Already existing disorders that are present, such as with the heart, kidneys, and most other organs and organ systems, can be severely exacerbated by drug abuse or dependence, depending on the particular drug. Some drugs may damage specific organs or organ systems. For example, many drugs are metabolized by the liver or the kidneys, and if these organs are already weak or impaired, then excessive and chronic drug abuse could lead to harm and even the failure of these organs.

Harmful effects to the brain Inhalant abuse may lead to brain damage, causing permanent memory loss as well as long-term or lifelong learning problems. (Psychiatric problems are discussed in a separate section of this essay.) The chronic abuse of marijuana may cause deficits in shortterm thinking, motivation, and memory.

Some drugs may lead to the development of neurological problems, such as seizures and memory loss or even strokes and/or brain damage. Drugs that may lead to neurological symptoms or disorders include cocaine, gamma-hydroxybutyrate (GHB), inhalants, marijuana, methylenedioxymethamphetamine (MDMA/ecstasy), methamphetamine, and prescription stimulants. In addition, the excessive abuse of barbiturates may cause delirium and seizures.

Benzodiazepines can cause drowsiness, slowed reaction times, poor judgment, and decreased impulse control. At higher doses, individuals may experience amnesiac episodes (blackouts) and confusion.

Damage to the Gastrointestinal System and the Liver

The abuse of some drugs may harm the gastrointestinal system, causing inflammation of the stomach, severe chronic constipation, and ulcers. Drugs that may cause gastrointestinal harm include cocaine, GHB, heroin, lysergic acid diethylamide (LSD), MDMA, and prescription opiates. In addition, most narcotics are severely constipating. Some individuals find that propoxyphene (Darvon, Darvocet) causes stomach pain.

Some drugs are particularly harmful to the liver and can cause serious liver damage, including heroin, inhalants, and anabolic steroids. The damage is accentuated if the person abuses alcohol in addiction to the drug, a situation that is common. Contaminants from illegally manufactured methamphetamine may include substances that are harmful to the liver.

The Heart and Circulatory System

The abuse of many drugs may have adverse effects on the heart and may cause an abnormal heart rate (abnormally low or abnormally high) as well as heart attack. The injection of illegal drugs can lead to collapsed veins and bacterial infections of the heart valves and blood vessels.

Some drugs that may harm the heart and circulatory system are cocaine, heroin, inhalants, ketamine, LSD, marijuana, MDMA, methamphetamine, phencyclidine, and prescription stimulants. Regular abusers of marijuana may also develop an increased heart rate. Abusers of steroids may develop problems with hypertension and high blood cholesterol, which together put them at an increased risk for experiencing a cardiovascular event, such as a stroke and/or heart attack.

The Urinary System and Kidneys

Drug abuse and dependence may be harmful to the kidneys and in the worst case can cause the destruction of the kidneys and lead to the need for kidney dialysis and, eventually, kidney transplantation. Drugs that may harm the kidneys specifically are heroin, inhalants, MDMA, and phencyclidine.

The Respiratory System

Some drugs are harmful to breathing and the respiratory system. They may slow the individual's breathing and can worsen already-existing asthma. Drugs that may be harmful to the respiratory system include cocaine, GHB, inhalants, ketamine, marijuana, phencyclidine, and prescription opiates. Heroin abuse and dependence can cause lung complications, such as tuberculosis and pneumonia.

Reproductive System

The abuse of anabolic steroids may permanently impair fertility in both men and women. Steroids can also cause feminizing effects in men and masculinizing effects in women, such as the development of permanently enlarged breast tissue (gynecomastia) in men and the development of increased facial hair in women, with decreased or absent menstruation.

Drug abusers and those who are addicted to drugs have an increased risk for contracting sexually transmitted diseases, which may also impair fertility if and when individuals wish to have a child.

Skin

Some drugs can cause extreme itching of the skin, such as methamphetamine. Drugs such as cocaine and amphetamines may lead to excessive scratching or more serious injuries due to the individual's delusion of parasites under the skin (formication). Chronic injections of illegal drugs may also cause skin sores, lesions, and infections that may spread throughout the body if untreated.

Immune System

Some drugs increase the risk to the abuser of contracting the human immunodeficiency virus (HIV) and the later development of acquired immune deficiency syndrome (AIDS). Individuals who use contaminated shared needles to inject their drugs intravenously are at greatest risk, such as those who inject cocaine, heroin, methamphetamine, and other drugs. These individuals also face an increased risk for contracting hepatitis as well as HIV and other infectious diseases that can be transmitted through shared needles.

Some studies, such as reported in Archives of Internal Medicine in 2004, have linked intravenous (IV) drug users of illegal drugs to a high risk of death, particularly among people ages 25-34 years.

The researchers studied IV drug users from 1980 to 2001. They found that most of the subjects died of drug overdoses. Say the researchers, "In particular, young female drug users in the 15-24 year age group have a very high relative risk of dying (increased by a factor of 76.3) compared with young females in the general population, and in nearly 90% of these cases drug overdose was the principal cause."

Prenatal Effects

Drug abuse and dependence can cause serious and potentially lifelong harm to the developing fetus. Pregnant women who abuse heroin risk a miscarriage or a premature delivery. The newborn who survives being delivered to a woman addicted to heroin has an increased risk of sudden infant death syndrome (SIDS). Other drugs that may be particularly harmful to the fetus of a pregnant woman include cocaine, heroin, inhalants, marijuana, MDMA, and methamphetamine.

The use of many legitimate prescription drugs used as directed can potentially be harmful to the fetus, but most doctors are very careful about the prescriptions they recommend to pregnant women and monitor side effects. Despite this, some pregnant women abuse drugs without their doctors' knowledge, and consequently, they risk harm to the babies they later bear. Of course, the most dangerous drug to the fetus is alcohol.

Psychiatric Problems

The abuse of amphetamines or cocaine may trigger suicidal thoughts or even lead to a psychotic break in some individuals, one that is similar to and often indistinguishable from the symptoms that are seen with the onset of schizophrenia. Not all individuals recover from this psychotic break, even when the drug is no longer abused.

The abuse of anabolic steroids may induce extreme rages leading to aggression, as well as paranoia. Steroid abusers may suffer from severe depression.

The abuse of MDMA can induce anxiety disorders, depression, confusion, panic attacks, and paranoia.

The abuse of GHB can cause both delusions and hallucinations.

Hallucinogenic drugs such as LSD may cause a psychotic break in users as well as depression. Phencyclidine (PCP) can induce both auditory and visual hallucinations in users and may also trigger a psychotic break. Users may experience paranoia and disorganized thinking, symptoms that resemble those of and are difficult to distinguish from schizophrenia.

Marijuana abusers who are chronic users may experience problems with depression and panic attacks. Heavy abuse may lead to paranoia and sometimes to psychosis.

The chronic use of methamphetamine can cause both visual and auditory hallucinations. Paranoia and extreme rages may precipitate violence among methamphetamine abusers. Some chronic users of methamphetamine suffer from formication, the terrifying delusion that insects are crawling underneath their skin.

Users of crystal methamphetamine risk psychotic symptoms that may persist for months or years. Other drugs that may induce psychiatric symptoms are inhalants, ketamine, and prescription stimulants. At high doses, narcotics may induce psychotic symptoms in some patients.

References:

Copeland, Lorraine, et al. "Changing Patterns in Cause of Death in a Cohort of Injecting Drug Users, 1980-2001." Archives of Internal Medicine 165 (June 14, 2004): 1,214-1,220.

Gordon, Rachel J., M.D., and Franklin D. Lowy, M.D. "Bacterial Infections in Drug Users." New England Journal of Medicine 353, no. 18 (November 3, 2005): 1,945-1,954.

Gwinnell, Esther, M.D., and Christine Adamec. The Encyclopedia of Addictions and Addictive Behaviors. New York: Facts On File, 2005.

Lange, Richard A., M.D., and L. David Hillis, M.D. "Cardiovascular Complications of Cocaine Use." New England Journal of Medicine 345, no. 6 (August 2, 2001): 351-358.

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