A three-year Vicodin addiction left Shannon Menosky, 40, from Riverside, Calif., deaf. Her habit, which at its peak was 50 pills a day, gradually killed the delicate hair cells in her inner ear until after a month of deteriorating hearing, Menosky woke up to total silence.
"It was kind of gradual," said Menosky, adding that she noticed it was difficult to talk on the phone, that her children had to shout to get her attention and that she had to turn up the volume on the television. "And then I woke up one morning and there was literally nothing," Menosky said.
Her doctors at the House Ear Institute in Los Angeles, Calif., explained that her hearing loss was permanent and would require a cochlear implant to restore it. Menosky said she broke down.
"Once I lost my hearing, I think I started taking Vicodin more," Menosky said. "I wouldn't leave the house. I was depressed that I couldn't hear my children or my family."
Medications that are ototoxic have chemical properties that make them toxic to the sensory cells in the ear.
Classes of drugs famous for this side effect include strong aminoglycoside antibiotics that are used in cases of life-threatening infections, such as a bone infection.
"These cause irreversible deafness," said Dr. Steven D. Rauch, professor of otology and laryngology at Harvard Medical School and the Massachusetts Eye and Ear Infirmary. It can be very rapid, very quick and very permanent."
Strong pain medications like Vicodin and oxycontin can kill inner ear cells, but over-the-counter pain medications such as ibuprofen and aspirin can also cause hearing loss to a lesser degree. High doses of mild pain medication may cause ringing in the ears before it begins to affect actual hearing and will go away after discontinuing use.
Platinum-based chemotherapy drugs are another class of ototoxic drugs because the heavy metals deposits on the hair cells and poisons them.
While the lungs receive the brunt of damage from smoking, the ears can be affected as well.
One blood vessel serves the cochlea within the ear and restricting that flow can prevent enough oxygen from reaching the organ.
Nicotine, a vasoconstrictor that causes blood vessels to shrink slightly, can have a profound effect on the small capillaries that serve the ear.
"The ear is tenuous and has a high demand for blood flow," Rauch said. "Every time you light up a cigarette, you are minimally reducing blood flow to the ear. Over a lifetime of being a smoker, you are suffocating the ear a little bit."
Although one study, published in the Journal of the Association for Research into Otolaryngology, showed that smokers have more difficulty hearing high frequency sounds compared to non-smokers, and that hearing deteriorates after smoking regularly for more than a year.
Toxic noise that leads to mechanical injury in the hearing structure of the inner ear -- the cochlea -- is one of the most important factors in hearing loss. But a noisy environment goes hand-in-hand with many occupations.
Musicians, construction workers, factory workers and firemen are some of the people that are at high risk for constant exposure to loud noise.
"Research indicates that noise injury is a gift that keeps on giving, like a snowball down a hill," said Rauch. "Noise between 70-90 Db does slowly cause increased wear and tear on your hearing... That is a huge implication for occupational impact noise exposure."