Health vs. Disease: the medical consequences of substance use

Substances of abuse are directly related to profound long term and short term medical consequences. Competent, caring and knowledgeable treatment of substance use disorders can greatly improve overall health of individuals and communities. Substance use screenings and treatment should be part and parcel of all health education and interventions.

Cardiovascular Effects

  • Researchers have found a connection between the abuse of most drugs and adverse cardiovascular effects, ranging from abnormal heart rate to heart attacks.
  • Injection drug use can also lead to cardiovascular problems such as collapsed veins and bacterial infections of the blood vessels and heart valves. (Medical Consequences of Drug Abuse 2005).

Respiratory Effects

  • Substance abuse can lead to a variety of respiratory problems.
  • Smoking cigarettes has been shown to cause bronchitis, emphysema and lung cancer.
  • Marijuana smoke may cause respiratory problems.
  • The use of some drugs may also cause breathing to slow, block air from entering the lungs or exacerbate asthma symptoms (Medical Consequences of Drug Abuse 2005).

Gastrointestinal Effects

  • Many drugs of abuse have been known to cause nausea and vomiting soon after use.
  • Cocaine use can also cause abdominal pain and bowel gangrene (Medical Consequences of Drug Abuse 2005).

Musculoskeletal Effects

  • Steroid use during childhood or adolescence, resulting in artificially high sex hormone levels, can signal the bones to stop growing earlier than they normally would have, leading to short stature.
  • Other drugs may also cause severe muscle cramping and overall muscle weakness (Medical Consequences of Drug Abuse 2005).

Kidney Damage

  • Some drugs cause kidney damage or failure, either directly or indirectly from dangerous increases in body temperature and muscle breakdown (Medical Consequences of Drug Abuse 2005).

Liver Damage

Chronic use of some drugs, such as heroin, inhalants, alcohol and steroids leads to significant liver disease (Medical Consequences of Drug Abuse 2005).

Neurological Effects

  • All drugs of abuse act in the brain to produce their euphoric effects
  • Many of them have severe negative consequences on the brain such as seizures, stroke, and widespread brain damage that can impact all aspects of daily life
  • Substance use can also cause brain changes that lead to problems with memory, attention and decision-making (Medical Consequences of Drug Abuse 2005).

Mental Health Effects
Chronic use of some drugs of abuse can cause long-lasting changes in the brain, which may lead to paranoia, depression, aggression, and hallucinations
(Medical Consequences of Drug Abuse 2005).

Hormonal Effects

  • Steroid abuse disrupts the normal production of hormones in the body, causing both reversible and irreversible changes.
  • These changes include infertility and testicle shrinkage in men, as well as masculinization in women (Medical Consequences of Drug Abuse 2005).

Cancer

  • Cigarette smoking is the most preventable cause of cancer in the U.S.
  • Smoking cigarettes has been linked to cancer of the mouth, neck, stomach, and lung, among others (Medical Consequences of Drug Abuse 2005).
  • Smoking marijuana also exposes the lungs to carcinogens and can cause precancerous changes to the lungs similar to cigarette smoke.
  • Alcohol consumption increases the risk for cancers of Oral cavity, Pharynx (Throat), Esophagus (Food tube leading to stomach), Larynx (Voice Box) Stomach, Colon, Rectum, Liver, Female breast, Ovaries (Bagnardi et al. 2001).

Prenatal effects of substance use

The full extent of the effects of prenatal drug exposure on a child is not known, however studies show that various drugs of abuse may result in premature birth, miscarriage, low birth weight, and a variety of behavioral and cognitive problems (Medical Consequences of Drug Abuse 2005).

Pregnancy and Alcohol Use Disorders

 

Fetal alcohol syndrome (FAS) is one of the leading known causes of mental retardation and birth defects.

  • FAS is an irreversible, lifelong condition that affects every aspect of a child’s life and the lives of the child’s family.

FAS is 100% preventable if a woman does not drink alcohol while she is pregnant (NOFAS 2009).

  • Effects of fetal alcohol syndrome (FAS) or Fetal Alcohol Effect (FAE) in children exposed to high doses of alcohol in utero include:
    • Low birth weight,
    • Poor coordination,
    • Hypotonia (poor muscle tone),
    • Neonatal (newborn) irritability,
    • Retarded growth and development,
    • Craniofacial (Head and face) abnormalities, including microcephaly (small head),
    • Cardiovascular (Heart and circulatory system) defects,
    • Mild to moderate mental retardation (preventable),
    • Childhood hyperactivity,
    • Impaired school performance (NOFAS 2009).
  • If a child was exposed to alcohol during pregnancy but does not have all of the symptoms of FAS, he or she may have alcohol-related neurodevelopmental disorder (ARND) or alcohol-related birth defects (ARBD).
  • Children with ARND experience learning and behavioral problems similar to those experienced by children with FAS.
    • Learning difficulties, poor school performance and poor impulse control.
    • Difficulties with mathematical skills, memory, attention, and/or judgment.
    • Problems with language and memory; visual-spatial abilities; and deficits in speed of information processing (NOFAS 2009).
  • Children with ARBD may have problems with the heart, kidneys, bones, and/or hearing.
  • Centers for Disease Control studies report FAS rates ranging from 0.2 to 1.5 cases per 1,000 live births in different areas of the United States.
  • ARND and ARBD are believed to occur about three times as often as FAS.
  • Brain images of some persons with FAS show that certain areas have not developed normally, that certain cells are not properly placed and tissues have died in some areas (NOFAS 2009).
  • The 10th Special Report to the U.S. Congress on Alcohol and Health estimated the annual cost of FAS in 1998 at $2.8 billion (Harwood, 2000).

Opiod Use during Pregnancy

  • Heroin abuse during pregnancy and its many associated environmental factors (e.g., lack of prenatal care) have been associated with adverse consequences including low birth weight, an important risk factor for later developmental delay.
  • Methadone maintenance combined with prenatal care and a comprehensive drug treatment program can improve many of the detrimental maternal and neonatal outcomes associated with untreated heroin abuse, although infants exposed to methadone during pregnancy typically require treatment for withdrawal symptoms
  • Current studies are attempting to establish the safety and effectiveness of buprenorphine in opioid-dependent pregnant women.
  • For women who do not want or are not able to receive pharmacotherapy for their heroin addiction, detoxification from opiates during pregnancy can be accomplished with relative safety, although the likelihood of relapse to heroin use should be considered (Medical Consequences of Drug Abuse 2005)

 

Effects of maternal cocaine use

  • Premature delivery, low birth weights and smaller head circumferences, shorter in length.
  • Significant deficits in some aspects of cognitive performance, information-processing, and attention to tasks; abilities that are important for success in school (Medical Consequences of Drug Abuse 2005).

 

HIV/AIDS, Hepatitis, and other Infectious Diseases

  • Drug abuse weakens the immune system and is linked to risky behaviors like needle sharing and unsafe sex.
  • The combination greatly increases the likelihood of acquiring HIV-AIDS, hepatitis and many other infectious diseases (Medical Consequences of Drug Abuse 2005).

HIV/AIDS, Hepatitis, and other Infectious Diseases

  • Drug abuse weakens the immune system and is linked to risky behaviors like needle sharing and unsafe sex.
  • The combination greatly increases the likelihood of acquiring HIV-AIDS, hepatitis and many other infectious diseases (Medical Consequences of Drug Abuse 2005).

Other Health Effects

  • Many drugs produce overall body changes, such as marked changes in appetite and increases in body temperature, which may influence a variety of health conditions.
  • Withdrawal from substances may lead to numerous adverse health effects, including restlessness, mood swings, fatigue, changes in appetite, muscle and bone pain, insomnia, cold flashes, diarrhea, and vomiting (Medical Consequences of Drug Abuse 2005).

Mortality

  • Drug-related deaths have more than doubled since the early 1980s.
  • There are more deaths, illness, and disabilities from substance abuse than from any other preventable health condition.
  • Today, one in four deaths is attributable to alcohol, tobacco, and illicit drug use (Medical Consequences of Drug Abuse 2005; McGinnis & Foege, 1999; Mokdad et al, 2000).

Pacific Academy of the Healing Arts hopes you enjoyed this informational post.

To receive continuing education credit for what you just learned or to learn more about becoming certified as a substance abuse counselor please visit our website at http://addictionsprofessional.com

 

 

References

  • Bagnardi V, Blangiardo M, La Vecchia C, et al: Alcohol consumption and the risk of cancer: a meta-analysis. Alcohol Res Health 25:263–270, 2001  [PubMed]
  • Harwood H: Updating Estimate of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data. Bethesda, MD, National Institute on Alcohol Abuse and Alcoholism, 2000.
  • McGinnis J.M., Foege W.H.: Mortality and morbidity attributable to use of addictive substances in the United States. Professional Association American Physicians 111:109–118, 1999.
  • Medical Consequences of Drug Abuse. (2005). The National Institute on Drug Abuse (NIDA). National Institutes of Health (NIH). U.S. Department of Health and Human Services. Bethesda, MD. http://www.nida.nih.gov/consequences/
  • Mokdad AH, Marks JS, Stroup DF, et al: Actual causes of death in the United States, 2000. JAMA 291:1238–1245, 2004 [PubMed]
  • National Organization on Fetal Alcohol Syndrome (NOFAS). http://www.nofas.org/

 

  • Promoting the health of babies, children and adults, and enhancing the potential for full, productive living. 1-888-212-5920, www.cdc.gov/ncbddd Department of Health and Human Services 072604.

Additional Resources

http://www.drugabuse.gov/nidamed/resguide/resourceguide.pdf

Chart of commonly abused drugs

http://www.drugabuse.gov/DrugPages/DrugsofAbuse.html

NIDA principles of Drug Abuse Treatment

http://www.drugabuse.gov/PODAT/PODATIndex.html

Selected Prescription Drugs of Abuse

http://www.drugabuse.gov/PDF/PrescriptionDrugs.pdf

MEDLINE plus Health Information on Substance Abuse

http://www.nlm.nih.gov/medlineplus/substanceabuseproblems.html

Addiction: “Drugs, Brains, and Behavior – The Science of Addiction”

http://www.drugabuse.gov/scienceofaddiction/sciofaddiction.pdf

Heads Up: Real News about Drugs and Your Body – A drug education series created by NIDA and SCHOLASTIC INC. for students in grades 6 to 12

http://www.teacher.scholastic.com/scholasticnews/indepth/headsup/

 

 

Kukula, K. Interactive Brain Map. Meet Your Incredible Brain.

http://www.teacher.scholastic.com/scholasticnews/indepth/headsup/brain/index.asp?article=brain_meet#

Center for Substance Abuse Treatment. Pregnant, Substance-Using Women. Treatment Improvement Protocol (TIP) Series 2 Rockville, MD: Substance Abuse and Mental Health Services Administration. HHS Publication No. (SMA) 95-3056. Rockville, MD: Substance Abuse and Mental Health Services Administration.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.22442

Center for Substance Abuse Treatment. Improving Treatment for Drug-Exposed Infants Treatment Improvement Protocol (TIP) Series. HHS Publication No. (SMA) 93-2011. Rockville, MD: Substance Abuse and Mental Health Services Administration.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.24127

Center for Substance Abuse Treatment. Screening for Infectious Diseases among Substance Abusers. Treatment Improvement Protocol (TIP) Series 6. Rockville, MD: Substance Abuse and Mental Health Services Administration.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.25461

Center for Substance Abuse Treatment. Treatment for HIV-Infected Alcohol and Other Drug Abusers. Treatment Improvement Protocol (TIP) Series: 15. HHS Publication No. (SMA) 95-3038. Rockville, MD: Substance Abuse and Mental Health Services Administration.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.34914

Center for Substance Abuse Treatment. Alcohol and Other Drug Screening of Hospitalized Trauma Patients. Treatment Improvement Protocol (TIP) Series 16. HHS Publication No. (SMA) 95-3039. HHS Publication. No. (SMA) 95-3047. Rockville, MD: Substance Abuse and Mental Health Services Administration

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.36481

Center for Substance Abuse Treatment. Tuberculosis Epidemic: Legal and Ethical Issues for Alcohol and Other Drug Treatment Providers. HHS Publication. No. (SMA) 95-3047. Rockville, MD: Substance Abuse and Mental Health Services Administration.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.38602

Center for Substance Abuse Treatment. A Guide to Substance Abuse Services for Primary Care Clinicians. Treatment Improvement Protocol (TIP) Series 24. HHS Publication No. (SMA) 97-3139. Rockville, MD: Substance Abuse and Mental Health Services Administration.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.45293

Center for Substance Abuse Treatment. Substance Abuse Treatment for Persons with HIV/AIDS Treatment Improvement Protocol (TIP) Series 37. Rockville, MD: Substance Abuse and Mental Health Services Administration.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.64746

Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies into Medical Practice. Treatment Improvement Protocol (TIP) Series 49. HHS Publication No. (SMA) 09-4380. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2009.

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.92752

National Inhalant Prevention Coalition http://www.inhalants.org/VPT

http://www.unodc.org/unodc/en/frontpage/2010/April/health-is-the-theme-of-the-2010-world-drug-campaign.html

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