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Sick and Addicted – Substance Abuse among People with Serious Illnesses

Usually, when people think about comorbid disorders, they think in terms of substance abuse and an accompanying mental illness. In fact, up to 45% of people with an addictive disorder also have a psychiatric condition. But what about when the co-occurring illness is physical? How does alcoholism or drug addiction affect other serious medical conditions – and how is the substance abuse disorder affected by the illness? It has long been known that substance abuse can be a contributing factor to the development of certain medical conditions and diseases. Likewise, people with serious medical conditions can also suffer from depression, anxiety, or PTSD – all of which contribute to the development of an addictive disorder. Let’s take a closer look at specific chronic illnesses, substance abuse, and how they relate to each other.

Blowing Your Stack – Hypertension and Substance Abuse

Substance abuse and hypertension is an important health concern, because several illicit drugs are potential causes of acute or newly-diagnosed high blood pressure, specifically:

  • Amphetamines
  • Methamphetamines
  • Cocaine
  • Marijuana

There is also a well-documented correlation between heavy alcohol consumption and hypertension. Consuming three or more drinks a day DOUBLES the risk of hypertension. It has been estimated that alcohol causes up to 20% of all hypertension cases.

Keeping It in Mind – Alzheimer’s and Substance Abuse

Alzheimer’s is a degenerative brain disease typified by a progressive loss of memory and cognitive function. It is the #1 cause of dementia in America. Because chronic, long-term alcoholism can result in a decline in cognitive ability, a change in brain chemistry, and the development of certain brain disorders, its effects may be related to Alzheimer’s Disease – making it plausible that excessive alcohol use increases the risk of developing AD. It was also discovered by researchers at the University of Edinburgh that the brains of intravenous heroin and methadone users resemble the brains of people in the early stages of Alzheimer’s.

Take It to Heart – Cardiovascular Disease and Substance Abuse

Almost all illicit drugs have some adverse effect on the heart – causing tachycardia, arrhythmia, or even a heart attack. Intravenous drug use can lead to some serious problems as infections of the heart valves and blood vessels and collapsed veins. Of all classes of illicit drugs, stimulants cause the most cardiovascular problems. The American Heart Association calls cocaine “the perfect heart attack drug”, because of its effect on the cardiovascular system:

  • 35% greater aortic stiffening
  • Systolic readings that are an average of 8 mm higher
  • 18% thicker left ventricle wall

In 2011, over 40% of drug-related ER visits were due to cocaine. For comparison, less than 21% of ER visits that year involved heroin.

Hard to Hold – Arthritis and Substance Abuse

There are a number of detrimental health effects resulting from chronic substance abuse that can place a person at an elevated risk for developing arthritis:

  • Osteoporosis – Addiction is often accompanied by malnutrition, which can, in turn, lead to decreased bone density – a precursor to osteoporosis.
  • Osteomyelitis – Intravenous drug use can lead to bone infections, leading to massive bone destruction and the potential development of infectious arthritis.
  • Spinal effects – Posture can play a part in the development of arthritic conditions. Individuals who take depressants – barbiturates, benzodiazepines, opioids – can have extremely poor posture, while stimulant abusers can have an overly-rigid posture that can, in time, damage the spine.

On the other hand, people who are diagnosed with arthritis are usually prescribed extremely-powerful opioid pain medications that have a very high potential for abuse.

Nothing Sweet about It – Diabetes and Substance Abuse

Diabetes, a metabolic disorder characterized by dysfunction in the way the body processes sugar, affects nearly 30 MILLION US residents, including 26% of Americans age 65 or older. Another 86 MILLION people in this country have prediabetes. Excessive alcohol abuse may contribute to the development of Type II Diabetes, the most common kind.

  • Many alcoholics suffer from pancreatitis, and about one-third of people with pancreatitis will develop diabetes.
  • Alcoholics may also become obese and suffer from glucose intolerance. Both conditions are connected to Type II Diabetes.
  • Excessive alcohol consumption – especially of high-carbohydrate beers and wines – can lead to dangerously high blood sugar.
  • On the other hand, too much alcohol can also lead to abnormally-low glucose levels, because it interferes with the liver’s ability to release stored glucose.
  • Alcohol abuse can exacerbate diabetic nerve and eye damage.
  • Alcohol interferes with the effectiveness of some diabetic medicines.

Among illicit drugs of abuse, stimulants are the most dangerous for diabetics, because they usually suppress the appetite, which can lead to potentially-life-threatening lowered blood glucose levels. Proper management of diabetes – including careful meal planning, exercise, weight loss, and lifestyle changes – is essential to avoid serious complications. Often, patients with diabetes can feel overwhelmed with a sense of catastrophic inevitability, which can in turn caused them to cope by self-medicating with intoxicating substances.

Chronic Health Conditions, Depression, and Substance Abuse

There are no chronic health conditions that directly cause substance abuse. However, many people with serious health conditions experience depression, which is a contributing factor in the development of an addictive disorder. Roughly 20% of people who struggle with depression also have a substance abuse disorder and vice versa.

  • People who take beta blockers or calcium channel antagonists for high blood pressure have TWICE the risk of being hospitalized for a major mood disorder such as depression.
  • 33% of heart attack patients develop some degree of depression.
  • Up to 40% of Alzheimer’s patients suffer from clinically-significant depression.
  • Individuals with rheumatoid arthritis are TWICE as likely to be depressed.
  • Women with diabetes have a 29% higher risk of developing depression, and if they take insulin, that elevated risk jumps to 53%.

How to Manage BOTH a Chronic Medical Condition and a Substance Abuse Disorder

So, what’s to be done? The key to living a productive life when you have such a dual diagnosis lies in the successful management of both conditions. If you have a serious medical condition, follow your physician’s advice – make the necessary lifestyle, dietary, behavioral, and activity changes prescribed in your treatment plan. When you are effectively managing your chronic disease, you will usually avoid the worst complications. And, when you practice those lifestyle changes diligently, they become second nature, and not a cause for undue anxiety or depression. If you can avoid clinically-significant anxiety or depression, you lessen your chances of developing or worsening an addictive disorder. If you have an addictive disorder, the key is to work a treatment plan prescribed by your addiction recovery team. Apply the lessons you learned in drug or alcohol treatment. When you remain abstinent, you won’t develop or worsen your comorbid medical problem. When you are willing to adopt the right mindset and put in the work, there is no reason why you can’t live a long and productive life, even when you are dealing with both a serious medical condition and an addictive disorder.