neurotoxicity.
The patient database shows that post Lyme infection, 12% of patients experienced substance abuse compared to 1% prior to infection. Authors suggest that we have the potential to prevent future tragedies by recognizing that borreliosis can be a contributor to substance abuse and substance use disorders. Attention to substance abuse in addition to effective diagnosis and treatment of borreliosis may help reduce suffering and death in patients with Lyme disease and requires greater attention and investigation.
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