Co-Occurring Physical Disorders

At Milwaukee Women’s Recovery Center, Inc., all clients are provided a physical health assessment by either a medical doctor or an Advanced Practice Nurse Prescriber or Physician Assistant to assess the client for any co-morbid somatic health disorders or risks, and referral is made to specialty physicians or other healthcare providers as appropriate.

Drug use can have serious effects on the body. For example:

  • The use of opioids can cause slow breathing, and can even result in ineffective breathing, which can lead to decreased oxygen in the blood, brain damage, or death.
  • The use of stimulants, such as cocaine, amphetamine, and methamphetamine, can cause acute health problems such as stroke, heart attacks, abnormal heart rhythm, and seizures, as well as more chronic conditions, such as heart or lung damage.
  • The use of drugs by smoking or vaping (for example, heroin, crack cocaine, marijuana) can make chronic obstructive pulmonary disease (COPD), asthma, and other lung conditions worse.
  • Other conditions that affect the immune response, such as HIV, are more common among people who use drugs, especially among those who inject drugs.

Source: Centers for Disease Control and Prevention (CDC): COVID-19 and People Who Use Drugs or Have Substance Use Disorder. Updated Apr. 20, 2021. Accessed May 10, 2021 from https://www cdc.gov/coronavirus/2019-ncov/need-extra-precautions/other-at-risk-populations/people-who-use-drugs/QA.html

Co-occurring disorders (CODs) are burdensome conditions that have significant physical (emphasis supplied), emotional, functional, social, and economic consequences for the people who live with these disorders and their loved ones. Society as a whole is also affected by the prevalence of CODs.

SAMHSA – Substance Use Disorder Treatment for People with Co-Occurring Disorders UPDATED 2020.  Retrieved from Substance Use Disorder Treatment for People With Co-Occurring Disorders TIP 42 (samhsa.gov) on May 2, 2021.

According to an international research study about somatic health risks of persons experiencing SUDs, there is significant somatic co-morbidity, to wit:

    1. In patients using addictive substances, physical comorbidity (emphasis added) is a common issue.
    2. [T]he current study found SUD to be related to an increased risk of infectious and digestive system disorders (such as diseases of the oral cavity, oesophagus, stomach and bowel, liver and pancreas).
    3. One review reported incidence rates for pneumonia, obstructive lung disease, hypertension, diabetes, chronic liver disease, peptic ulcer, stroke and sexually transmitted diseases including HIV to be more than doubled in persons with addiction problems as compared to matched controls (DeAlba, Samet & Saitz, 2004).
    4. Another study reported increased rates for heart disease, asthma, gastrointestinal disorders, skin infections and acute respiratory disorders among patients with SUD, and this finding was found to hold also in the absence of comorbid psychotic disorders (Dickey, Normand, Weiss, Drake & Azeni, 2002).
    5. Alcohol consumption has been linked to injuries and diabetes, hypertension and coronary heart disease (Puddey, Rakic, Dimmitt & Beilin, 1999Wadland & Ferenchick, 2004), and it is also related to cardiomyopathy and liver cirrhosis (Wadland & Ferenchick, 2004).
    6. Alcohol use increases the risk of cancer of the mouth, pharynx, larynx, oesophagus and liver as well as other cancers, liver cirrhosis, injuries and poisoning (Gutjahr, Gmel & Rehm, 2001Longnecker & Enger, 1996).
    7. Review papers have concluded that tobacco smoking is associated with many chronic diseases (e.g., lung and other cancers, cardiovascular and chronic respiratory diseases, duodenal and gastric ulcers) with a high mortality risk (Wadland & Ferenchick, 2004).
    8. Cannabis use is associated with respiratory and cardiovascular health problems similar to those experienced by tobacco smokers (Ashton, 2001). Associations of marijuana use with sexually transmitted diseases, bronchitis and lung cancer, of cocaine use with pancreatitis, of hallucinogen use with tinnitus/sexually transmitted diseases and of inhalant use with tinnitus, sexually transmitted and infectious diseases were reported by the National Survey on Drug Use and Health in the US adult population (Han, Gfroerer & Colliver, 2010).
    9. Skin and soft tissue infections as well as infectious diseases such as tuberculosis and viral hepatitis (Deiss, Rodwell & Garfein, 2009Reimer et al., 2007) and cirrhosis (Wadland & Ferenchick, 2004) and HIV (Fischer et al., 2005Rehm, Taylor & Room, 2006) are common among injection drug users, especially women (Brown & Ebright, 2002). There is little evidence on the somatic consequences of tranquilizer use. Luderer, Schulz & Mayer (1995)reported comorbid SUD (mostly alcohol) in 70% of tranquilizer users but did not investigate somatic conditions.
    10. In patients with cocaine use, myocardial infarction, cardiomyopathy and other complications have been reported (Wadland & Ferenchick, 2004). Amphetamine users experience an excess incidence of acute coronary syndrome and cardiac arrhythmias, as well as (haemorrhagic and ischaemic) stroke, hyperthermia, rhabdomyolysis with acute renal failure and other complications due to vasoconstriction. Amphetamine inhalation can result in noncardiogenic edema (Wadland & Ferenchick, 2004).

Source: International Journal of Social Psychiatry – Physical illness in psychiatric inpatients: Comparison of patients with and without substance use disorders.  Accessed on a paid basis on May 2, 2021 from:

Physical illness in psychiatric inpatients: Comparison of patients with and without substance use disorders – Karel Frasch, Jens Ivar Larsen, Joachim Cordes, Bent Jacobsen, Signe Olrik Wallenstein Jensen, Christoph Lauber, Jørgen Achton Nielsen, Kenji J Tsuchiya, Richard Uwakwe, Povl Munk-Jørgensen, Reinhold Kilian, Thomas Becker, 2013 (sagepub.com)

Purchase date: May 2, 2021, purchased from: Sage Journal; Order number: SJ-20210502-10108193; Electronic, Individual (access for 24 hours) granted to karl@ghpwi.com.