Physical diseases and addictive disorders: Associations and implications

Abstract

Increasingly, the identification, assessment and treatment of unhealthy use of alcohol and other drugs often occur within general medical settings. Within this climate, there is a growing awareness of the physical effects connected to acute or chronic use of substances of abuse. By examining these associations and their purported biological causative mechanisms, greater clinical attention-in the form of screening, identification and treatment-to co-occurring medical conditions as well as to the use of illicit substances itself may be possible. In this review, we examine recent peer-reviewed literature regarding three substances of abuse (cocaine, marijuana and opioids) and their direct associations with physical disorders. We group the association of diseases based on organ systems and critically examine the literature regarding the evidence to supporting those associations and causative mechanisms. There is good evidence to support the association of cocaine, marijuana and opioid use with a variety of physical health conditions. Unfortunately, while the causative evidence of these associations is preliminary, we could conclude that the use of these substances can incite a host of medical illnesses or complicate their treatment. When combined with societal, mental health and public health harms associated with the use of illicit substances, co-occurring or incident physical health conditions associated with substance use may present a substantial healthcare cost to the individual as well as to the healthcare system at large, resulting in a debilitating strain on often limited time and resources.