A few years ago, Michelle Hughes, an audiologist and professor of special education and communication disorders, came across a journal article about an individual who experienced a drug overdose and ended up with sudden hearing loss. Then she found more articles featuring similar stories. 

She was fascinated. 

Her interest led to conversations with a friend and colleague, Amanda Chiao, pediatric audiologist and professor of surgery in the Division of Otolaryngology Head and Neck Surgery at the Texas Tech University Health Sciences Center in El Paso, Texas, and a former assistant professor at the University of Nebraska–Lincoln. 

“It seemed as though researchers in some fields knew about these connections, and those in other fields didn’t,” said Hughes, director of the UNL’s Cochlear Implant Research Lab. “We knew there was a ripe opportunity for research to fill in a lot of knowledge gaps.” 

Hughes and Chiao secured a two-year, $25,000 grant through the University of Nebraska–Lincoln’s Rural Drug Addiction Research Center to collect pilot data on comprehensive hearing and balance assessments on a group of people with substance use disorders and an age-matched control group without SUDs. 

Their work led to a large-scale, multi-site grant from the National Institutes of Health–National Institute on Deafness and Other Communication Disorders to examine the implications of SUDs on both hearing and balance, and to determine the factors that increase such risk for people with SUDs. Chiao serves as the project’s principal investigator; Hughes is the Nebraska subcontract lead investigator. 

Substance use disorders continue to rise, affecting more than 35 million people worldwide. Such disorders and overdoses have significantly increased since the COVID-19 pandemic, disproportionately among minority populations. Research suggests that such disorders are associated with hearing and/or vestibular losses — an impairment in the inner ear’s balance mechanism — that create communication barriers and reduce physical mobility and independence for those with SUDs. Research team members for the current NIH study are spread across UNL, Texas Tech University Health Sciences Center–El Paso and the University of Illinois Chicago to capture racial and regional differences in SUDs. 

Researchers also aim to collect comprehensive hearing and balance data from 1,000 diverse participants — 667 with SUDs and 333 age-, race-, ethnicity- and sex-matched control group participants. Hughes is working with Patrick Habecker, research assistant professor at RDAR, to recruit participants through RADR’s database of people who self-identify as having SUDs. Data will be gathered through hearing tests, balance assessments and other physical evaluations at Hughes’ lab in the Barkley Memorial Center on UNL’s East Campus. Through statistical analysis, researchers will examine the impacts of other potential social, demographic or comorbidity issues that might be associated with greater risk of hearing or vestibular loss. 

“For this subject matter, there is so much untapped knowledge out there,” she said. “Nobody else is doing this work — certainly not on this scale. That’s what’s thrilling about it; it’s very cutting-edge, and it focuses on a population that is widely marginalized.” 

Hughes’ goal is to expand clinical knowledge and to help health care providers assess and treat those with SUDs. 

“Our body is all integrated,” she said. “Sometimes, medical care can become so specialized and operate in silos, to where specialists aren’t sharing information across disciplines. The result is that it’s possible to lose sight of the big picture — that our whole body as an integrated organism.”

Special Education and Communication Disorders