Wernicke's encephalopathy in crack-cocaine addiction

HypothesisCrack-cocaine addiction is associated with a variety of conditions that increase risk of thiamine deficiency and Wernicke's encephalopathy.EvidenceWe report a case of Wernicke's encephalopathy in a crack-cocaine addict who did not habitually consume alcohol. We list some conditions associated with crack-cocaine addiction that may contribute to thiamine deficiency.ImplicationsClinicians should bear in mind that crack-cocaine addiction may be associated with Wernicke's encephalopathy, mainly due to malnutrition. We suggest that routine Wernicke's encephalopathy prophylaxis with parenteral thiamine be provided to patients with chronic crack-cocaine addiction, as is already established practice in chronic alcoholics, so as to prevent cognitive damage in this population.