Physical Considerations for Treatment Complications of Alcohol and Drug Use and Misuse

  • Giovanni Addolorato
  • Lorenzo Leggio
  • Cristina D’Angelo
  • Anna Ferrulli
  • Antonio Mirijello
  • Silvia Cardone
  • Veruscka Leso
  • Noemi Malandrino
  • Esmeralda Capristo
  • Raffaele Landolfi
  • Giovanni Gasbarrini


The effects of chronic abuse of alcohol and/or other substances of abuse vary considerably, depending, for example, on the concentration and dose. Furthermore, other factors also may play a role, such as nutritional status, gender, and ethnicity. This chapter analyzes the main medical consequences related to substance abuse, namely alcohol, nicotine, opioids, cocaine, amphetamine, and benzodiazepines. The effects of these substances on the liver, gut, pancreas, nervous system, cardiovascular system, and endocrine system are analyzed and discussed. The link between substance abuse disorders and tumors is also reported, as well as the relationship between substances of abuse and nutrition and body composition.


Alcohol Nicotine Opioids Cocaine Amphetamine Benzodiazepines Substance abuse Liver Gut Pancreas Nervous system Cardiovascular system Endocrine system Oncology Body composition 


  1. 1.
    Addolorato G, Capristo E, Greco AV et al (1997) Energy expenditure, substrate oxidation and body composition in chronic alcoholism: new findings from metabolic assessment. Alcohol Clin Exp Res 21:962–967PubMedGoogle Scholar
  2. 2.
    Addolorato G, Montalto M, Capristo E et al (1997) Influence of alcohol on gastrointestinal motilità: lactulose breath hydrogen testing in orocecal transit time in chronic alcoholics, social drinkers and teetotaler subjects. Hepatogastroenterology 44:1076–1081PubMedGoogle Scholar
  3. 3.
    Addolorato G, Capristo E, Caputo F et al (1998) The influence of chronic alcohol abuse on energy metabolism and substrate oxidation in human: evaluation of nutritional status in subjects with and without liver cirrhosis. Alcologia, Eur J Alcohol Studies 10:56–61Google Scholar
  4. 4.
    Addolorato G, Capristo E, Greco AV et al (1998) Influence of chronic alcohol abuse on body weight and energy metabolism: is ethanol consumption in excess a risk factor for obesity or malnutrition? J Intern Med 244:387–395PubMedCrossRefGoogle Scholar
  5. 5.
    Addolorato G, Capristo E, Caputo F et al (1998). The influence of chronic alcohol abuse on energy metabolism and substrate oxidation in human: evaluation of nutritional status in subjects with and without liver cirrhosis. Alcologia, Eur J Alcohol Studies 10:56–61Google Scholar
  6. 6.
    Addolorato G, Capristo E, Greco AV et al (1998) Three months of abstinence from alcohol normalizes energy expenditure and substrate oxidation in alcoholics: a longitudinal study. Am J Gastroenterol 93:2476–2481PubMedCrossRefGoogle Scholar
  7. 7.
    Addolorato G, Capristo E, Caputo F et al (1999) Nutritional status and body fluid composition in chronic alcoholics compared with controls. Alcohol Clin Exp Res 23:1232–1237PubMedCrossRefGoogle Scholar
  8. 8.
    Addolorato G, Capristo E, Marini M et al (2000) Body composition changes induced by chronic ethanol abuse: evaluation by dual energy X-ray absorptiometry. Am J Gastroenterol 95:2323–2327PubMedCrossRefGoogle Scholar
  9. 9.
    Addolorato G, Di Campli C, Simoncini M et al (2001) Oxygen free radical production in rat liver: dose-related effect of ethanol on perfusion injury. Dig Dis Sci 46:1057–1066PubMedCrossRefGoogle Scholar
  10. 10.
    Addolorato G, Abenavoli L, Leggio L et al (2005) How many cravings? Pharmacological aspects of craving treatment in alcohol addiction: a review. Neuropsychobiology 51:59–66PubMedCrossRefGoogle Scholar
  11. 11.
    Addolorato G, Leggio L, Abenavoli L et al (2005) Alcoholism Treatment Study Group. Neurobiochemical and clinical aspects of craving in alcohol addiction: a review. Addict Behav 30:1209–1224PubMedCrossRefGoogle Scholar
  12. 12.
    Addolorato G, Capristo E, Leggio L et al (2006) Relationship between ghrelin levels, alcohol craving and nutritional status in current alcoholic patients. Alcohol Clin Exp Res 30:1933–1937PubMedCrossRefGoogle Scholar
  13. 13.
    Addolorato G, Leggio L, Agabio R et al (2006) Baclofen: a new drug for the treatment of alcohol dependence. Int J Clin Pract 60:1003–1008PubMedCrossRefGoogle Scholar
  14. 14.
    Addolorato G, Leggio L, Ferrulli A et al (2007) Effectiveness and safety of baclofen for maintenance of alcohol abstinence in alcohol-dependent patients with liver cirrhosis: randomised, double-blind controlled study. Lancet 370:1915–1922PubMedCrossRefGoogle Scholar
  15. 15.
    Addolorato G, Leggio L, Ojetti V et al (2008) Effects of short-term moderate alcohol administration on oxidative stress and nutritional status in healthy males. Appetite 50:50–56PubMedCrossRefGoogle Scholar
  16. 16.
    Agabio R (2005) Thiamine administration in alcohol-dependent patients. Alcohol Alcohol 40:155–156PubMedCrossRefGoogle Scholar
  17. 17.
    Akahane K, Furukawa Y, Ogiwara Y et al (1987). Pharmacological analysis of chrono and inotropic responses to diazepam in the isolated, blood-perfused canine atrium. Arch Int Pharmacodyn Ther 290:173–184PubMedGoogle Scholar
  18. 18.
    Alameda F, Fontane J, Corominas JM et al (2000) Reactive vascular lesion of nasal septum simulating angiosarcoma in a cocaine abuser. Hum Pathol 31:239–241PubMedCrossRefGoogle Scholar
  19. 19.
    Albano E (2006) Alcohol, oxidative stress and free radical damage. Proc Nutr Soc 65:278–290PubMedCrossRefGoogle Scholar
  20. 20.
    Albertson T, Walby W, Derlet R (1995) Stimulant induced pulmonary toxicity. Chest 198:1140–1149CrossRefGoogle Scholar
  21. 21.
    Al-Mulla Hummadi YM, Najim RA, Farjou IB (2001) Benzodiazepines protect against ethanol-induced gastric mucosal damage in vitro. Fundam Clin Pharmacol 15:247–254PubMedCrossRefGoogle Scholar
  22. 22.
    Altura BM, Altura BT, Carella A (1983). Ethanol produces coronary vasospasm: evidence for a direct action of ethanol on vascular muscle. Br J Pharmacol 78:260–262PubMedCrossRefGoogle Scholar
  23. 23.
    Andrews P (1997) Cocaethylene toxicity. J Addict Dis 16:75–84PubMedCrossRefGoogle Scholar
  24. 24.
    Anton RF, O’Malley SS, Ciraulo DA et al (2006) COMBINE Study Research Group. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 295:2003–2017PubMedCrossRefGoogle Scholar
  25. 25.
    Ashley MJ (1997) Smoking and diseases of the gastrointestinal system: an epidemiological review with special reference to sex differences. Can J Gastroenterol 11:345–352PubMedGoogle Scholar
  26. 26.
    Atkinson HH, Cesari M, Kritchevsky SB et al (2005) Predictors of combined cognitive and physical decline. J Am Geriatr Soc 53:1197–1202PubMedCrossRefGoogle Scholar
  27. 27.
    Atkinson RL, Berke LK, Drake CR et al (1985) Effects of long-term therapy with naltrexone on body weight in obesity. Clin Pharmacol Ther 384:419–422CrossRefGoogle Scholar
  28. 28.
    Augustyńska B, Ziółkowski M, Odrowaz-Sypniewska G et al (2007) Menstrual cycle in women addicted to alcohol during the first week following drinking cessation—changes of sex hormones levels in relation to selected clinical features. Alcohol Alcohol 42:80–83PubMedCrossRefGoogle Scholar
  29. 29.
    Bagnardi V, Blangiardo M, La Vecchia C et al (2001) A meta-analysis of alcohol drinking and cancer risk. Br J Cancer 85:1700–1705PubMedCrossRefGoogle Scholar
  30. 30.
    Baker KG, Harding AJ, Halliday GM et al (1999) Neuronal loss in functional zones of the cerebellum of chronic alcoholics with and without Wernicke’s encephalopathy. Neuroscience 19:429–438CrossRefGoogle Scholar
  31. 31.
    Bang-Ping J (2009) Sexual dysfunction in men who abuse illicit drugs: a preliminary report. J Sex Med 6:1072–1080Google Scholar
  32. 32.
    Baylen CA, Rosenberg H (2006) A review of the acute subjective effects of MDMA/ecstasy. Addiction 101:933–947PubMedCrossRefGoogle Scholar
  33. 33.
    Bode C, Bode JC (2003) Effect of alcohol consumption on the gut. Best Pract Res Clin Gastroenterol 17:575–592PubMedCrossRefGoogle Scholar
  34. 34.
    Brambilla G, Carrozzino R, Martelli A (2007) Genotoxicity and carcinogenicity studies of benzodiazepines. Pharmacol Res 56:443–458PubMedCrossRefGoogle Scholar
  35. 35.
    Brown R, Balousek S, Mundt M et al (2005) Methadone maintenance and male sexual dysfunction. J Addict Dis 24:91–106PubMedCrossRefGoogle Scholar
  36. 36.
    Bujanda L (2000) The effects of alcohol consumption upon the gastrointestinal tract. Am J Med 95:3374–3382Google Scholar
  37. 37.
    Carlsson S, Hammar N, Grill V (2005) Alcohol consumption and type 2 diabetes meta-analysis of epidemiological studies indicates a U-shaped relationship. Diabetologia 48:1051–1054PubMedCrossRefGoogle Scholar
  38. 38.
    Carmichael FJ, Orrego H, Saldivia V et al (1993) Effect of propylthiouracil on the ethanol-induced increase in liver oxygen consumption in awake rats. Hepatology 18:415–421PubMedCrossRefGoogle Scholar
  39. 39.
    Cass WA (1997) Decreases in evoked overflow of dopamine in rat striatum after neurotoxic doses of methamphetamine. J Pharmacol Exp Ther 280:105–113PubMedGoogle Scholar
  40. 40.
    Chai C, Wang S (1966) Cardiovascular actions of diazepam in the cat. J Pharmacol Exp Ther 154:271–280PubMedGoogle Scholar
  41. 41.
    Chanraud S, Martelli C, Delain F et al (2007) Brain morphometry and cognitive performance in detoxified alcohol-dependents with preserved psychosocial functioning. Neuropsychopharmacology 32:429–438PubMedCrossRefGoogle Scholar
  42. 42.
    Cheng JY, Ng EM, Chen RY et al (2007) Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies. Int J Impot Res 19:343–352PubMedCrossRefGoogle Scholar
  43. 43.
    Chiueh CC, Kopin IJ (1978) Centrally mediated release by cocaine of endogenous epinephrine and norepinephrine from the sympathoadrenal medullary system of unanesthetised rats. J Pharmacol Exp Ther 205:148–154PubMedGoogle Scholar
  44. 44.
    Cho CH, Wu KK, Wu S et al (2003) Morphine as a drug for stress ulcer prevention and healing in the stomach. Eur J Pharmacol 460:177–182PubMedCrossRefGoogle Scholar
  45. 45.
    Chowdhury P, MacLeod S, Udupa KB, Rayford PL (2002) Pathophysiological effects of nicotine on the pancreas: an update. Exp Biol Med 227:445–454Google Scholar
  46. 46.
    Chowdhury P, Gupta P (2006) Pathophysiology of alcoholic pancreatitis: an overview. World J Gastroenterol 12:7421–7427PubMedGoogle Scholar
  47. 47.
    Cobb Scott J, Woods SP, Matt GE et al (2007) Neurocognitive effects of methamphetamine: a critical review and meta-analysis. Neuropsychol Rev 17:275–297PubMedCrossRefGoogle Scholar
  48. 48.
    Cofrancesco J Jr, Brown TT, Luo RF et al (2007) Body composition, gender, and illicit drug use in an urban cohort. Am J Drug Alcohol Abuse 33:467–474CrossRefGoogle Scholar
  49. 49.
    Colell A, Garcia-Ruiz C, Miranda M et al (1998) Selective glutathione depletion of mitochondria by ethanol sensitizes hepatocytes to tumor necrosis factor. Gastroenterology 115:1541–1551PubMedCrossRefGoogle Scholar
  50. 50.
    Connor TJ (2004) Methylenedioxymethamphetamine (MDMA, `Ecstasy’): a stressor on the immune system. Immunology 111:357–367PubMedCrossRefGoogle Scholar
  51. 51.
    Cooper SJ (2005) Palatability-dependent appetite and benzodiazepines: new directions from the pharmacology of GABA(A) receptor subtypes. Appetite 44:133–150PubMedCrossRefGoogle Scholar
  52. 52.
    Cordain L, Bryan ED, Melby CL et al (1997) Influence of moderate daily wine consumption on body weight regulation and metabolism in healthy free-living males. J Am Coll Nutr 16:134–139PubMedGoogle Scholar
  53. 53.
    Curran HV, Robjant K (2006) Eating attitudes, weight concerns and beliefs about drug effects in women who use ecstasy. J Psychopharmacol 20:425–431PubMedCrossRefGoogle Scholar
  54. 54.
    Czlonkowski A, Stein C, Herz A (1993) Peripheral mechanisms of opioid antinociception in inflammation: involvement of cytokines. Eur J Pharmacol 242:229–235PubMedCrossRefGoogle Scholar
  55. 55.
    Daglish MRC, Nutt DJ (2003). Brain imaging studies in human addicts. Eur Neuropsychopharmacol 13:453–458PubMedCrossRefGoogle Scholar
  56. 56.
    Daniell HW (2002) Hypogonadism in men consuming sustained-action oral opioids. J Pain 3:377–384PubMedCrossRefGoogle Scholar
  57. 57.
    Davey M (2005) Grisly effect of one drug: “meth mouth”. New York Times, 2005 June 11.Google Scholar
  58. 58.
    Dhuna A, Pascual-Leone A, Belgrade M (1991) Cocaine-related vascular headaches. J Neurol Neurosurg Psychiatry 54:803–806PubMedCrossRefGoogle Scholar
  59. 59.
    Diehl AM (2002) Liver disease in alcohol abusers: clinical perspective. Alcohol 27:7–11PubMedCrossRefGoogle Scholar
  60. 60.
    DiMartini A, Javed L, Russell S et al (2005) Tobacco use following liver transplantation for alcoholic liver disease: an underestimated problem. Liver Transpl 11:679–683PubMedCrossRefGoogle Scholar
  61. 61.
    Dorey G (2001) Is smoking a cause of erectile dysfunction? A literature review. Br J Nurs 10:455–465PubMedGoogle Scholar
  62. 62.
    Ehlers SL, Rodrigue JR, Widows MR et al (2004) Tobacco use before and after liver transplantation: a single center survey and implications for clinical practice and research. Liver Transpl 10:412–417PubMedCrossRefGoogle Scholar
  63. 63.
    Ettinger PO, Wu CF, De La Cruz C Jr et al (1978) Arrhythmias and the “Holiday Heart”: alcohol-associated cardiac rhythm disorders. Am Heart J 95:555–562PubMedCrossRefGoogle Scholar
  64. 64.
    Facchinetti F, Grasso A, Petraglia F et al (1984) Impaired circadian rhythmicity of beta-lipotrophin, beta-endorphin and ACTH in heroin addicts. Acta Endocrinol (Copenh) 105:149–155Google Scholar
  65. 65.
    Facchini FS, Hollenbeck CB, Jeppesen J et al (1992) Insulin resistance and cigarette smoking. Lancet 339:1128–1130PubMedCrossRefGoogle Scholar
  66. 66.
    Fekete C, Lechan RM (2006) Neuroendocrine implications for the association between cocaine- and amphetamine regulated transcript (CART) and hypophysiotropic thyrotropin-releasing hormone (TRH). Peptides 27:2012–2018PubMedCrossRefGoogle Scholar
  67. 67.
    Forrester JE, Tucker KL, Gorbach SL (2005) The effect of drug abuse on body mass index in Hispanics with and without HIV infection. Public Health Nutr 8:61–68PubMedCrossRefGoogle Scholar
  68. 68.
    Fossey MD, Hamner MB (1994) Clonazepam-related sexual dysfunction in male veterans with PTSD. Anxiety 1:233–236PubMedGoogle Scholar
  69. 69.
    Freudenberger RS, Cappell MS, Hutt DA (1990) Intestinal infarction after intravenous cocaine administration. Ann Intern Med 113:715–716PubMedGoogle Scholar
  70. 70.
    Gabilondo AM, Meana JJ, Barturen F et al (1994) Mu-opioid receptor and alpha(2)-adrenoceptor agonist binding-sites in the postmortem brain of heroin-addicts. Psychopharmacology 115:135–140PubMedCrossRefGoogle Scholar
  71. 71.
    Garavan H, Hester R (2007) The role of cognitive control in cocaine dependence. Neuropsychol Rev 17:337–345PubMedCrossRefGoogle Scholar
  72. 72.
    Garbutt JC, Kranzler HR, O’Malley SS et al (2005) Efficacy and tolerability of long-acting injectable naltrexone for alcohol dependence: a randomized controlled trial. JAMA 293:1617–1625PubMedCrossRefGoogle Scholar
  73. 73.
    Garbutt JC, Flannery B (2007) Baclofen for alcoholism. Lancet 370:1884–1885PubMedCrossRefGoogle Scholar
  74. 74.
    Gavish M (1995) Hormonal regulation of peripheral-type benzodiazepine receptors. J Steroid Biochem Mol Biol 53:57–59PubMedCrossRefGoogle Scholar
  75. 75.
    Gerzanich V, Zhang F, West GA et al (2001) Chronic nicotine alters NO signaling of Ca2+ channels in cerebral arterioles. Circ Res 88:359–365PubMedCrossRefGoogle Scholar
  76. 76.
    Ghuran A, Nolan J (2000) Recreational drug misuse: issues for the cardiologist. Heart 83:627–633PubMedCrossRefGoogle Scholar
  77. 77.
    Glauser J, Queen JR (2007) An overview of non-cardiac cocaine toxicity. J Emerg Med 32:181–186PubMedCrossRefGoogle Scholar
  78. 78.
    Go VLW, Gukovskaya A, Pandol SJ (2005) Alcohol and pancreatic cancer Alcohol 35:205–211Google Scholar
  79. 79.
    Gómez-Lechón MJ, Ponsoda X, Jover R et al (1987–1988) Hepatotoxicity of the opioids morphine, heroin, meperidine, and methadone to cultured human hepatocytes. Mol Toxicol 1:453–463PubMedGoogle Scholar
  80. 80.
    Gourgoutis G, Das G (1994) Gastrointestinal manifestations of cocaine addiction. Int J Clin Pharmacol Ther 32:136–141PubMedGoogle Scholar
  81. 81.
    Graziano MJ, Dorough HW (1984). Effect of cigarette smoking on hepatic biotransformations in rats. Toxicol Appl Pharmacol 75:229–239PubMedCrossRefGoogle Scholar
  82. 82.
    Greco AV, Mingrone G, Benedetti G et al (1998) Daily energy and substrate metabolism in patients with cirrhosis. Hepatology 27:346–350PubMedCrossRefGoogle Scholar
  83. 83.
    Hanna ST (2006) Nicotine effect on cardiovascular system and ion channels. J Cardiovasc Pharmacol 47:348–358PubMedGoogle Scholar
  84. 84.
    Harvez SC, Gilman AG, Goodman LS et al (1985) Hypnotics and sedatives. In: Gilman AG, Goodman LS (eds) Goodman and Gilman’s the pharmacological basis of therapeutics. Macmillan, New YorkGoogle Scholar
  85. 85.
    Havranek EP, Nademanee K, Grayburn PA et al (1996) Endothelium-dependent vasorelaxation is impaired in cocaine arteriopathy. J Am Coll Cardiol 28:1168–1174PubMedCrossRefGoogle Scholar
  86. 86.
    Hecht SS (2003) Tobacco carcinogens, their biomarkers and tobacco-induced cancer. Nat Rev Cancer 3:733–744PubMedCrossRefGoogle Scholar
  87. 87.
    Heesch CM, Negus BH, Keffer JH et al (1995) Effects of cocaine on cortisol secretion in humans. Am J Med Sci 310:61–64PubMedCrossRefGoogle Scholar
  88. 88.
    Heffernon JJ, Smith WR, Berk JE et al (1976) Hyperamylasemia in heroin addicts. Characterization by isoamylase analysis. Am J Gastroenterol 66:17–22PubMedGoogle Scholar
  89. 89.
    Henning RJ, Wilson RD, Glauser JM (1994) Cocaine plus ethanol is more cardiotoxic than cocaine or ethanol alone. Crit Care Med 22:1896–1906PubMedGoogle Scholar
  90. 90.
    Hermann D, Heinz A, Mann K (2002) Dysregulation of the hypothalamic–pituitary–thyroid axis in alcoholism. Addiction 97:1369–1381PubMedCrossRefGoogle Scholar
  91. 91.
    Herzberg M, Fishel B, Wiener MH (1977) Hepatic microsomal enzyme induction and its evaluation in a clinical laboratory. Isr J Med Sci 13:471–476PubMedGoogle Scholar
  92. 92.
    Hillemacher T, Kraus T, Rauh J et al (2007) Role of appetite-regulating peptides in alcohol craving: an analysis in respect to subtypes and different consumption patterns in alcoholism. Alcohol Clin Exp Res 31:950–954PubMedCrossRefGoogle Scholar
  93. 93.
    Hollander J (1995) The management of cocaine associated myocardial ischemia. N Engl J Med 333:1267–1271PubMedCrossRefGoogle Scholar
  94. 94.
    Hrubec Z, Omenn GS (1981) Evidence of a genetic predisposition to alcoholic cirrhosis and psychosis; twin concordances for alcoholism and its biological endpoints by zygosity among male veterans. Alcohol Clin Exp Res 9:306–309Google Scholar
  95. 95.
    Hutchinson MA, Smith PF, Darlington CL (1996) The behavioural and neural effects of the administration of benzodiazepine anxiolytic and hypnotic drugs. Prog Neurobiol 49:73–97PubMedGoogle Scholar
  96. 96.
    Imperiale TF, McCullough A (1990) Do corticosteroids reduce mortality from alcoholic hepatitis? A meta-analysis of the randomized trials. Ann Intern Med 113:299–303PubMedGoogle Scholar
  97. 97.
    Järvinen A, Rägo L, Männistö PT (1992) Effects of central and peripheral type benzodiazepine ligands on thyrotropin and prolactin secretion. Neuropeptides 21:183–191PubMedCrossRefGoogle Scholar
  98. 98.
    Jensen EX, Fusch C, Jaeger P, Peheim E, Horber FF (1995) Impact of chronic cigarette smoking on body composition and fuel metabolism. J Clin Endocrinol Metab 80:2181–2185PubMedCrossRefGoogle Scholar
  99. 99.
    Jokoiama A, Omori T (2005) Genetic polymorphisms of alcohol and aldehyde dehydrogenases and risk for esophageal and head and neck cancers. Alcohol 35:175–185CrossRefGoogle Scholar
  100. 100.
    Jones AL, Simpson KJ (1999) Review article: mechanisms and management of epatotoxicity in ecstasy (MDMA) and amphetamine intoxications. Aliment Pharmacol Ther 13:129–133PubMedCrossRefGoogle Scholar
  101. 101.
    Juenemann KP, Lue T, Luo J et al (1987) The effect of cigarette smoking on penile erection. J Urol 138:438–441PubMedGoogle Scholar
  102. 102.
    Kamijo Y, Soma K, Nishida M et al (2002) Acute liver failure following intravenous methamphetamine. Vet Hum Toxicol 44:216–217PubMedGoogle Scholar
  103. 103.
    Kapoor D, Jones TH (2005) Smoking and hormones in health and endocrine disorders. Eur J Endocrinol 152:491–499PubMedCrossRefGoogle Scholar
  104. 104.
    Kelley JR, Duggan JM (2003) Gastric cancer epidemiology and risk factors. J Clin Epidemiol 56:1–9PubMedCrossRefGoogle Scholar
  105. 105.
    Kish SJ, Kalasinsky KS, Derkach P et al (2001) Striatal dopaminergic and serotonergic markers in human heroin users. Neuropsychopharmacology 24:561–567.PubMedCrossRefGoogle Scholar
  106. 106.
    Kloner RA, Rezkalla AH (2007) To drink or not to drink? That is the question. Circulation 116:1306–1317PubMedCrossRefGoogle Scholar
  107. 107.
    Koike H, Sobue G (2006) Alcoholic neuropathy. Curr Opin Neurol 19:481–486.PubMedCrossRefGoogle Scholar
  108. 108.
    Kolarzyk E, Pach D, Wojtowicz B et al (2005) Nutritional status of the opiate dependent persons after 4 years of methadone maintenance treatment. Przegl Lek 62:373–377PubMedGoogle Scholar
  109. 109.
    Kuper H, Boffetta P, Adami HO (2002) Tobacco use and cancer causation: association by tumour type. J Intern Med 252:206–224PubMedCrossRefGoogle Scholar
  110. 110.
    Kutscher S, Heise DJ, Banger M et al (2002) Concomitant endocrine and immune alterations during alcohol intoxication and acute withdrawal in alcohol-dependent subjects. Neuropsychobiology 45:144–149PubMedCrossRefGoogle Scholar
  111. 111.
    Lee TS, Fu L, Fleming P (2006) Using focus groups to investigate the educational needs of female injecting heroin users in Taiwan in relation to HIV/AIDS prevention. Health Educational Res 21:55–65CrossRefGoogle Scholar
  112. 112.
    Leggio L, Ferrulli A, Cardone S et al (2008) Renin and aldosterone but not the natriuretic peptide correlate with obsessive craving in medium-term abstinent alcohol-dependent patients: a longitudinal study. Alcohol 42:375–381PubMedCrossRefGoogle Scholar
  113. 113.
    Leggio L, Ferrulli A, Cardone S et al (2008) Relationship between the hypothalamic-pituitary-thyroid axis and alcohol craving in alcohol-dependent patients: a longitudinal study. Alcohol Clin Exp Res 32:2047–2053Google Scholar
  114. 114.
    Leggio L, Ferrulli A, Malandrino N et al (2008) Insulin but not insulin growth factor-1 correlates with craving in currently drinking alcohol-dependent patients. Alcohol Clin Exp Res 32:450–458PubMedCrossRefGoogle Scholar
  115. 115.
    Levine SR, Brust JCM, Futrell N et al (1991) A comparative study of the cerebrovascular complications of cocaine: alkaloidal versus hydrochloride—a review. Neurology 41:1173–1177PubMedCrossRefGoogle Scholar
  116. 116.
    Libby P, Ridker PM, Maseri A (2002) Inflammation and atherosclerosis. Circulation 105:1135–1143PubMedCrossRefGoogle Scholar
  117. 117.
    Lieber CS (1991) Perspectives: do alcohol calories count? Am J Clin Nutr 54:976–982PubMedGoogle Scholar
  118. 118.
    Lieber CS (2004) The discovery of the microsomal ethanol oxidizing system and its physiologic and pathologic role. Drug Metab Rev 36:511–529.PubMedCrossRefGoogle Scholar
  119. 119.
    Lipski J, Stimmel B, Donoso E (1973) The effect of heroin and multiple drug abuse on the electrocardiogram. Am Heart J 86:663–668PubMedCrossRefGoogle Scholar
  120. 120.
    Lovallo WR (2006) Cortisol secretion patterns in addiction and addiction risk. Int J Psychophysiol 59:195–202PubMedCrossRefGoogle Scholar
  121. 121.
    Lucas DL, Brown RA, Wassef M et al (2005) Alcohol and the cardiovascular system. J Am Coll Cardiol 45:1916–1924PubMedCrossRefGoogle Scholar
  122. 122.
    Ma L, Chow JYC, Cho CH (1999) Cigarette smoking delays ulcer healing: role of constitutive nitric oxide synthase in rat stomach. Am J Physiol 276:G238–G248PubMedGoogle Scholar
  123. 123.
    Marin J, Hernandez J (2002) Diazepam potentiates the effects of endogenous catecholamines on contractility and cyclic AMP levels in rat ventricular myocardium. Naunyn Schmiedebergs Arch Pharmacol 365:260–268PubMedCrossRefGoogle Scholar
  124. 124.
    Marmor M, Penn A, Widmer K et al (2004) Coronary artery disease and opioid use. Am J Cardiol 93:1295–1297PubMedCrossRefGoogle Scholar
  125. 125.
    Marselli L, Trincavelli L, Santangelo C et al (2004) The role of peripheral benzodiazepine receptors on the function and survival of isolated human pancreatic islets. Eur J Endocrinol 151:207–214PubMedCrossRefGoogle Scholar
  126. 126.
    Matochik JA, London ED, Eldreth DA et al (2003) Frontal cortical tissue composition in abstinent cocaine abusers: a magnetic resonance imaging study. Neuroimage 19:1095–1102PubMedCrossRefGoogle Scholar
  127. 127.
    McKillop IH, Schrum LW (2005) Alcohol and liver cancer. Alcohol 35:195–203PubMedCrossRefGoogle Scholar
  128. 128.
    Mehendale SR, Yuan CS (2006) Opioid-induced gastrointestinal dysfunction. Dig Dis 24:105–112PubMedCrossRefGoogle Scholar
  129. 129.
    Melichar JK, Hume S, Williams T et al (2005) Using [C-11]diprenorphine to image opioid receptor occupancy by methadone in opioid addiction: clinical and preclinical studies. J Pharmacol Exp Ther 312:309–315PubMedCrossRefGoogle Scholar
  130. 130.
    Mello NK, Mendelson JH (1997) Cocaine’s effects on neuroendocrine systems: clinical and preclinical studies. Pharmacol Biochem Behav 57:571–599PubMedCrossRefGoogle Scholar
  131. 131.
    Meyer JS, Rauch G, Rauch RA et al (2000) Risk factors for cerebral hypoperfusion, mild cognitive impairment, and dementia. Neurobiol Aging 21:161–169PubMedCrossRefGoogle Scholar
  132. 132.
    Mittleman MA, Mintzer D, Maclure M (1999) Triggering of myocardial infarction by cocaine. Circulation 99:2737–2741PubMedCrossRefGoogle Scholar
  133. 133.
    Mouhaffet A, Madu E, Satmary W et al (1995) Cardiovascular complications of cocaine. Chest 107:1426–1434CrossRefGoogle Scholar
  134. 134.
    Mousavi S, Toussy J, Zahmatkesh M (2007) Opium addiction as a new risk factor of sphincter of Oddi dysfunction. Med Sci Monit 13:CR528–CR531PubMedGoogle Scholar
  135. 135.
    Munarriz R, Hwang J, Goldstein I et al (2003) Cocaine and ephedrine-induced priapism: case reports and investigation of potential adrenergic mechanisms. Urology 62:187–192PubMedCrossRefGoogle Scholar
  136. 136.
    Murray LJ, Lane AJ, Harvey IM (2002) Inverse relationship between alcohol consumption and active Helicobacter Pylori infection: the Bristol Helicobacter project. Am J Gastroenterol 97:2750–2755PubMedCrossRefGoogle Scholar
  137. 137.
    Nakajima M, Iwata K, Yamamoto T et al (1998) Nicotine metabolism in liver microsomes from rats with acute hepatitis or cirrhosis. Drug Metab Dispos 26:36–41PubMedGoogle Scholar
  138. 138.
    Nakamura M, Haruma K, Kamada et al (2002) Cigarette smoking promotes atrophic gastritis in Helicobacter pylori-positive subjects. Dig Dis Sci 47:675–681PubMedCrossRefGoogle Scholar
  139. 139.
    Neiman J, Haapaniemi M, Hillbom M (2000) Neurological complications of drug abuse: pathophysiological mechanism. Eur J Neurol 7:595–606PubMedCrossRefGoogle Scholar
  140. 140.
    Nieters A, Rohrmann S, Becker N et al (2008) Smoking and lymphoma risk in the European prospective investigation into cancer and nutrition. Am J Epidemiol 167:1081–1089PubMedCrossRefGoogle Scholar
  141. 141.
    O’Brien CP (2005) Benzodiazepine use, abuse, and dependence. J Clin Psychiatry 66:28–33PubMedCrossRefGoogle Scholar
  142. 142.
    Offiah C, Hall E (2008). Heroin-induced leukoencephalopathy: characterization using MRI, diffusion-weighted imaging, and MR spectroscopy. Clin Radiol 63:146–152PubMedCrossRefGoogle Scholar
  143. 143.
    Oscar-Berman M, Bowirrat A (2005) Genetic influences in emotional dysfunction and alcoholism-related brain damage. Neuropsychiatr Dis Treat 1:211–229PubMedGoogle Scholar
  144. 144.
    Oscar-Berman M, Marinkovic’ K (2007) Alcohol: effects on neurobehavioral functions and the brain. Neuropsychol Rev 17:239–257PubMedCrossRefGoogle Scholar
  145. 145.
    Ozsoy S, Esel E, Izgi HB et al (2006) Thyroid function in early and late alcohol withdrawal: relationship with aggression, family history, and onset age of alcoholism. Alcohol Alcohol 41:515–521PubMedCrossRefGoogle Scholar
  146. 146.
    Pascual-Leone A, Dhuna A (1990) Cocaine-associated multifocal tics. Neurology 40:999–1000PubMedCrossRefGoogle Scholar
  147. 147.
    Pascual-Leone A, Dhuna A, Anderson DC (1991) Cerebral atrophy in habitual cocaine abusers: a planimetric CT study. Neurology 41:34–38PubMedCrossRefGoogle Scholar
  148. 148.
    Payabvash S, Beheshtian A, Salmasi AH et al (2006) Chronic morphine treatment induces oxidant and apoptotic damage in the mice liver. Life Sci 79:972–980PubMedCrossRefGoogle Scholar
  149. 149.
    Perkins KA, Epstein LH, Stiller RL et al (1989) Acute effects of nicotine on resting metabolic rate in cigarette smokers. Am J Clin Nutr 50:545–550PubMedGoogle Scholar
  150. 150.
    Pessione F, Ramond MJ, Peters L et al (2003) Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence. Liver Int 23:45–53PubMedCrossRefGoogle Scholar
  151. 151.
    Piano MR (2002) Alcoholic cardiomyopathy: incidence, clinical characteristics, and pathophysiology. Chest 121:1638–1650PubMedCrossRefGoogle Scholar
  152. 152.
    Pinter EJ, Patee CJ (1968) Fat-mobilizing action of amphetamine. J Clin Invest 47:394–402PubMedCrossRefGoogle Scholar
  153. 153.
    Powell CJ, Charles SJ, Mullervy J (1994) Cocaine hepatotoxicity: a study on the pathogenesis of periportal necrosis. Int J Exp Pathol 75:415–424PubMedGoogle Scholar
  154. 154.
    Purohita V, Khals J, Serrano J (2005) Mechanisms of alcohol-associated cancers: introduction and summary of the symposium. Alcohol 35:155–160CrossRefGoogle Scholar
  155. 155.
    Rajendram R, Preedy VR (2005) Effect of alcohol consumption on the gut. Dig Dis 23:214–221PubMedCrossRefGoogle Scholar
  156. 156.
    Repetto A, Bello BD, Pasotti M et al (2005) Coronary atherosclerosis in end-stage idiopathic dilated cardiomyopathy: an innocent bystander? Eur Heart J 26:1519–1527PubMedCrossRefGoogle Scholar
  157. 157.
    Sabbagh MN, Lukas RJ, Sparks DL et al (2002) The nicotinic acetylcholine receptor, smoking, and Alzheimer’s disease. J Alzheimers Dis 4:317–325PubMedGoogle Scholar
  158. 158.
    Sacerdote P (2006) Opioids and the immune system. Palliat Med 20:9–15Google Scholar
  159. 159.
    Salvagnini M, Martines D (1997) Alcohol and nutrition: changing the risk from malnutrition to hypernutrition. Eur J Alcohol 9:75–76Google Scholar
  160. 160.
    Santolaria-Fernandez FJ, Gomez-Sirvent JL, Gonzalez-Reimers CE et al (1995) Nutritional assessment of drug addicts. Drug Alcohol Depend 38:11–18PubMedCrossRefGoogle Scholar
  161. 161.
    Santolaria F, Pérez-Manzano JL, Milena A et al (2000) Nutritional assessment in alcoholic patients. Its relationship with alcoholic intake, feeding habits, organic complications and social problems. Drug Alcohol Depend 59:295–304PubMedCrossRefGoogle Scholar
  162. 162.
    Schifano F, Corkey JM, Cuffolo G (2007) Smokable (“ice”, “crystal meth”) and smokable amphetamine-type stimulants: clinical pharmacological and epidemiological issues, with special reference to the UK. Ann Ist Super Sanità 43:110–115PubMedGoogle Scholar
  163. 163.
    Selim K, Kaplowitz N (1999) Hepatotoxicity of psychotropic drugs. Hepatology 29:1347–1351PubMedCrossRefGoogle Scholar
  164. 164.
    Spijkerman IJ, van Ameijden EJ, Mientjes GH et al (1996) Human immunodeficiency virus infection and other risk factors for skin abscesses and endocarditis among injection drug users. J Clin Epidemiol 49:1149–1154PubMedCrossRefGoogle Scholar
  165. 165.
    Strieter RM, Remick DG, Ward PA et al (1988) Cellular and molecular regulation of tumor necrosis factor-alpha production by pentoxifylline. Biochem Biophys Res Commun 155:1230–1236PubMedCrossRefGoogle Scholar
  166. 166.
    Suter PM, Hasler E, Vetter W (1997) Effects of alcohol on energy metabolism and body weight regulation: is alcohol a risk factor for obesity? Nutr Rev 55:157–171PubMedCrossRefGoogle Scholar
  167. 167.
    Swan GE, Lessov-Schlaggar CN (2007) The effects of tobacco smoke and nicotine on cognition and the brain. Neuropsychol Rev 17:259–273PubMedCrossRefGoogle Scholar
  168. 168.
    Sztalryd C, Hamilton J, Horwitz BA, Johnson P, Kraemer FB (1996) Alterations in lipolysis and lipoprotein lipase in chronically nicotine-treated rats. Am J Physiol 270:E215-E223PubMedGoogle Scholar
  169. 169.
    Talamini R, Polesel J, Spina M et al (2008) The impact of tobacco smoking and alcohol drinking on survival of patients with non-Hodgkin lymphoma. Int J Cancer 122:1624–1629PubMedCrossRefGoogle Scholar
  170. 170.
    Tanko LB, Christiansen C (2004) An update on the antiestrogenic effect of smoking: a literature review with implications for researchers and practitioners. Menopause 11:104–109PubMedCrossRefGoogle Scholar
  171. 171.
    Tennant F (2001) Hepatitis C, B, D, and A: contrasting features and liver function abnormalities in heroin addicts. J Addict Dis 20:9–17PubMedCrossRefGoogle Scholar
  172. 172.
    Teyssen S, Singer MV (2003) Alcohol-related diseases of the oesophagus and stomach. Best Pract Res Clin Gastroenterol 17:557–573PubMedCrossRefGoogle Scholar
  173. 173.
    Thomas GA, Rhodes J, Ingram JR (2005) Mechanisms of disease: nicotine—a review of its actions in the context of gastrointestinal disease. Nat Clin Pract Gastroenterol Hepatol 2:536–544PubMedCrossRefGoogle Scholar
  174. 174.
    Thomson AD (2000) Mechanisms of vitamin deficiency in chronic alcohol misusers and the development of the Wernicke-Korsakoff syndrome. Alcohol Acohol Suppl 35:2–7Google Scholar
  175. 175.
    Thorgeirsson TE, Geller F, Sulem P et al (2008) A variant associated with nicotine dependence, lung cancer and peripheral arterial disease. Nature 452:638–642PubMedCrossRefGoogle Scholar
  176. 176.
    Tilg H, Diehl AM (2000) Cytokines in alcoholic and nonalcoholic steatohepatitis. N Engl J Med 343:1467–1476PubMedCrossRefGoogle Scholar
  177. 177.
    Tilg H, Day CP (2007) Management strategies in alcoholic liver disease. Nat Clin Pract Gastroenterol Hepatol 4:24–34PubMedCrossRefGoogle Scholar
  178. 178.
    Tome S, Lucey MR (2004) Review article: current management of alcoholic liver disease. Aliment Pharmacol Ther 19:707–714PubMedCrossRefGoogle Scholar
  179. 179.
    Troisi RJ, Heinold JW, Vokonas PS, Weiss ST (1991) Cigarette smoking, dietary intake, and physical activity: effects on body fat distribution—the Normative Aging Study. Am J Clin Nutr 53:1104–1111PubMedGoogle Scholar
  180. 180.
    Trummer H, Habermann H, Haas J et al (2002) The impact of cigarette smoking on human semen parameters and hormones. Hum Reprod 17:1554–1559PubMedCrossRefGoogle Scholar
  181. 181.
    Tseng M, Weinberg CR, Umbach DM et al (1999) Calculation of population attributable risk for alcohol and breast cancer (United States). Cancer Causes Control 10:119–123PubMedCrossRefGoogle Scholar
  182. 182.
    Veenman L, Gavish M (2006) The peripheral-type benzodiazepine receptor and the cardiovascular system. Implications for drug development. Pharmacol Ther 110:503–524CrossRefGoogle Scholar
  183. 183.
    Vestergaard P (2002) Smoking and thyroid disorders. Eur J Endocrinol 146:153–161PubMedCrossRefGoogle Scholar
  184. 184.
    Vollenweider F, Gamma A, Liechti M, Huber T (1998) Psychological and cardiovascular effects and short-term sequelae of MDMA (‘ecstasy’) in MDMA-naive healthy volunteers. Neuropsychopharmacology 19:241–251PubMedGoogle Scholar
  185. 185.
    Walsh K, Alexander G (2000) Alcoholic liver disease. Postgrad Med J 76:280–286PubMedCrossRefGoogle Scholar
  186. 186.
    Weller IV, Cohn D, Sierralta A et al (1984) Clinical, biochemical, serological, histological and ultrastructural features of liver disease in drug abusers. Gut 25:417–423PubMedCrossRefGoogle Scholar
  187. 187.
    Whitehead TP, Robinson D, Allaway SL (1996) The effects of cigarette smoking and alcohol consumption on serum liver enzyme activities: a dose-related study in men. Ann Clin Biochem 33:530–535PubMedGoogle Scholar
  188. 188.
    Winniford MD (1990) Smoking and cardiovascular function. J Hypertens 9:S17–S23.Google Scholar
  189. 189.
    Wood JD, Galligan JJ (2004) Function of opioids in the enteric nervous system. Neurogastroenterol Motil 16:17–28PubMedCrossRefGoogle Scholar
  190. 190.
    Wu WKK, Cho CH (2004) The pharmacological actions of nicotine on the gastrointestinal tract. J Pharmacol Sci 94:348–358PubMedCrossRefGoogle Scholar
  191. 191.
    Yates WR, Labrecque DR, Pfab D (1998) The reliability of alcoholism history in patients with alcohol-related cirrhosis. Alcohol Alcohol 33:488–494PubMedCrossRefGoogle Scholar
  192. 192.
    Yen DJ, Wang SJ, Ju TH et al (1994) Stroke associated with methamphetamine inhalation. Eur Neurol 34:16–22PubMedCrossRefGoogle Scholar
  193. 193.
    Yu MC, Yuan JM (2004) Environmental factors and risk for hepatocellular carcinoma. Gastroenterology 127:S72–S78PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Giovanni Addolorato
    • 1
  • Lorenzo Leggio
    • 2
  • Cristina D’Angelo
    • 1
  • Anna Ferrulli
    • 1
  • Antonio Mirijello
    • 1
  • Silvia Cardone
    • 1
  • Veruscka Leso
    • 1
  • Noemi Malandrino
    • 3
  • Esmeralda Capristo
    • 3
  • Raffaele Landolfi
    • 1
  • Giovanni Gasbarrini
    • 1
  1. 1.Institute of Internal Medicine, Catholic University of RomeRomeItaly
  2. 2.Center for Alcohol and Addiction Studies, Brown University Medical SchoolProvidenceUSA
  3. 3.Institute of Internal Medicine and Metabolic Unit, Catholic University of RomeRomeItaly

Personalised recommendations