• Physical damage due to drug dependence : ZonMw study

      van Amsterdam JGC; Pennings EJM; Brunt TM; van den Brink W; GBO; vgc (Rijksinstituut voor Volksgezondheid en Milieu RIVMMaastricht Forensic InstituteAcademisch Medisch Centre - Amsterdam Institute for Addiction Research, 2012-10-19)
      Excessive use of alcohol, tobacco and illicit drugs cause long term physical health damage. Smoking can cause lung cancer, and alcohol abuse may lead to liver cirrhosis and tumors in the oral cavity, esophagus and liver. The medical treatment of the diseases leads to financial costs. The health effects and treatment of alcohol and tobacco use are higher as compared to those of illicit drugs use. This is mainly due to the relatively large number of people smoking (27 percent of the Dutch population) or excessive alcohol use (84 percent drink, of which 10 percent drink excessive). Illicit drugs are, however, used by relatively few people (recent use is 0.1 to 4.2 percent) and mostly used for only some years. At the individual level, the physical health effects of alcohol and tobacco use are similar to those of recreational use of hard drugs heroin and crack. In general, only the intensive use of illicit drugs i.e. the abuse of drugs leads to great physical health damage. Physical effects of drugs are limited This emerged from a literature review of the RIVM, which gives an overview of the physical health damage of seventeen recreational drugs, alcohol and tobacco. The study was commissioned by ZonMw, that has also initiated research to the psychological and social effects of illicit drugs. The latter consequences are often greater than the physical health damage. Physical effects of the four most commonly used drugs Of the four most commonly used illicit drugs, like ecstasy, cocaine, cannabis, amphetamine, ecstasy seems not to lead to serious physical health damage. Cannabis smoking can cause lung cancer and COPD. The use of heroin, cocaine and crack can cause infectious diseases, AIDS and tuberculosis; the use of dirty needles caused the most problems here. Cocaine, crack and (repeated) amphetamine use is related to heart disease. Of all illicit drugs, risk of (fatal) heart attack is greatest when snorting cocaine. The use of khat and anabolic steroids is associated with cardiovascular disease, but the evidence is fairly weak. Urological complications by regular use of the anesthetic ketamine are reported in the literature, but they are rare. Oral cancers can be caused by intensive use khat. Finally, almost all the problematic hard drug users suffer from dental disease. For most illicit drugs, it is difficult to indicate the association between the use and the diseases caused by them, because the drugs are frequently combined with other drugs, tobacco and alcohol (poly drug use). In particular, the extent to which and how the illicit drugs are used in the past, is hardly known. This knowledge is necessary to link disease to the use of various drugs.