Physical complications of substance abuse: what the psychiatrist needs to know

Purpose of review There is an essential, ongoing and background updating of our knowledge of the social determinants and public health issues related to substance abuse. It is also vital that psychiatrists remain aware of the medical and surgical problems that patients with substance use disorders may develop. The present review examines the recent literature on physical complications of substance abuse. Recent findings Recent research has focused on the complications of alcohol and other drugs in pregnancy and their dose-related effects on end organs. Studies reviewed here reported on the effects of opiate use in the past and present, and prescribed in treatment programmes, and on the effects of alcohol on mortality. Research on stimulants suggests that there is often subtle neurotoxicity and a measurable impact on the cardiovascular system. Summary Substance abuse is associated with significant mortality and morbidity as a consequence of an array of physical complications. Not all complications are acute, and many may manifest themselves some years in the future. For many substances of abuse the long-term complications are yet to be researched.