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Long-Term Effects of Drug and Alcohol Addiction

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According to a report from the Substance Abuse and Mental Health Services Administration (SAMHSA), 48.7 million people aged 12 or older met the criteria for a substance use disorder in 2022.1 The long-term consequences from of chronic drug and alcohol misuse use associated with addiction and addiction can be devastating, leading to different adverse physical and mental health effects.
What you will learn:
The potential long-term effects of drug and alcohol use
Whether these effects can be reversed
How to seek treatment for long-term drug or alcohol addiction

Long-Term Effects of Alcohol Addiction

Excessive alcohol use—which includes binge drinking, heavy drinking (8 or more drinks per week for women and 15 or more drinks per week for men), and any alcohol use by a pregnant woman—can negatively impact the entire body and even lead to death.2 The long-term adverse effects of alcohol on the body may include:

  • Heart problems. Long-term alcohol use can result in a variety of detrimental cardiovascular effects, including pathological changes in heart rhythm, chronic elevations in blood pressure, and a related increased risk of stroke.3 Chronic alcohol misuse can also lead to an increased risk of coronary arterial disease (when the coronary arteries struggle to supply enough blood, oxygen, and nutrients to the heart), peripheral arterial disease (a narrowing of the vessels that carry blood from the heart to the legs), and alcohol-related cardiomyopathy (a disease that weakens the heart muscle and diminishes cardiac function, making it harder for the heart to pump blood to the rest of the body).4
  • Neurological issues. Over time, excessive alcohol use can lead to various neurophysiological changes that underlie the development of substance tolerance, dependence, and withdrawal as well as chronic behavioral changes, such as the compulsive alcohol seeking commonly seen in alcohol use disorder.5 It may also cause or worsen certain mental health conditions, such as anxiety or depression, as well as a range of other brain issues—from persistent learning and memory problems to more serious neurological conditions, like Wernicke-Korsakoff syndrome, which affects vision, movement, language, sleep, memory, and motivation.6,7 Additionally, research indicates that moderate and high levels of alcohol consumption may be associated with hippocampal atrophy (or shrinkage of the hippocampus) and other white matter abnormalities.8
  • Liver diseases. Chronic or episodic heavy drinking can damage the liver and lead to certain alcohol-induced liver diseases—including alcoholic fatty liver disease, alcoholic hepatitis, and cirrhosis—which can ultimately result in liver failure and death.9 While alcohol-related liver disease often progresses sequentially through these conditions, each may develop independently of the others in association with problematic drinking.9,10 Drinking alcohol may also contribute to the development of liver cancer.2
  • Pancreatic damage. Over time, heavy alcohol consumption can increase the risk of pancreatitis, a very painful and potentially fatal inflammation and swelling of pancreatic tissues, which can lead to disruptions in endocrine function as well as digestive problems.11,12
  • Kidney health problems. The link between alcohol and kidney injury isn’t completely understood. Though there may be some directly nephrotoxic effects of alcohol and its metabolic intermediaries, alcohol’s impact on organs like the liver and heart suggest several additional mechanisms that may lead to kidney dysfunction. For example, alcohol-related cardiomyopathies may ultimately decrease renal blood flow and lead to progressive kidney dysfunction.13
  • Gastrointestinal (GI) system issues. Chronic, excessive alcohol use can lead to a variety of upper GI problems, including the exacerbation of certain existing GI conditions, inflammation, and damage to the organs within the GI tract. This can result in the aforementioned issues of progressive liver disease and pancreatitis, as well as alcohol-related gastritis (inflammation of the stomach and small intestine), and an increased risk of esophageal and rectal cancer.14

Long-Term Effects of Cocaine Addiction

Cocaine use can have a variety of long-term effects on the brain and body—some of which depend on the route of administration—and all of which can negatively impact a person’s physical and mental health.15 The long-term effects of cocaine addiction can include:

  • Brain changes. Chronic cocaine use impairs cognitive function, causing problems with attention and memory, impulse control, decision making, and motor task performance. Long-term cocaine use is also associated with an increased risk of stroke and seizures as well as other neurological problems, such as bleeding in the brain and balloon-like bulges in the walls of cerebral blood vessels. Additionally, over time, years of chronic cocaine use may be associated with movement disorders like Parkinson’s disease.15
  • Gastrointestinal system issues. Cocaine can impact the GI system in different ways. Cocaine reduces the blood flow in the gastrointestinal tract, potentially resulting in ulcers and tears and increasing the risk of bowel wall necrosis or tissue decay.15,16 Individuals may also suffer from decreased appetite due to chronic cocaine use, which can lead to nutritional deficiencies and severe weight loss.15
  • Heart and cardiovascular problems. Continued cocaine use carries significant health risks to the heart and cardiovascular system, including disturbances in heart rhythm, chest pain, heart attack, inflammation of the heart muscle (cardiomyopathy), reduced ability of the heart muscle to contract, coronary artery disease, plaque buildup on the artery walls (atherosclerosis), aortic ruptures, and an increased risk of stroke.15,17
  • Adverse respiratory effects. Cocaine’s long-term impact on the respiratory system can vary by method of use. For example, individuals who snort cocaine may develop a loss of smell, get frequent nosebleeds, or have a chronic runny nose. Snorting cocaine can also lead to a perforated septum and chronic sinusitis over time. On the other hand, individuals who regularly smoke cocaine may develop a cough, asthma, respiratory distress, and be more prone to infections like pneumonia.16 Additionally, smoking cocaine can make lung conditions, like asthma and chronic obstructive pulmonary disorder (COPD), worse.18

Long-Term Effects of Opioid Addiction

Chronic opioid misuse is associated with several adverse effects on the organs and systems within the body, including:

  • Gastrointestinal system issues. Long-term opioid use and misuse is associated with slowed GI activity or decreased gut motility, which can result in nausea, vomiting, cramping, and bloating.19,20 When severe, opioid-related constipation can increase the risk of bowel obstruction and perforation.20
  • Respiratory problems. Chronic opioid use has been associated with sleep-disordered breathing, including central sleep apnea (which occurs because the brain doesn’t send the proper signals to the muscles that control breathing), irregular breathing with irregular pauses, and carbon dioxide retention.20 Additionally, opioid misuse can cause respiratory depression, characterized by dangerously slowed or shallow breathing.21
  • Brain and central nervous system effects. Respiratory depression can lead to hypoxia, a condition that results when too little oxygen reaches the brain. Hypoxia can have adverse psychological and neurological effects, including permanent damage, coma, and death.21 Chronic opioid use is also associated with an increased risk of severe depression and suicidality.19
  • Cardiovascular events. Limited research suggests that long-term opioid use may be associated with an increased risk of cardiac events, such as heart attack or heart failure. Opioid overdose, which is a life-threatening condition, can cause bradycardia (very slow heartbeat) and dangerously low blood pressure.20
  • Kidney diseases. Clinical studies suggest that individuals with certain opioid use disorders—specifically those involving the intravenous use of opioids such as morphine or heroin—may be at an increased risk for progressive renal failure.22 Additionally, heroin use has been linked to kidney damage and several renal complications, including kidney inflammation, nephrotic syndrome (a kidney disorder that causes the body to pass too much protein into your urine), and rhabdomyolysis (which occurs when damaged muscle tissue release its proteins and electrolytes into the blood, which can, in turn, increase the risk of kidney injury).22

Long-Term Effects of Meth Addiction

Long-term meth use and addiction is associated with a number of adverse effects that can negatively impact a person’s physical and mental health.23 These effects can include:

  • Brain and central nervous system changes. Studies indicate that persistent methamphetamine use can cause severe structural and functional changes in areas of the brain associated with emotion and memory. Additionally, long-term meth use may lead to significant anxiety, confusion, insomnia, mood changes, paranoia, violent behavior, visual and auditory hallucinations, and delusions. Recent research suggests that meth use may contribute to the development of Parkinson’s disease and increase an individual’s risk of stroke.23 Furthermore, methamphetamine misuse is associated with increased risk-taking behaviors, such as having unprotected sex or sharing needles—both of which can lead to a higher incidence of contracting infectious diseases like HIV.24
  • Cardiovascular problems. Chronic meth use is associated with an increased risk of cardiovascular disease, vasoconstriction (the narrowing of the blood vessels), pulmonary hypertension (a condition that makes the heart work harder to pump blood into the lungs), plaque buildup in the inner lining of the arteries, cardiac arrhythmias, and cardiomyopathy.25

Long-term meth use can also cause severe dental problems, tooth decay, weight loss, and sores on the skin.23

Long-Term Effects of Marijuana Addiction

There is growing evidence that chronic marijuana use can have lasting consequences on an individual’s physical and mental health.26,27 Long-term effects may be dependent on the method of use, but can include:

  • Brain issues. Some research indicates that regular marijuana use during adolescence—while the brain is still developing—may result in structural and functional changes to areas of the brain important for memory, learning, and impulse control.27 For adults, evidence is inconclusive, but some studies link an IQ decline to chronic or heavy marijuana use. Additionally, several studies indicate a link between marijuana use and an earlier onset of psychosis in people who have genetic risk factors for diseases like depression, anxiety, suicidal thoughts, and schizophrenia. Long-term marijuana use may also worsen symptoms of schizophrenia for those who already have the mental health disorder.26
  • Respiratory difficulties. Smoking marijuana can, over time, cause breathing problems, lung irritation, cough, persistent phlegm, frequent lung illnesses, and an increased risk of lung infections.26 Smoking marijuana is also associated with large airway inflammation, increased airway resistance, lung hyperinflation (which can happen when air gets trapped in the lungs and causes them to overinflate), and chronic bronchitis. Some case studies suggest that smoking marijuana may increase an individual’s susceptibility to lung infections such as pneumonia in those with immune deficiencies, but larger cohort studies have not confirmed this association.27
  • Cardiovascular problems. Marijuana can increase heart rate and raise blood pressure immediately after use—both of which can increase the risk of heart attack, and it may also increase the risk of stroke, heart disease, and other vascular diseases.26,28

Chronic marijuana use may also lead to a rare condition known as cannabinoid hyperemesis syndrome, which causes cyclic and severe nausea, vomiting, and dehydration.26

Can the Long-Term Effects of Drug and Alcohol Use be Reversed?

Some of the long-term, detrimental effects of drugs on the body or the effects of chronic alcohol misuse can improve with treatment and abstaining from substance use.

Improvements can take time. Studies indicate, for instance, that the serious psychotic consequences that may develop from long-term meth use—with symptoms that include paranoia, hallucinations, and delusions—can last for months or years after meth use stops.23

Additionally, some of the neurological issues associated with alcohol use, can improve when drinking stops, but some brain changes may be more lasting. There are a growing number of studies that suggest that some alcohol-induced brain changes—that impact thinking, feeling, and behaving, for example—can improve and possibly reverse with treatment and sustained abstinence.29 Abstinence can also improve some conditions associated with alcohol-related damage to adaptable organs, such as the liver and heart, which can heal from exposure to toxins.30 Other alcohol-induced issues, like some gastrointestinal effects problems, may be completely reversible with abstinence.11

Other conditions may not be entirely reversible, however, some of the symptoms associated with them may be. For instance, the muscle and vision problems associated with Wernicke-Korsakoff syndrome are reversible with proper thiamine treatment, while other symptoms, like confusion and lack of energy, may not be completely reversible or may take time to respond.7

If you or a loved one struggle with alcohol or drug addiction, it is never too late to get help. Proper treatment can help you recover, become healthier, and regain control of your life.31

Finding Help for Long-Term Drug or Alcohol Addiction

Despite the impact that drugs and alcohol have had on your health and well-being, it’s never too late to seek help. It doesn’t matter how long the substance use or misuse has been going on, treatment can help you stop; address the thoughts, emotions, and behaviors that may have led to the substance use in the first place; and improve issues with your physical and mental health; social, occupational, and family relationships; and legal concerns as well.31

Treatment looks different for every individual, depending on your specific needs and the substance used but may start with detox followed by subsequent inpatient or outpatient rehab and aftercare.31 While treatment methods vary, it may involve a combination of medication so you can safely stop using the substance—and return to a medically-stable state—and behavioral therapies and counseling to help you work on the underlying issues that contributed to your substance use and make positive behavioral changes that can help you deal with stress and sustain lasting recovery.31

If you or a loved one are ready to get help, call American Addiction Centers (AAC) at to speak to one of our compassionate and knowledgeable admissions navigators, who can listen to your story, answer your questions, explain your options, and get you started on your path to recovery.

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