The first case was in 2012.
At the time it seemed like an odd anomaly, a one-off case that required no further explanation.
But then it happened again. And again. And again.
And by the time Jed Barash and Alfred DeMaria went to press with their findings earlier this year, the scientists had found a Massachusetts cluster of at least 12 cases where heroin users terrifyingly suffered spontaneous amnesia.
Max Meehan became patient zero when he showed up to Lahey Hospital and Medical Center five years ago with an inability to remember things, a bizarre condition BuzzFeed detailed in an extensive investigation published this week.
He’d spent the night before partying, celebrating his upcoming 23rd birthday. He’d smoked some cigarettes, downed some liquor, and scored some smack. Finally, he’d passed out on the couch, but when he woke up the next morning, he’d lost the ability to form new memories.
Since uncovering Meehan’s case, Massachusetts doctors have identified 14 other patients with similar brain damage and the sudden inability to form memories. Twelve of those patients have a history of opioid use.
Although it’s not clear what about the drug use may have sparked memory loss, in every case doctors saw a telltale pattern of hippocampal damage clustered in two distinct orbs near the center of the brain.
In past literature, they found scattered examples of similar damages, caused by everything from cocaine use to carbon monoxide poisoning to the flu. But it’s not clear why that pattern of damage is showing up in so many drug users in Massachusetts.
Some experts think it’s a genetic sensitivity to something in the drugs. Others think it could be a gradual weakening of hippocampal neurons over time, caused by the respiratory depression of strong opioid use. And others posit that it’s a side effect of an overdose or prolonged slow breathing.
“I would fully expect this to happen with respiratory depression or respiratory arrest from opioids,” said Gary Franklin, a research professor in neurology at the University of Washington. “If they think that something extremely special is going on here, like one of these drugs did something very targeted, I don’t think so.”
But Barash and DeMaria say that doesn’t make sense, or there would be far more cases turning up at ERs across the country.
This month, Massachusetts officials are set to recognize CHIAS—complete hippocampal ischemic amnestic syndrome—as a “reportable” disease and for the next year, Bay State doctors will flag officials whenever they see a new case, just like they might for Ebola or Zika.
Hopefully, that could help experts gather enough data to connect the dots and figure out a cause—but with relatively few cases per year, answers are far from guaranteed.
“The reality is that science and medicine, they’re messy. You see a lot of things that don’t necessarily get answered. You have to live with…