About this episode

This episode features a discussion on the neurological aspects of drug misuse with Dr. Robin Howard, highlighting various drugs and their clinical presentations.

Neurology requires some detective work at times, and identifying the patterns of symptoms associated with drug misuse can be a tricky mystery indeed. For this episode, we're receiving a masterclass from Dr. Robin Howard¹ on the wide variety of drugs that bring patients into hospital, as well as the mechanisms they act on. His paper "Neurological aspects of drug misuse" is the Editors' Choice for the October 2025 issue, and he joins PN podcast editor Dr. Amy Ross Russell in the studio. From the new dangers of synthetic psychoactives to the profound consequences of chronic use, the discussion unveils critical clinical presentations every neurologist should recognize. We delve into fascinating phenomena including "punding," compulsive repetitive behaviors seen with stimulant abuse, and the rare but striking CHANTER syndrome, with its signs of disturbed consciousness and extensive cerebellar involvement. Hear too about the distinctive spongiform leukoencephalopathy associated with "chasing the dragon," a dangerous method of heroin inhalation, but which can also be caused by cocaine usage. Read the paper: https://pn.bmj.com/content/25/5/411 (1) Guy's and St. Thomas’ NHS Foundation…

People in this episode

Host: Dr. Amy Ross Russell

Guest: Dr. Robin Howard

Topics covered

• drug misuse
• neurology
• clinical presentations
• synthetic psychoactives
• stimulant abuse
• heroin inhalation

Keywords

• drug misuse
• neurology
• synthetic psychoactives
• stimulant abuse
• CHANTER syndrome
• spongiform leukoencephalopathy
• heroin
• cocaine

Mentioned in this episode

Organizations: Guy's and St. Thomas’ NHS Foundation Trust

Books & works: Neurological aspects of drug misuse

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