An Olfactory Piriform Cortex-Lateral Hypothalamus Neural Circuit Contributes to Linalool-Induced Analgesia.

Methamphetamine is an addictive central nervous system stimulant that is widely abused in the United States, with the National Survey on Drug Use and Health (NSDUH) reporting over 2.7 million people ≥ 12 years of age with usage in 2022. The abuse of this highly addictive substance has become increasingly prevalent, with an increase of 231% in hospital admissions from 2008 to 2020. Approximately 1.8 million people who reported methamphetamine use on the NSDUH met diagnostic criteria for methamphetamine use disorder. Methamphetamine use disorder is a rapidly developing condition marked by cycles of heavy methamphetamine use followed by periods of abstinence. It results in serious medical consequences that are difficult to treat, such as cognitive, neurological, cardiovascular, and cerebrovascular conditions, and can lead to death. An increased risk is seen in males, those without a high school degree, individuals who earn < $20,000 annually, and those with Medicaid only or no insurance., Given the high rate of methamphetamine-associated morbidity, increasing usage rates are highly likely to increase methamphetamine-related morbidity, emergency department (ED) visits, and healthcare costs. One of the most dangerous consequences of methamphetamine use is systolic heart failure, traditionally characterized by reduced left ventricular ejection fraction (LVEF), increased left ventricular mass index, and increased end-diastolic volume index.– Heart failure of this etiology is known as methamphetamine-associated heart failure with reduced ejection fraction. As with other forms of heart failure, optimal management and reduction in morbidity and mortality require early diagnosis, accurate assessment of left ventricular function, and timely intervention. The ED often serves as the entryway to the healthcare system for methamphetamine users, typically during acute methamphetamine-related medical emergencies. As many of these patients are frequently discharged without a hospital admission, the ED may be their only interaction with the healthcare system. However, because methamphetamine users often present to the ED with non-cardiac complaints, including altered level of consciousness, skin infections, abdominal pain, suicide attempts, psychosis and/or trauma, underlying cardiac dysfunction may be underrecognized in this setting.