Comorbidity is a term that is used to describe a condition where two or more diseases or disorders occur at the same time. If a person has a substance use disorder (addiction) and a comorbid medical condition, both conditions require simultaneous treatment.
The addiction may or may not have led to the development of the medical condition, but in most cases, addictive behaviors will exacerbate any medical issues you may have.
Medical conditions that are comorbid with substance use disorders occur across numerous physical systems, including:
- The cardiovascular system.
- The liver.
- The gastrointestinal system (stomach and intestines).
- The skeletal system.
- The central nervous system.
In addition, two conditions that affect numerous organ systems are worth special consideration: diabetes and cancer.
Treatment for Comorbid Conditions
If you have a comorbid medical condition and a substance use disorder, it’s best to treat both issues at the same time. For example, it doesn’t make sense for a physician to ignore your substance abuse and try to treat your high blood pressure when substance abuse is often the cause of high blood pressure or significantly exacerbates high blood pressure.
You can be treated for all these issues together in an addiction treatment program, provided physicians are on staff. If you are undergoing medical detox or have very serious medical issues that require around-the-clock hospitalization or access to medical care, inpatient treatment will most likely be needed. You can also be treated for comorbid issues as an outpatient. The level of care will depend on your particular situation.
While an addiction treatment program may have physicians on staff or consulting physicians, you may be required to see many different specialists depending on your situation. The specialists will often communicate with one another to gauge your overall progress and decide on the best path forward.
The American Heart Association (AHA) describes several comorbid issues that can occur with abuse of alcohol or other drugs. Even though there have been some studies that suggest mild alcohol use can be beneficial to your cardiovascular system, AHA strongly opposes anyone attempting to drink alcohol for its “health benefits.” Instead, the organization, like most health organizations, encourages you not to use alcohol.
There are various comorbid cardiovascular issues that can occur with substance use disorders.
- Hypertension (high blood pressure) is associated with numerous risks, including an increased risk for heart attack.
- High levels of cholesterol in the blood often occur in people who have drug addictions.
- Obesity is associated with many health issues, including cardiovascular issues. It is commonly linked with alcohol or drug abuse.
- Heartbeat irregularities, increased potential for stroke, increased potential for damage to the veins and arteries (especially when drugs are injected), and frank damage to the heart tissue (cardiomyopathy) are associated with chronic abuse of drugs or alcohol.
Poor cardiovascular health can also affect your recovery from your substance use disorder. Cardiovascular issues are typically addressed by a physician and would be part of your overall recovery routine.
The primary function of the liver is to cleanse the blood of waste products and other toxins. If you abuse alcohol or other drugs, you can suffer serious damage to your liver.
Your liver works hard to rid drug toxins from your system. This can lead to the development of fatty deposits in your liver, liver damage, and the development of scar tissue over time. If there is significant scar tissue on your liver, you may have a serious condition like cirrhosis or liver cancer, which can impede the functioning of your liver and potentially be fatal.
Liver disease may be irreversible if it is advanced, but it may be treatable if it is caught early. You would be advised to stop using drugs or alcohol in the case of any diagnosed liver disease or liver problem.
Chronic and severe liver damage can lead to other issues, including dementia and organ failure. A liver transplant is an option for some people with extensive liver disease, but not for someone who is actively abusing alcohol or drugs.
Alcohol and drugs are toxic to many organs, including your gastrointestinal system. The substances often result in inflammation in your stomach lining or intestines.
Inflammation in the stomach lining is known as gastritis. If it persists, your stomach may develop abscesses.
Over time, you may develop ulcers in your intestines or stomach, and these can be life-threatening. When these abscesses heal, you could be left with significant scar tissue in your gastrointestinal tract. This can result in digestive complications because scar tissue is not functional.
The most efficient first step to treat these issues if you are abusing alcohol or drugs is to stop your substance use. You shouldn’t simply stop using drugs or drinking if you have been doing so at high levels for a long time. Withdrawal symptoms from some substances can be life-threatening, so medical supervision is needed during detox.
Chronic abuse of drugs or alcohol can affect the metabolism calcium in your body. Over time, this increases your risk to develop skeletal issues like osteoporosis, a medical condition that occurs when bone density has significantly declined. Your bones become more brittle and prone to breaking.
Although osteoporosis is more common in older people, especially older women, alcohol or drug abuse can contribute to the development of osteoporosis in anyone.
Prevention is the best form of cure. In some cases, treatment may reverse some of the effects of osteoporosis that have already developed. The first step of any treatment for osteoporosis is to stop using alcohol or drugs.
Central Nervous System
The central nervous system (CNS) is composed of the brain and spinal cord. It is the fundamental operation system of your entire body.Any use of alcohol or drugs affects your CNS. Having a substance use disorder can lead to:
- Damage to the neurons in the brain. If extensive enough, it can lead to numerous issues, including problems with cognition, emotional control, and movement.
- Alterations to the pathways in the brain that result in many changes, particularly in your ability to focus your attention, remember things, and even to experience pleasure.
- Damage that can result in seizures, arterial problems that can lead to stroke, and generalized damage that can lead to diseases like dementia.
- Damage to the veins and arteries in the brain that can increase your potential to develop a stroke.
Depending on the extent of the damage to the brain, any deficits as a result of substance use disorder may not be reversible. In some cases, you may recover somewhat, but you may still experience some issues, like minor problems with concentration, emotional control, motivation, or planning and impulse control.
There are no medications that can fully reverse these conditions.
When you eat your food, it is digested and converted to glucose for energy. Your pancreas helps with this function by producing the hormone insulin that helps to deliver glucose to the cells in your body. If you have diabetes, you either do not produce enough insulin or you cannot use the insulin that you do produce.
There are several different types of diabetes. The two most well-known are:
- Type 1 diabetes. Also known as insulin-dependent diabetes mellitus, type 1 diabetes is usually diagnosed earlier in life. It occurs as a result of the pancreas not producing enough insulin. You need insulin injections if you have this type of diabetes.
- Type 2 diabetes. Also known as adult onset diabetes, type 2 diabetes accounts for the majority of cases of diabetes. It results from the pancreas not producing enough insulin, or the body not being able to use the insulin that the pancreas does produce. This type of diabetes is most often associated with lifestyle issues like poor diet, lack of exercise, and chronic drug abuse.
Although people with diabetes should not drink alcohol or use tobacco products, many studies suggest that nearly 20 to 60 percent of individuals diagnosed with diabetes drink or smoke.
Alcohol abuse can affect your liver functioning. In people with diabetes, this can lead to a severe issue with hypoglycemia (low blood sugar) that can be potentially fatal. The abuse of other drugs can place a similar burden on the liver.
In addition, people with substance use disorders often do not pay attention to their diabetes, so it goes unmanaged. This can result in a dangerous situation for them as their disease becomes more severe.
Uncontrolled diabetes is associated with various serious health conditions, including cardiovascular problems and potential brain damage. The only way to curb the effects of substance abuse on your diabetes is to stop using drugs, alcohol, and tobacco products. You should have a doctor supervising your case since the comorbid medical issue can be complex.
Cancer is a group of related diseases where the body develops abnormal cells that divide and spread, eventually disrupting the functioning of many organ systems. Research suggests that drug abuse, alcohol abuse, and even the abuse of over-the-counter products like tobacco products increases the risk of many types of cancer. Many of these cancers can be fatal if left untreated, and they will often require significant medical treatment to control.
When you combine drugs like chronic tobacco abuse and chronic alcohol abuse, the risk to develop various forms of cancer increases dramatically. The only way to address the effect of substance abuse on any comorbid cancer is to stop abusing the substance in question.
If you have developed a comorbid medical condition and a substance use disorder, both disorders will need treatment. In many cases, substance abuse is known to cause certain types of medical conditions. In nearly every case, the abuse of alcohol or drugs will exacerbate any comorbid medical condition you have.
The only way to check the effects of your substance abuse on any comorbid medical conditions is to stop using drugs or alcohol.
When addiction is present, simply stopping drug use isn’t an option. Addiction is defined as a disease that is signified by a lack of control over substance use.
Your inability to stop using drugs or drinking has nothing to do with your overall willpower or personal strength. Addiction has made changes in your brain that make it almost impossible to stop using without help.
The good news is that addiction treatment can be that help you need. With comprehensive treatment, including behavioral therapy, you can effectively stop using drugs or alcohol.