Substance abuse does not just affect someone’s brain—it also wages war on the entire body system. The psychological and mental aspects of addiction usually get more attention, but the physical injury often bears a more urgent story. Each organ system takes its hit, and the longer someone uses, their body will start to break down in ways that can become permanent.
What is especially sobering is how quickly that damage can accumulate. People tell themselves this is just a habit, or a coping mechanism, or whatever they want to call it—the body however is totally fine with their reasoning, liver damage, heart strain, and immune suppression are all the body cares about—and respond to the input you are providing to it the body each day.
The Heart Under Attack
Cardiac damage can happen quickly with many different substances, but it is one of the first consequences we often ignore. That racing heart after stimulant use—it’s not excitement—there’s no reason for your heart to be working that much harder than usually, during the use of stimulants for example, cocaine and methamphetamine cause the heart to accelerate and beat harder while simultaneously decreasing blood vessels, leading to an increased chance of heart attack, even in young, otherwise healthy patients.
Most people experience chest pain, or irregular heart beats, but they will tell themselves it’s anxiety or something similar. The emergency department deals with this regularly—somebody comes in thinking they are having a panic attack, but it’s truly their heart distressed from substance use. It is alarming that damages to the heart can result from just one use of a stimulant, and yet many do not even realize how close they might have been to a serious medical condition.
Alcohol also causes its own type of damage to the heart over time. Drinking large amounts of alcohol leads to heart muscle weakening. This is identified as cardiomyopathy, which refers to the heart’s inability to contract and pump blood effectively. People notice they get tired much quicker, their legs swell, yet they do not connect the effects of their drinking until it inevitably becomes a more serious and irreparable damage.
When Breathing Becomes a Challenge
Inhalation and injection have also caused continued damage to the respiratory system, and crack cocaine has particularly caused damage to the lungs because this type of stimulant is smoked at an extremely high temperature and immediately destroys fragile lung tissue. People have presented with “crack lung” from the scarring and inflammation and are left with a chronic cough and difficulty breathing, leading them to seek out crack cocaine addiction treatment.
However, it is not just illegal drugs that cause concern with the respiratory system. Clinical opioids provide risks of slowing down breathing to potentially fatal levels, and this is why opioid overdoses are so deadly. A patient most likely dies not from the drug, but because they stop breathing during an overdose. What many would not realize is even if the patient is removed prior to a fatal overdose, oxygen flow to brain is altered, which over time, has potential to cause brain damage, with more significant cognitive problems also occurring over time.
Opioid users are at risk of pneumonia and other lung infections from medications, along with shallow breathing, and do not have a sufficient cough reflex leading to buildup of mucus travelling to the lungs with bacteria present. Combining all of these effects of conflicting breathing and decreased immune response can set the scene for serious lung infections.
The Liver’s Lost Battle
Your liver is essentially working overtime to process everything, and therefore, it pays a price. Alcohol is the obvious problem; everybody knows about cirrhosis. But alcohol is not the only thing that can cause liver disease. For example, acetaminophen (Tylenol) when combined with alcohol is a particularly deadly combination; and if you were to think about it, many people take pain relief medication while drinking.
What is concerning is how quietly liver damage develops. Although people may experience fatigue or even belly pain once in a while, liver disease often will not produce acute symptoms until it is fairly advanced. By the time a person’s skin becomes yellow or their abdomen swells with fluid, that person has likely already sustained a fair amount of liver damage.
In particular, injection drug abuse creates additional problems for the liver because of hepatitis. Sharing needles or other injecting equipment can lead to hepatitis B and C infections, which can produce inflammation of the liver that subsequently causes liver failure or even liver cancer. Some who even carry these infections for years are largely asymptomatic while their liver continues to erode.
When Addiction Has Affected So Much Physical Damage
When substance abuse leads to a more significant amount of physical damage, getting clean and taking care of oneself becomes more complicated. The body requires medical support and stabilization to heal properly; this is why evidence-based programs do work at looking at the brain; this is also why some evidence-based programs to also address and focus on the medical issues associated and patients with a long-time stimulant history.
Regular detox care sometimes does not have enough knowledge in the complex medical issues related to someone, whose had significant amount of damage to their body from substance abuse. While someone could be experiencing withdrawal, they could be in need of cardiac stabilization, respiratory support, or treating multiple serious infections. That is why medical monitoring is so important—the body is in a multi-faceted fight.
Physical Changes in the Brain
People view addiction as a mental illness; however, the brain is a physical organ as well, and substances cause changes to brain tissue, and these changes can be measured. Alcohol causes atrophy of brain tissue, especially in the pre-frontal areas responsible for decision making and impulse control; although stimulant abuse could potentially damage the brain’s blood vessels, which ultimately increases the likelihood of stroke. Young adults have suffered strokes because of the blood vessel damage done by stimulant use.
There are physical changes seen with methamphetamines that can be severe, and brain scans easily reveal the damage. Chronic meth users will develop memory, attention and motor skill deficits that may last many months after the person quits using, and some of those problems may be permanent—but the brain also has incredible healing capabilities when allowed to recover and heal.
These physical changes made to the brain often reveal why will power alone is insufficient to treat addiction. Decision making and impulse control are a result of the involved brain regions. Consequently, it is an unrealistic expectation to think that a person can simply “choose” to stop their substance use, and it is crucial that a person is evaluated and supported by medical and behavioral health providers in order to work around the limitations that the person’s drug use has caused in the brain.
Nutritional Destruction
Nutritional considerations regarding substance abuse are affected in many different ways. For example, stimulant use suppresses appetite and promotes weight loss to disordered dietary habits. Some individuals can go for days with very little food, resulting in the breakdown of muscle for energy. Alcohol tends to be relatively calorically dense and provides “empty” calories to help fill people up while offering fewer nutrients that the body needs.
There are damaging effects on the whole system that interfere with a person’s ability to absorb nutrients. Alcohol irritates the stomach lining and may also cause bleeding. Opioids will slow digestion and can lead to chronic constipation and gut dysfunction. Even when people work on trying to eat better, their digestive dysfunction will prevent an effective process of digestion to occur.
Malnutrition has a multiplying effect: healing is slower, the immune system becomes compromised, and the brain is deprived fuel for optimal function. And all of those consequences compound not only on one another, but they develop a vicious cycle because poor nutrition makes it difficult to have clear thoughts or make good decisions related to recovery.
Effects on the Immune System
Substance abuse compromises the functioning of the immune system in ways that make them vulnerable to infections they would normally, routinely fight off with success. People regularly comment on how they become sick more easily and take longer to get back to optimal function with smaller illnesses. More alarmingly, they can even become at risk for infections that are associated with significant morbidity and mortality.
Drugs that are injected increase the exposure to infection risks, for example, use of contaminated needles or other equipment. Often abscesses, infection of the blood, and infection of the heart valves become more frequent and can ultimately lead to death if they are not treated. Others develop infections that are antibiotic resistant and extremely difficult to treat.
When you combine the poor nutrition, organ damage, and impaired immune response, there is an environment that the body is unable to counter injury or illness due to illness of some type. For example, when a cut becomes infected, a cold becomes pneumonia, an abscess becomes systemic.
The Long Road to Physical Recovery
The good news is the human body has incredible powers to heal itself when supported appropriately. The liver can regenerate damaged tissue, the heart can regain function and strength, and the brain can develop new neural pathways. But, healing takes time and will often require medical support.
Recovery from physical substance abuse is not just getting substances out of the system. Often, it includes repairing health that has been declining for months, and sometimes even years. Sometimes it includes treating infections, repairing heart problems, correcting nutritional deficits, and providing new support to return to the previous level of health.
The physical part of recovery is as important as the psychological parts and often more urgent. For example, an individual may require highly significant and urgent medical care for a sobering complication while trying to address the emotional and behavioral aspects of addiction. It is exactly why addiction treatment must focus on the individual and not just the substance and use of the substance.
Understanding the physical damage or toll substance abuse takes is helpful to understanding how and why extensive medical intervention can be so important. The body is not simply trying to deal with or combat the addiction, it is fighting for basic health and survival. That being said, many analogies of healing and recovering can turn into amazing stories of recovery and healing with the appropriate medical intervention, even after extensive tissue damage.
