{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:59:49Z","timestamp":1778857189716,"version":"3.51.4"},"reference-count":8,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,6,25]],"date-time":"2015-06-25T00:00:00Z","timestamp":1435190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:p>\n                    Oxymorphone, a semisynthetic \u03bc\u2010opioid receptor agonist, is the major active metabolite of oxycodone. It is a highly potent narcotic analgesic due to its high lipid solubility, which allows it to readily cross the blood\u2010brain barrier and enter the central nervous system. It is available as both an immediate\u2010release and extended\u2010release (\n                    <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                    ) formulation. Oxymorphone can be abused by injection or inhalation of crushed tablets; thus, in 2011, the manufacturer of\n                    <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                    oxymorphone reformulated the drug with crush\u2010resistant technology to deter its misuse and abuse. We describe the case of a previously healthy, 24\u2010year\u2010old male who experienced reproducible acute subjective bilateral temporary hearing loss that occurred after inhalation of oxymorphone. He presented to the emergency department complaining of acute bilateral hearing loss after he reported snorting a crushed oxymorphone\n                    <jats:styled-content style=\"fixed-case\">ER<\/jats:styled-content>\n                    30\u2010mg tablet. Emergency department evaluation revealed obvious bilateral hearing loss as well as coincidental aspiration pneumonia. The patient's medical history revealed that he had experienced a similar episode of hearing loss after a previous episode of oxymorphone inhalation. His hearing loss began to improve 3\u00a0hours after presentation to the emergency department and was completely resolved by the following day. Use of the Naranjo adverse drug reaction probability scale revealed oxymorphone to be a probable cause of this patient's acute hearing loss (score of 6). The mechanism of action of opioid\u2010associated hearing loss (\n                    <jats:styled-content style=\"fixed-case\">OAHL<\/jats:styled-content>\n                    ) is not completely understood, but it is thought to be due to disturbances within the cochlea, such as cochlear ischemia. To our knowledge, this is only the second published case report of acute reversible hearing loss following oxymorphone inhalation and the first published case report of reproducible\n                    <jats:styled-content style=\"fixed-case\">OAHL<\/jats:styled-content>\n                    . Since opioid misuse continues to be prevalent despite attempts at reformulations to make the drugs crush resistant, a high degree of clinical suspicion is needed to evaluate and treat patients who present with unique findings after episodes of substance abuse, especially those related to tamper\u2010resistant formulations.\n                  <\/jats:p>","DOI":"10.1002\/phar.1605","type":"journal-article","created":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T01:15:02Z","timestamp":1435281302000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Acute Sensorineural Hearing Loss After Abuse of an Inhaled, Crushed Oxymorphone Extended\u2010Release Tablet"],"prefix":"10.1002","volume":"35","author":[{"given":"Lisa E.","family":"MacDonald","sequence":"first","affiliation":[{"name":"Novant Health Forsyth Medical Center Winston\u2010Salem North Carolina and Novant Health Kernersville Medical Center Kernersville North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer E.","family":"Onsrud","sequence":"additional","affiliation":[{"name":"Novant Health Forsyth Medical Center Winston\u2010Salem North Carolina and Novant Health Kernersville Medical Center Kernersville North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Mullins\u2010Hodgin","sequence":"additional","affiliation":[{"name":"Novant Health Forsyth Medical Center Winston\u2010Salem North Carolina and Novant Health Kernersville Medical Center Kernersville North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,25]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/34.8.521"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.02.022"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.01.015"},{"key":"e_1_2_5_5_1","first-page":"4","article-title":"Opioid\u2010induced hearing loss: a trend to keep listening for?","volume":"44","author":"Kopec KT","year":"2012","journal-title":"Emerg Med"},{"key":"e_1_2_5_6_1","unstructured":"Data on file (EN3202\u2010EN3203_Safety_Update) Endo Pharmaceuticals Inc."},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-013-0293-z"},{"key":"e_1_2_5_8_1","first-page":"1","article-title":"Review of opioid\u2010associated hearing loss and possible mechanism of opioid\u2010mediated endothelin\u20101\u2010dependent cochlear vasoconstriction","volume":"3","author":"Nguyen KD","year":"2014","journal-title":"J Otol Rhinol"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1605","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fphar.1605","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.1605","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T17:32:41Z","timestamp":1761067961000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.1605"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,25]]},"references-count":8,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2015,7]]}},"alternative-id":["10.1002\/phar.1605"],"URL":"https:\/\/doi.org\/10.1002\/phar.1605","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,25]]},"assertion":[{"value":"2015-06-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}