Long Term Effects Of Substance Abuse Disorder

Introduction

Substance abuse disorder is an important health issue globally. According to the United Nations, in 2019 there were over 35 million people suffering from drug use disorders worldwide. This figure highlights the need for more accessible awareness, education, and treatment for the condition.

Definition of substance abuse disorder

Substance abuse disorder, also known as substance use disorder (SUD), is a disease commonly referred to as ‘drug addiction’. According to the Centers for Disease Control and Prevention substance abuse disorders are mental health conditions characterised by compulsive and recurrent use of one or more problematic substances. Problematic substances can include alcohol, cocaine and prescription medications amongst others. Addiction to problematic substances can cause you to continue taking them even though they can have detrimental physical, mental and social effects. 

Overview of long-term effects

There are many short- and long-term effects associated with substance abuse disorder. These can impact a person's physical health, mental health and ultimately their overall quality of life. Long-term effects commonly associated with SUD can include heart disease, liver damage, anxiety, depression and financial problems. 

Importance of understanding long term effects

It is important to understand the long-term effects of substance abuse. An understanding of substance abuse and its long-term effects is critical for the prevention of this condition. Furthermore, if you are already struggling with substance abuse disorder, understanding the long-term effects of this condition can help with early intervention and planning treatment. 

Physical effects of substance abuse disorder

Substance abuse disorder can affect your body in multiple ways. Substance abuse disorder can affect your cardiovascular system, respiratory system, gastrointestinal system, liver/kidney function, nervous system and immune system. The physical effects of SUD can lead to serious and potentially life threatening conditions.

Cardiovascular system

Substance abuse disorder can cause issues with the cardiovascular system which include:

• High blood pressure¹
• Arrhythmia (irregular heartbeat)²
• Damage to the heart muscle
• Atherosclerosis (a blockage in an artery to the heart)³
• Infective endocarditis (an infection of the hearts inner lining or valves)⁴
• Sudden cardiac death

Respiratory system

The effects of SUD on the respiratory system include:⁵

• Chronic bronchitis (long term inflammation of the airways, commonly caused by smoking and vaping tobacco or marijuana)
• Emphysema (damage to small air sacs in the lungs, which can also be caused by smoking and vaping tobacco or marijuana)
• Asthma can be triggered by substance abuse in those with pre-existing asthma
• Pneumonia (an infection of the lungs)
• Lung Cancer
• Respiratory depression (a slowing/ stopping of breathing which can be life-threatening)

Gastrointestinal  system

• Nausea and vomiting
• Gastrointestinal bleeding - associated most strongly with alcohol abuse. This can be a life threatening condition 
• Gastritis (inflammation of the stomach lining causing abdominal pain, vomiting and nausea)⁶
• Ulcers (in the stomach and small intestine)
• Pancreatitis (Inflammation of the pancreas, most commonly associated with alcohol abuse)

Liver and kidney function^{7, 8}

• Liver damage (substance abuse can cause liver damage e.g. cirrhosis which is a liver disease that can lead to failure of the liver)
• Chronic alcohol abuse can cause chronic liver disease
• Impaired liver function can result in toxin build up in the body which lead to further health problems
• Hepatitis B and C can be contracted through injection drug use, and lead to inflammation and liver damage
• Kidney damage can be caused by long term substance abuse, particularly through the of certain drugs including cocaine and heroin
• Acute kidney injury can be caused by the use of opioids. It refers to a sudden and usually reversible loss of kidney function

Nervous system

• Brain damage can be caused by the long-term use of methamphetamine amongst other drugs⁹
• Seizures are the result of electrical disturbances in the brain and are usually sudden and uncontrolled. They can be caused by drugs similar to cocaine and amphetamines¹⁰
• Peripheral neuropathy is damage to nerves not located in the brain and spinal cord. This can cause numbness, tingling and pain in hands and/or feet

Immune system

• An increased infection susceptibility due to a weakened immune system caused by substance abuse¹¹
• Impaired wound healing
• Higher cancer risk (long term use of certain drugs increasing the risk of the development of certain cancer type e.g. tobacco and lung cancer)
• Autoimmune disorders can be triggered and exacerbated by substance abuse
• Allergies to substances can cause allergic reactions, including anaphylaxis

Mental health effects of substance abuse disorder

The mental health effects of substance abuse disorder can be severe and even threatening to life. If you are struggling with substance abuse disorder it is important you seek treatment and make lifestyle changes that will reduce the risk of developing mental health issues.

Substance-induced disorders

Substance-induced disorders include mood disorders, anxiety disorders, psychotic disorders, sleep disorders and cognitive disorders. The symptoms of these disorders can be mild to severe.

Changes in mood, anxiety, sleep, cognitive ability, and the development of psychotic episodes are common symptoms of substance induced disorders. These disorders can develop whilst actively using a substance, whilst intoxicated by a substance or during withdrawal from a substance.¹²

Co-occurring mental health disorders¹³

Having both substance abuse and a mental health condition is very common. When you have a problem with your mental health and SUD, it is referred to as a ‘co-occuring’ disorder. Having a co-occuring mental health condition alongside SUD can complicate your treatment. Despite this, with the correct treatment, support and your own determination you can recover.

Examples of co-occurring mental health conditions include:

• Depression
• Anxiety
• PTSD (post-traumatic stress disorder)
• Bipolar disorder
• Personality disorder

Cognitive impairment

Cognitive impairment is a decline in abilities that include decision-making, attention and memory.¹⁴ Cognitive impairment caused by substance abuse can be both short- and long-term.

Long-term effects on cognitive function caused by SUD include:

• Persistent cognitive impairment that affects an individual's ability to carry out daily tasks
• A higher dementia risk
• Changes to brain structure which contribute the development of neurological conditions and cognitive impairment

Personality changes

Personality changes are frequently observed in those with substance abuse disorder. These changes can be either short- or long-term.

Permanent long-term changes caused by SUD include:

• Chronic irritability
• Mood swings
• Social withdrawal

Social effects of substance abuse disorder

Substance abuse disorder can affect both individuals and their communities.

Relationship problems

Individuals suffering with SUD report having strained relationships with family, romantic partners and friends. This strain can lead to conflicts and relationship breakdowns.¹⁵

Employment and financial issues

SUD can cause a decrease in productivity. This can lead to an inability to meet school or work targets, and eventually may result in a loss of employment or educational opportunity.

Certain substances can be expensive, this can result in financial implications including debt, bankruptcy and homelessness.

Legal problems

Those suffering with substance abuse disorder may be more likely to engage in criminal activity to get substances. This can include drug trafficking and theft, both of which have serious legal consequences. 

Housing instability

As a result of financial, relationship and legal problems people with SUD may find it difficult to maintain a stable housing situation. This can worsen substance abuse problems.

Long-term effects on children of substance-abusing parents

Children of substance-abusing parents may experience a variety of long-term effects to their mental and physical health, education, career and social relationships. Furthermore, being a child to a parent with substance-abuse issues puts you at a higher risk of developing substance abuse disorder.¹⁵

Physical health effects

Children of parents with SUD have an increased risk of asthma, allergies and obesity.

Mental health effects

Children of parents with SUD are at increased risk of depression, anxiety, and post-traumatic stress disorder (PTSD).

Behavioural issues

Children of substance abusing parents may feel isolated, stigmatised and discriminated against. This can make relationships with peers and adults difficult. In addition, they also have an increased risk of abuse and neglect. In turn, these can result in educational problems of truancy which can limit their education opportunities and future career.

Prevention and treatment of substance abuse disorder

The prevention and treatment of SUD involves a range of strategies, including education, early intervention, effective treatment, and ongoing support.

Importance of early intervention

Preventing SUD progressing to a more severe and chronic condition is essential, therefore early intervention is critical. As with most diseases, the earlier it is diagnosed and treated, the better the prognosis and chance for a full recovery. Early intervention for substance abuse disorder can save lives.

Evidence-based treatment approaches

There are several evidence-based treatment approaches for substance abuse disorder that are effective. Examples include:

• Cognitive behavioural therapy (CBT) is a form of talk therapy that aims to revert patterns of behaviour and thinking that contribute to substance abuse¹⁶
• Motivational interviewing is a form of goal-oriented counseling shown to promote behaviour change
• Contingency management is a type of incentive-based behavioural therapy
• Medication-assisted treatment uses medications to help manage withdrawal symptoms associated with substance abuse
• 12 step programmes are self help programs aimed at giving social support to individuals with SUD whilst recovering
• Family therapy works with the whole family to address issues that have arisen as a result of substance abuse¹⁷

Recovery and maintenance

Recovery and maintenance for SUD involves ongoing efforts to maintain sobriety, manage triggers, and address underlying issues that may contribute to substance abuse. Ways to maintain your recovery and prevent relapse include:

• Continued treatment to address ongoing issues related to substance abuse
• Lifestyle changes such as avoiding triggers and learning new ways to manage stress
• Social support e.g attending support groups and involving your loved ones in the recovery process¹⁷
• Monitoring: regular drug testing and check-ins with your healthcare provider can address issues early, preventing a relapse
• Self care supports physical and emotional well being and therefore, reduces the chance of relapse
• Continued learning about SUD keeps you informed about your recovery

Recovery journeys can have setbacks and challenges. However, with ongoing support, motivation, and a commitment to sobriety, you can achieve and maintain long-term recovery from substance abuse disorder.

Summary

To summarise, substance abuse disorder is a mental health condition commonly referred to as ‘drug addiction’. It is characterised by compulsive and recurrent use of one or more problematic substances. Substance abuse disorder can have long term effects on all aspects of your life including your physical, mental and social state. Treatment for this disease is available, however, it requires a combination of determination, support and commitment to achieve and maintain sobriety.